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Affidavit for Birth Certificate

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Title

Applicant Name

Relation *

Guardian's Name *

Address *

Child's Name *

Child's Date of Birth *

Hospital / Place of Birth *

Father's Name

Mother's Name *

Reason

Verified Date *

EDrafted

AFFIDAVIT

I, Miss., S/o ____________, resident of ____________, do hereby solemnly affirm and declare as under:

That I am a citizen of India and competent to swear this affidavit.
That the name of the child is ____________.
That the child was born on ____________ at ____________(Hospital/Home/Place of Birth), situated at ____________
That the name of the father of the child is ____________.
That the name of the mother of the child is ____________.
That due to ____________ the Birth Certificate could not be obtained / requires correction / requires delayed registration.
That this affidavit is being executed for the purpose of obtaining / correcting / registering the Birth Certificate before the concerned authority.
That the statements made herein are true and correct to the best of my knowledge and belief, and nothing material has been concealed therefrom.

DEPONENT

VERIFICATION

I, Miss., the above-named deponent, do hereby verify that the contents of this affidavit are true and correct to the best of my knowledge and belief, and that nothing material has been concealed therefrom.

Verified at ____________ on this ____________.

DEPONENT

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Get Affidavit for Birth Certificate for Other States

Affidavit for Birth Certificate