BIRTH / DEATH CERTIFICATE CORRECTION AFFIDAVIT
I, __________, __________, resident of __________, holding __________, ordinarily resident within __________ (the "Deponent" or "I"), do hereby solemnly affirm and declare as follows:
- 1. THE CERTIFICATE
- 2. THE ERROR
- 3. PROOF OF THE CORRECT PARTICULARS
- 4. APPLICATION AND DECLARATION
4.1 This affidavit is sworn in support of my application to the Registrar of Births and Deaths who keeps the register in which the entry was made, for correction of the entry and issue of a corrected certificate.
4.2 Every statement made above is true to my own knowledge and belief, and I have concealed nothing material. I understand that the Registrar may verify the documents, may ask for further proof, and may decline to correct the entry on this affidavit alone. I am aware that making a false declaration in an affidavit is an offence.
VERIFICATION
DEPONENT
Signature: ______________________________
__________
ATTESTATION
Notary Public / Oath Commissioner
Registration No. and seal: ____________________