Birth affidavit for a minor applicant

Should only be completed if the parent or legal guardian cannot obtain a Birth Certificate for the
Minor Applicant.

I _________________________________________________________________________________
(full name of parent/legal guardian)

of ________________________________________________________________________________
(current address in full)

HEREBY, AFFIRM, DECLARE and SWEAR THAT

__________________________________________of______________________________________
(full name of Minor Applicant incl. middle names) (current address in full)

was born on the ________ day of __________ 19_______ at ________________________________

(name of town/district)

in the country of ___________________________________________________________________.

(country of birth)

I further say that his/her father is ______________________________________________________

(full name of applicant’s father)

born on the ________ day of __________ in the year ____ at ________________________________

(name of town/district)

in the country of ____________________________________________________________________

(country of birth)

and that his/her mother is ___________________________________________________________.

(full maiden name of applicant’s mother)

The reason I cannot furnish a copy of the Minor Applicant’s Birth Certificate is:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

I HEREBY AFFIRM, DECLARE AND SWEAR THAT I BELIEVE THE ABOVE DETAILS TO BE TRUE.

Signature of applicant: _______________________________________________________________

Signature of Solicitor/Commissioner for Oaths: ___________________________________________

Date: ______________________