I, __________, __________ of the deceased named below, resident of __________, do hereby solemnly affirm and declare as under:
That I am the deponent above named and am competent to swear this affidavit.
That __________, son/daughter/wife/husband of __________, aged about __________ years, last resident of __________, died on __________ at __________.
That the fact of death is evidenced by __________
That this death has not previously been registered under the Registration of Births and Deaths Act, 1969.
That the death could not be registered within the twenty-one days ordinarily allowed under that Act because __________
That the date of death falls __________
That I request the __________, __________, to register this death accordingly.
That the contents of this affidavit are true and correct to my knowledge, no part of it is false, and nothing material has been concealed therefrom.
DEPONENT
VERIFICATION
Verified at __________ on __________ that the contents of paragraphs 1 to 8 above are true and correct to my knowledge, that no part of it is false and that nothing material has been concealed therefrom.
DEPONENT
AFFIDAVIT FOR DELAYED REGISTRATION OF DEATH
I, __________, __________ of the deceased named below, resident of __________, do hereby solemnly affirm and declare as under:
That I am the deponent above named and am competent to swear this affidavit.
That __________, son/daughter/wife/husband of __________, aged about __________ years, last resident of __________, died on __________ at __________.
That the fact of death is evidenced by __________
That this death has not previously been registered under the Registration of Births and Deaths Act, 1969.
That the death could not be registered within the twenty-one days ordinarily allowed under that Act because __________
That the date of death falls __________
That I request the __________, __________, to register this death accordingly.
That the contents of this affidavit are true and correct to my knowledge, no part of it is false, and nothing material has been concealed therefrom.
DEPONENT
VERIFICATION
Verified at __________ on __________ that the contents of paragraphs 1 to 8 above are true and correct to my knowledge, that no part of it is false and that nothing material has been concealed therefrom.