Birth Affidavit

BIRTH AFFIDAVIT I XXXXXXX (name) Son/ Daughter of YYYYYYYY (father name), Indian, Hindu/christian/muslim Residing at ZZZZZZZZZZZZZz (address inc state) do hereby solemnly affirm and sincerely state as follows : (1) I state that i was born on xx/yy/zzzz at ************* (address where u born refer hospital name in case u r born in hospital) through my parents namely XXXXX (dad name) and YYYY (mother name) (2) I am submitting my Educational qualification certificate as a proof of my date of birth (xx/yy/zzzz) (3) I will get the Birth Extract from the competent authority and the same will be produce before you at the time of verification (4) I state that I solemnly confirm my Date of Birth is xx/yy/zzzz (5) All the above particulars are true and correct.

sign of notary solemnly affirmed and signed before me on this date (date u make this affidavit)

your sign DEPONENT