Birth Certificate Affidavit Format
I ___ son of ____ R/o ____ do hereby solemnly affirm and declare as under:-
1- 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. ____. The photocopy of the Receipt issued by the Hospital is enclosed herewith as Annexure –A. On the basis of which the date of birth of the deponent was recorded in office ____ of Birth & Death City Zone ____ vide birth registration dated ____. Thus the actual and correct birth of birth of deponent is ____ (In Words ____ ). The photocopy of the Birth Certificate is enclosed as Annexure –B.
2- That at the time of admission of the plaintiff in the first class in the School the ____ of the plaintiff due to some confusion got mentioned the date of birth the plaintiff as ____ instead of ____.
3- That the plaintiff passed Middle exams in the year ___, matriculation examinations in the year ____ and the incorrect date of birth of the plaintiff i.e. ____ continued in the records of middle, matriculation and senior secondary exams. The photocopies of the marks-sheets of matriculation and senior secondary are enclosed as Annexure- C & D.
4- That suddenly in the month of ____ the plaintiff found the original birth records of the ____ and Hospital receipt then the plaintiff came to know that his actual date of birth was ____. After that the plaintiff verified the records and came to know about his correct date of birth.
5- That the deponent wrote a letter dated ____ for correction of his date of birth into the educational records to the ____ and other authorities for the correction of the date of birth in the relevant educational records of the deponent. The photocopy of letter dated ___, postal receipt and reply dated ____ are enclosed as Annexure –E to G.
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 ___________