AFFIDAVIT

I _________ son/daughter of __________ resident of __________ do hereby solemnly affirm and declare as under:-

1.  That the exact and correct date of Birth of my son/daughter _________ is_________ who born at _________.

2. That the deponent was born in _________ Hospital, _________ on _________ and the birth event of the deponent was recorded in the said Hospital on the same vide Serial No. _________.

3. That the name of the mother of may above said son/daughter is_________.

4. That due to inadvertence, I did not register the date of birth of my above said daughter/son _________ with the concerned department at the time of birth.

Deponent

Verification:

Verified that the contents of my above affidavit are true to best of my knowledge and belief and nothing has been concealed therein.

Verified at _________ on _________

Deponent

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