Sample Birth Affidavit by Father for US Green Card



I, the undersigned, BHATT Jaydevbhai Hasmukhlal aged – 69 years, Hindu by religion, presently residing at 23 Gulmahor Society, Alkapuri, Baroda – 390001, India, do hereby solemnly affirm and declare on oath that:

  1. I am the deponent herein and a citizen of India. 

  2. I was born on Jan 7, 1940, at Ankleshwar, Gujarat, India.

  3. I was married to BHATT Renukaben Jaydevbhai (name after marriage) on Oct 7, 1965, in Surat, Gujarat, India.

  4. As it is customary, my wife had gone to her parents’ place in Bikaner, Rajasthan, India for the delivery of our first child in Nov 1967.

  5. Smita was born on Dec 17, 1967, in Bikaner, Rajasthan, India. I have the personal knowledge of Smita’s birth because I am her father, I took my wife (mother of Smita) to the hospital, and I was present at the time of Smita’s birth. I and Renukaben (mother of Smita) are the natural birth parents of Smita, born from our marriage.

  6. Smita’s full name at the time of birth was given as BHATT Smita Jaydevbhai. 

  7. Smita’s birth was not registered because it was not customary at that time to register the birth of children. There is no official record of birth concerning BHATT Smita Jaydevbhai.

  8. It is customary in our region to add the tag “ben” for female first names for showing respect, while it is customary to add the tags, such as “chandra”, “bhai”, “kumar”, “lal”, etc. for male first names for the same purpose. This is similar to putting Mr., Mrs., Ms., etc. in front of the names in the U.S.

  9. Therefore, the tag “ben” was added to Smita’s first name in some of her documents. My first name was used as my middle name in some of my documents. The tag “kumar” or “bhai” was interchangeably added in my first name.

  10. Smita was married to JADAV Dipesh Morarilal on Apr 2, 1992, in Ahmedabad, Gujarat, India. I had attended their wedding.

  11. Therefore, the following names refer to the one and the same person, my daughter Smita:
    BHATT Smita Jaydevbhai
    (Name after birth)
    BHATT Smitaben Jaydevbhai
    (Name recorded in school)
    BHATT Smitaben Jaydevkumar
    (Name variation in school)
    BHATT Smita Jaydevkumar
    (Name in older passport)
    JADAV Smita Dipesh
    (Name after marriage)

    Except the married name, the above set of names should be considered the variations of the same name and should not be considered name change. 

    Also, the following names refer to the one and the same person, myself:
    BHATT Jaydevbhai Hasmukhlal
    BHATT Jaydevkumar Hasmukhlal
    BHATT Jaydev Hasmukhlal

    The above names should be considered the variations of the same name and should not be considered a name change.

So I do hereby solemnly affirm that the foregoing are true and correct statements.

Place: Baroda, Gujarat, India
Date: March 30, 2019


Note: The above affidavit is just a sample. The Microsoft Word template below has been provided solely as a formatting template and is formatted in such a way that you can directly print onto the standard stamp paper used in India so that you don’t have to go through the hassle of a manual typewriter. It is not for filling in the blanks because your situation will vary.

You should modify the wording accordingly and make your own document. Different sample affidavits on this web site by different relatives try to cover a few different scenarios. Therefore, the sample affidavits for the same person vary. However, you should try to make consistent affidavits for your particular case.

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