Affidavit of Birth
State of ______________
County of ______________
Before me, the undersigned authority, personally appeared:
Name of Affiant: ______________________________________________________
Address: _______________________________________________________________
City, State, Zip: _____________________________________________________
Who being duly sworn, deposes and says:
- The affiant is the parent or legal guardian of:
- Name of Child: _____________________________________________________
- Date of Birth: ______________________________________________________
- Place of Birth: _____________________________________________________
This affidavit serves to establish the birth of the above-named child.
As per the laws of the State of ______________, the affiant acknowledges that:
- The information provided herein is accurate and truthful.
- Any false statements may result in legal consequences.
- This affidavit may be used for official purposes as required by law.
Witness my hand and official seal this ____ day of __________, 20___.
_________________________________
Signature of Affiant
_________________________________
Notary Public Signature
My commission expires: ________________
Notary Seal: