Affidavit Of Baptism Form

Affidavit of Baptism

This form is used when there is a verifiable Baptism,

but no official document or certificate exists.

In the presence of the ________________________________________________________________________

(name of Catholic cleric under whose authority this affidavit is accepted by the Catholic Church)

I (we) testify that ____________________________________________________________________________

(full legal name of person baptized)

child of ___________________________________________________________________________________

(full legal name of mother of person baptized)

and _______________________________________________________________________________________

(full legal name of father of person baptized)

born in ____________________________________________________________________________________

(include locality (town, city, county, etc.), region (state, province, territory, etc.), and country)

on the ______________________________ day of _____________________________ in ________________

(day of birth)

(month of birth)

(year of birth)

WAS BAPTIZED

on the ______________________________ day of _____________________________ in ________________

(day of Baptism)

(month of Baptism)

(year of Baptism)

at ________________________________________________________________________________________

(place of Baptism,including church name (or hospital,etc.),locality (town,city,county,etc.),region (state,province,territory,etc.),and country)

by ________________________________________________________________________________________

(name of the individual who performed the Baptism (include the title of the individual, if known))

the godparents (or sponsors) being ______________________________________________________________

(if known)

and _______________________________________________________________________________________

(if known)

Witness(es) to the Baptism

_____________________________________________________________ Date ________________________

(signature of witness (this can be the subject of the affidavit if he/she was old enough to remember the Baptism))

_____________________________________________________________ Date ________________________

(signature of second witness, if required by the diocese)

Office Use Only:

Date affidavit received ___________________________ Received by _________________________________

Parish receiving affidavit record ________________________________________________________________

Full address of parish _________________________________________________________________________

The Association for Catechumenal Ministry (ACM) grants the original purchaser (parish, local parochial institution, or individual) permission to reproduce and modify this form.