Affidavit Of Birth Template

4.95 – 5 (5353 Reviews)

Updated – 2025 /2026


Disclaimer

The material provided is intended solely as a general example for official documentation purposes. It does not constitute legal advice and should not be relied upon as a substitute for consulting a qualified attorney specializing in identity verification or vital records. Laws and regulations may vary depending on the state or jurisdiction, and adjustments may be required to ensure compliance with local requirements. The use of this example is the sole responsibility of the user, and we assume no liability for any errors, omissions, or consequences arising from its use without professional review.


PDF

PDF

Word

Word

Sample

Sample

Template

Template


Please note that this is a sample template; slight modifications may be necessary to suit specific circumstances and regulations.

Affidavit of Birth Template

Parties Involved:

Affiant: Jane Elizabeth Doe
Address: 789 Pine Street, Springfield, IL 62704

Notary Public: Samuel Johnson
Address: 101 Maple Avenue, Springfield, IL 62704

Purpose of Declaration:

This affidavit is made to affirm the birth details of Jane Elizabeth Doe, born on March 15, 1990, as per personal knowledge and available records.

Declaration:

I, Jane Elizabeth Doe, hereby declare under oath that the foregoing is true and correct to the best of my knowledge, understanding that any false statement made herein may be subject to legal penalties.

Birth Details:

Full Name at Birth: Jane Elizabeth Doe
Date of Birth: March 15, 1990
Place of Birth: Springfield General Hospital, Springfield, Illinois

Signed this ____ day of __________, 20__.

Place: Springfield, Illinois

________________________
Jane Elizabeth Doe (Affiant)
________________________
Samuel Johnson (Notary Public)