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Self - Declared Affidavit Is Not Accepted. 2. All Blanks To Be Duly Filled

This document provides an affidavit format for obtaining a birth certificate in Arunachal Pradesh, India. It includes blanks for the applicant's name and details, their relationship to the person whose birth certificate is being requested, that person's name and details including date and place of birth. The applicant declares the information provided is true to the best of their knowledge and if false they may face punishment under the registration of Birth and Death Act, 1969. The document must be executed and signed before the Executive Magistrate.

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Sanjan Sanju
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62 views

Self - Declared Affidavit Is Not Accepted. 2. All Blanks To Be Duly Filled

This document provides an affidavit format for obtaining a birth certificate in Arunachal Pradesh, India. It includes blanks for the applicant's name and details, their relationship to the person whose birth certificate is being requested, that person's name and details including date and place of birth. The applicant declares the information provided is true to the best of their knowledge and if false they may face punishment under the registration of Birth and Death Act, 1969. The document must be executed and signed before the Executive Magistrate.

Uploaded by

Sanjan Sanju
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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AFFIDAVIT FORMAT TO OBTAIN BIRTH CERTIFICATE

Note:

1. Self – declared affidavit is not accepted.


2. All blanks to be duly filled.

IN THE COURT OF EXECUTIVE MAGISTRATE:: ITANAGAR/NAHARLAGUN/BANDERDEWA


PAPUM PARE DISTRICT::ARUNACHAL PRADESH

AFFIDAVIT

I Shri/Smt. (APPLICANT NAME), son/daughter/wife of Shri (APPLICANT’S FATHER/HUSBAND NAME),


Permanent resident of village (VILLAGE/TOWN), PO- (POST OFFICE), PS- (POLICE STATION), Distt.-
(District), State of (State) and presently residing at ward No- (Ward No.), Of (SECTOR) Sector of
Itanagar/Naharlagun/Banderdewa, District -PapumPare.

1. That Shri/Miss (NAME OF THE PERSON ON WHICH BIRTH CERTIFICATE TO BE ISSUED) is my


(RELATION OF THE PERSON TO APPLICANT).
2. That his/her actual date of birth is on (DATE OF BIRTH (dd/mm/yyyy).
3. That his/her place of birth is at (PLACE OF BIRTH).
4. That this affidavit is sworn into obtain birth certificate from the competent authority.

DECLARATION
I Shri /Smti. (APPLICANT’S NAME) do hereby declare that the above statements from Para 1 to 4 are
true to the best of my knowledge and belief, if I am furnished wrong information, I shall be liable to
punishment under the registration of Birth and Death Act,1969.

DEPONENT

Executed and signed before me by Shri/Smti………………………………………………………………..in my court on


this……day of…………20... (ALL BLANKS IN THIS SECTION TO BE FILLED BY THE MAGISTRATE).

EXECUTIVE MAGISTRATE

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