GOVERNMENT OF MAHARASHTRA
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                         ]ALGAON CITY MUNICIPAL CORPORATION JALGAON
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 REG STER   NO: 2016/2                    sERl\LNo: 4045                             PAGE NO: 298

                                                                                     REG. parE   : 1411212016
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                               AT HOME JALGAON

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 NAME OF FATHER/IU5BAND : BHAGWANTRAO DAlr,lOJ GHOLAP

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                               LAXM BAI BHAGWANTRAO GHOLAP
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