Instructions for Preparing Birth Affidavits:
Below these instructions you will find a template for you to use for your birth affidavits. Please obtain 2 birth affidavits in this format, preferably one from each of your parents if possible. If your parent(s) are not living, you may obtain 2 birth affidavits in this format, one each from 2 direct witnesses of your birth who were at least 10 years old at the time of your birth.
These affidavits will need to be notarized. They may be prepared either on plain paper, or on stamp paper, it does not matter. The affidavits should be notarized in whatever country the affiant is currently physically residing (whether it is their permanent residence, or their temporary place of stay). Please be sure to write out the full names of all individuals mentioned in the affidavits (do not use initials), and remove the prompts in red once the blanks are filled in with the appropriate information. Please make sure that all information provided in the affidavits is correct and that no errors or typos have been made in the final affidavits. It is important that all names are spelled correctly and that all dates are accurate. Where dates are required, please write out the month in words to avoid confusion.
Once the affidavits are prepared and notarized, please forward copies to our office for review and keep the originals in a safe place in case they are needed in the future. Please do not send originals of the affidavits to our office at this time.
NOTE: If you will be applying for an Immigrant Visa via Consular Processing (not the I-485), then you will be required to provide the original of all documents mentioned herein once the National Visa Center notifies you that it is time to send documents to their office.
AFFIDAVIT OF BIRTH
I, (full name of person preparing the Affidavit, “Affiant”), after being duly sworn, do hereby depose and say that:
1. I am a citizen and national of (country), born on (date) at (place/country). I reside at (full street address, city, state, country) .
2. I have direct knowledge of the birth of (full name of person for whose benefit the Affidavit is being prepared “Beneficiary”; also include maiden name if applicable), as I am his/her (state the relationship, for example, father/mother/uncle/aunt, etc.) and (SELECT ONE AS APPROPRIATE: I gave birth to him/her, was present at birth, was telephoned by mother, or visited next day in hospital).
3. (Beneficiary) was born on (date of birth) at (place of birth, including country).
4. ’s (name of Beneficiary) natural parents are
, the mother (full name of mother) and , the father (full name of father).
5. This Affidavit is being submitted in support of the birth facts and parentage of ______(person for whose benefit the Affidavit is being prepared “Beneficiary”).
6. It is my prayer that this Affidavit be accepted for this purpose.
I AFFIRM under penalty of perjury and upon personal knowledge that the above statements and facts are true and accurate to the best of my knowledge, information and belief.
Signature :
(Typed Name of Affiant)
Date :
STATE OF , CITY/COUNTY OF ,TO WIT :
I HEREBY CERTIFY THAT on this day of , 20_ , before me, a Notary Public of the aforesaid State and City/County, personally appeared (name of Affiant), known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing instrument, who acknowledged that s/he has executed it for the purposes therein set forth.
Notary Public
My Commission expires: