I, Peetala Gangamma (old surname), W/o Peetla Nataraju, R/o Indiramma Colony, Valmiki Kalyanamandapam backside, Settur Road, Kalyandurg, Ananthapuramu District - 515761, Andhra Pradesh, hereby declare that I have changed my surname to Peetla. Henceforth, I shall be known as Peetla Gangamma for all future purposes.