Sample Birth Affidavit by Uncle for US Green Card

Sample Birth Affidavit by Uncle for US Green Card



I, the undersigned, Mr. SHAH Kantilal Ramnikbhai, aged – 63 years, Hindu by religion, residing at C-280 Jagdambe Nagar, Rakhiyal, Ahmedabad 385432, 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 April 13, 1946 Bikaner, Rajasthan, India. 

  3. My sister BHATT Renukaben (mother of Smita) was married to Mr. BHATT Jaydevbhai Hasmukhlal on Oct 7, 1965, in Surat, Gujarat, India.

  4. Smita was born on Dec 17, 1967 in Bikaner, Rajasthan, India. I have the personal knowledge of Smita’s birth because I am her uncle (mother’s brother), and we are very close relatives, and I recall Smita’s birth clearly OR I was immediately informed of her birth OR I was present at the time of her birth.

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

  6. It is a religious custom in India to name the child after its birth in a religious ceremony. Therefore, Smita’s name was not recorded in the original birth registration. Therefore, the official record of birth is incomplete concerning BHATT Smita Jaydevbhai.

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

Place: Ahmedabad, Gujarat, India
Date: May 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 on to 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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