Birth Affidavit Template
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1
2APPLICATION TO USE BIRTH AFFIDAVIT
APPLICANT NAME:
APPLICANT DATE OF BIRTH:
APPLICANT ADDRESS:
REASON FOR SUBMITTING A BIRTH AFFIDAVIT:
OTHER INFORMATION IN SUPPORT OF APPLICATION TO USE A BIRTH AFFIDAVIT
Please note that not being in possession of a birth certificate is not acceptable grounds for use of this
affidavit. You will be required to provide evidence that you were unable to obtain a copy of your
birth certificate/registration.
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