Sworn Statement Replacing a Birth Certificate

Sworn Statement Replacing a Birth Certificate

REGARDING attesting to the birth of a biological child, ______, in the absence of a Birth Certificate.

I, ______, residing at ______, do solemnly swear and state the following:

1. I am the ______ of the applicant, ______, and as such, have knowledge of the matters herein.

2. The purpose of this affidavit is to confirm my relationship to my child. I am the biological ______ of ______.

3. ______ was born on ______ in ______ and is a ______ citizen by birth. The applicant was born to me and my partner, ______, who is the applicant's other biological parent.

4. A birth certificate was issued for ______; however, it has been misplaced. While our family is making every effort to locate the original document, the applicant must apply for restoration of temporary status within a strict timeframe.

5. I am providing this affidavit to confirm our relationship in the event the birth certificate is not recovered prior to the filing deadline.

6. At this time, I do not have other primary evidence to prove the relationship between myself and my child.

7. I make this affidavit for the purpose of confirming ______’s date of birth and biological relationship to me as my ______.