Affidavit Of Conversion


I, _____@ ____Shamim D/o. Sh. Vinay Lal  R/o. C-______________, Street No.9, Bhajanpura, Near Police Station, Delhi-110053, do hereby solemnly affirm and declare as under:

  1. That I am permanent resident of above noted address.
  2. That I am adult and my date of birth is _____.1985 and as on date I am 25 years old.
  3. That I am not prone with any disease and also not mentally disturb and possess good health and physique and am sound mind. Therefore competent to take decision about my live and life and future.
  4. That I have embraced Islam and converted my religion from Hindu to Islam(Muslim) with my free will and consent and without any force, pressure and coercion from any corner and without consuming any intoxicating substance.
  1. That I have embraced the Islam due to its attractive religious principles and aims and object and also goodness of Islamic (Muslim) religious.
  2. That I have converted my name from ____Ms. ____Shamim, now I will be known as Ms. _____Shamim by name in place of Sonamin future for all intent and purposes.
  3. That it is my true statement.



Verified at New Delhi on this ____th day of April 2007, that the contents of above affidavit are true and correct to the best of my knowledge and nothing material has been concealed therefrom.



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