Birth Affidavit Drafting Tool

We highly recommend watching our YouTube video by Sujit Ramchand, Esq., Partner at Ramchand & Raval, P.C. regarding Birth Affidavits before proceeding.

WHO SHOULD SIGN?

The person signing the affidavit should be aware of the facts of the birth personally. Therefore, please select a person with personal knowledge of the birth who is 10+ years older than the Applicant (as someone born after the Applicant or around the same time would not be old enough to know or remember the facts).

DIRECTIONS

DO NOT COPY THE AFFIDAVIT BEFORE FULLY COMPLETING THE BELOW QUESTIONS FIRST. Follow these steps:
1. Complete each of the questions below
2. Click "Next" to take you to the Sample Affidavit
3. Copy/paste the Affidavit generated into a Word document
4. Print the Affidavit after any needed edits.

Note: This is a SAMPLE – please edit as needed to fit the facts of your matter.
Name of person who's birth is being verified ("APPLICANT") - in case of a Middle Name, write the First Name leave a space and the write the Middle Name in the same box*

First NameLast Name
Name of person giving the Affidavit ("SIGNOR") - in case of a Middle Name, write the First Name leave a space and the write the Middle Name in the same box*

First NameLast Name
Date of birth of the SIGNOR*
City, State, Country of birth of the SIGNOR*
Full address of the SIGNOR*
Relationship of the SIGNOR to the APPLICANT - the SIGNOR is the*
Country of citizenship of the SIGNOR*
Birth date of the APPLICANT*
City, State, Country of birth of the APPLICANT*
Full name of APPLICANT'S Father*
Full name of APPLICANT'S Mother*
Select ONE - how the SIGNOR knows of the APPLICANT'S birth*

I was personally present during the birth of the Applicantduring the time of the birth of the Applicant, I was living in the same location
Select ONE as applicable*

The birth of the Applicant was not registered with the governmental authority at the time of the Applicant's birth.The birth of the Applicant was not registered with the governmental authority, and therefore a birth certificate for the Applicant is not available.The birth records for individuals born during such time and at such place as the Applicant are difficult if not impossible to obtain, and that a birth certificate was not issued to the Applicant.The birth certificate issued to the Applicant does not mention the Applicant's name because the naming ceremony for the Applicant was held on a date that was chosen by custom, such date was after the birth registration of the Applicant, and this was acceptable to register the birth of a child without first naming the child.The birth certificate issued to the Applicant does not mention the Applicant's name because it was not customary at that time to include the child’s name on the birth certificate.The birth certificate issued to the Applicant does not state the Applicant's mother's name, such omissions we common in birth certificates issued at this time and place.The birth certificate issued to the Applicant does not state the Applicant's mother's full name, such omissions were common in birth certificates issued at this time and place.The birth certificate issued to the Applicant does not state the Applicant's father's name, such omissions were common in birth certificates issued at this time and place.The birth certificate issued to the Applicant does not state the Applicant's father's full name, such omissions were common in birth certificates issued at this time and place.The birth certificate issued to the Applicant has a spelling error, and incorrectly states the Applicant's name as __________. Such mistakes were common in birth certificates issued at this time and place.The birth certificate issued to the Applicant has a spelling error, and incorrectly states the Applicant's father's name as __________. Such mistakes were common in birth certificates issued at this time and place.The birth certificate issued to the Applicant has a spelling error, and incorrectly states the Applicant's mother's name as __________. Such mistakes were common in birth certificates issued at this time and place.