Petition To Amend Birth Certificate - Superior Court Of Gwinnett County Page 6
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12SUPERIOR COURT OF GWINNETT COUNTY
Civil Action
Plaintiff,
File No.:
v.
Defendant.
AFFIDAVIT IN SUPPORT OF
PETITION TO AMEND BIRTH CERTIFICATE
Having first been placed under oath or affirmation by a notary public, I hereby swear or
affirm that the following information is true.
1.
My name is
and I am
years old. I
am competent to testify.
2.
I am named as the G mother ☐ father on the minor child’s birth certificate.
3.
The minor child’s birth certificate should be amended as follows:
☐ (a) Child's Name:
Currently reads:
Should read:
☐ First Name
☐ Middle Name
☐ Last Name
Affidavit in Support of Petition to Amend Birth Certificate - Rev. March 2016
Page 1
Provided by the Gwinnett Family Law Clinic
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