BIRTH OF XXX
I, the undersigned, XXX aged – 64 years, presently residing at ___street, ___city, ____province – postcode____, China, do hereby solemnly affirm and declare on oath that:
- I am the deponent herein and a citizen of China.
- (If currently in the USA)
I am currently visiting the United States and temporarily residing at my daughter XXX’s house at 23445 W Parker Road, Allen, TX 75002.
I am a permanent resident of the U.S. My A Number is A1234567.
I am a naturalized U.S. citizen. My naturalization certificate number is 34789035489, and I was naturalized on Feb 17, 2015, in Fairfax, Virginia.
- I was born on Mar 17, 1954, in xxx city, xxx province, China.
- I was married to XXX on Oct 7, 1975, in xxx city, xxx province, China.
- XXX was born on Dec 17, 1977, in xxx city, xxx province, China. I have the personal knowledge of her birth because I am her mother, and I gave her birth.
- XXX’s full name at the time of birth was given as ____________.
- XXX’s birth was registered later because it was not customary at that time to register the birth of children.
XXX’s birth was not registered with the Records Office of XXX, China, and therefore, a birth certificate is not available at this time.
XXX’s birth was registered with the Records Office of XXX, China. However, XXX’s name was not listed on the birth certificate at the time of registration.
XXX’s birth was registered with the Records Office of XXX, China. However, due to civil unrest/war in China, the birth certificate is not available at this time.
- I, XXX and my husband, XXXX had the following children born from our marriage:
First Name XX Last Name XX
- XXX was married to XXX on Apr 2, 2002, in XXX, China. I had attended their wedding.
So I do hereby solemnly affirm that foregoing are true and correct statements.
Date: March 30, 2019
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