Kuwait Undertaking For Issue Of Birth Certificate (Page 2 of 4) in pdf

Kuwait Undertaking For Issue Of Birth Certificate Page 2

UNDERTAKING FOR ISSUE OF BIRTH CERTIFICATE

(for self)

I, the undersigned

________________________________________________________

holder of Indian Passport No.

____________ issued at

_________ on

_______

hereby state on oath the following :

1. I was born on

_____________ (date)

I was born at

___________________

I solemnly declare that the birth certificate submitted by me in support to my

undertaking is a genuine document. I hold myself fully responsible for the authenticity of

the document mentioned above and would be solely responsible for the consequences

should this document be found to be untrue.

Further I indemnify the Embassy of India, Kuwait incase the document (s) furnished by me

are not found to be genuine at any stage.

I hereby request the Embassy of India, Kuwait to issue a birth certificate in respect

of self which is a requirement of the Government of the State of Kuwait to enable me to

obtain visa etc.

Arabic text of proposed certificate is as per

proposed

certificate in

English

(Undertaking to be given only by those bringing pre-prepared texts of certificate not prepared in

(The proposed certificate, undertaking etc. should be type written only)

the Embassy.)

Place : Kuwait

Date :

Signature as in Passport

Name of applicant :

_____________________

Local Address :

_____________________

Contact telephone No.

_____________________

Civil Identity Card No.

_____________________

Kuwait Undertaking For Issue Of Birth Certificate Page 2