Birth Certificate Affidavit

AFFIDAVIT

I, ________________________ S/o ___________________ residing at __________________________ _________________________________________________, do hereby solemnly affirm and state on oath as under:

i)                    That my Date of Birth is ____________________________.

ii)                   That my Place of Birth is ____________________________.

iii)                  That name of my Father is ____________________________________.

iv)                  That name of my Mother is ____________________________________.

v)                   That address of my parents at the time of my birth was_______________________ ________________________________________________________________________.

vi)                  That permanent address of my parents is _______________________________________________________________________________________________________________________.

I, ___________________ do hereby solemnly affirm that the contents of this affidavit from Paragraphs 1(i) to 1 (vi) are true and correct to the best of my personal knowledge and belief. I do understand that if the above affirmation is proved to be false, I will be solely responsible for any situation arising thereafter.

      Deponent                                                                                 Sworn Before Me 
    (Amit Kumar Gupta)                                                                     [Notary’s Seal/Sign]