I, _______ SON OF _______ RESIDENT OF _______, do hereby solemnly affirm and declare as under:-
1. That I am the permanent resident of above said address.
2. That I am the Ration Card Holder bearing its No. ________.
3. That my father’s namely _______ (Aged about ___ years) & my mother namely _______ (Aged about ___ years).
4. That I want to delete/remove my _______ name in my Ration Card.
5. That my above said statement true and correct.
Verified that the contents of above my said affidavit are true and correct to the best of my knowledge and belief and nothing has been concealed therein.