Affidavit of Birth
This Affidavit of Birth is prepared in accordance with the relevant laws of [State Name], as per the regulations governing birth documentation.
I, [Affiant's Full Name], residing at [Affiant's Address], being duly sworn, do hereby declare the following under penalty of perjury:
- Name of Child: [Child's Full Name]
- Date of Birth: [Child's Date of Birth]
- Place of Birth: [City, County, State where Child was Born]
This affidavit is made to establish proof of birth for the child named herein. The information provided is accurate and truthful to the best of my knowledge.
Additional information may include:
- Mother's Full Name: [Mother's Full Name]
- Father's Full Name: [Father's Full Name]
- Mother's Address: [Mother's Address]
- Father's Address: [Father's Address]
This affidavit was executed on [Date of Execution] in [City, State].
Signature of Affiant: [Affiant's Signature]
Sworn to and subscribed before me this [Day] of [Month], [Year].
Notary Public Signature: [Notary Public Signature]
My Commission Expires: [Date of Expiration]