Affidavit for Birth Certificate

AFFIDAVIT

AFFIDAVIT FOR LATE REGISTRATION OF BIRTH

I ________________ S/O resident of H.No. ______________ do hereby solemnly affirm and decline as under: -

1. That a Male/Female child was born to my wife Mrs. __________________ at __________________ on __________________. The order of this male/female child is ____________.

2. That the said male/female child was finally names as ______________________.

3. That the delivery case was conducted by Dr./Dai __________________ resident of H.No. ___________________________________________.

4. That the said male/female child name is real and natural child of Mrs. _______________ W/o Sh. _________________ has not been adopted by Mrs. __________________ W/o Sh. _____________________ or Sh.__________________ s/o Sh. _________________ either through Court Sub Magistrate or otherwise.

5. That the said event of birth of male/female child has not been registered previously either by the deponent of Doctor or Dai.

6. That the date and place of birth of this male/female child has not been changed/manipulated.

7. That the deponent prey for the registration of birth of this male/female child.

DEPONENT


VERIFICATION: -

Verified that the above statement of mine are true and correct to the best of my knowledge and belief and nothing has been concealed therein.

Verified at (NAME OF THE CITY) on.

DEPONENT