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1. Title and Jurisdiction: States the document type and the jurisdiction where it is being executed
2. Affiant Information: Details of the person making the affidavit, including full name, age, citizenship, and residence
3. Child's Information: Complete details of the child including full name, date of birth, time of birth, sex, and place of birth
4. Parents' Information: Full names, citizenship, religion, occupation, and residence of both parents
5. Birth Circumstances: Detailed account of the circumstances of birth, including location, attending medical professionals or witnesses
6. Reason for Execution: Explanation of why the affidavit is being executed (e.g., late registration, loss of original documents)
7. Attestation: Sworn statement affirming the truth of the contents
8. Jurat: Notarial section including date, place of execution, and notary details
1. Medical Attendant's Certification: Section for the attending physician or midwife to certify the birth, used when such professional was present at birth
2. Witnesses' Declarations: Statements from witnesses who can attest to the birth, used when there was no medical professional present
3. Religious Ceremony Details: Information about baptism or other religious ceremonies, used when such documents support the birth claim
4. Local Civil Registrar Annotation: Space for LCR annotations, used when the affidavit is being submitted for late registration
5. Previous Registration Attempts: Details of any previous attempts to register the birth, used when applicable
6. Indigenous Peoples Declaration: Special section for indigenous peoples' cultural identity and circumstances, used when the child belongs to an indigenous community
1. Supporting Documents List: Enumeration of all supporting documents attached to the affidavit
2. Witness Information Sheet: Detailed information about witnesses including their contact information and relationship to the child
3. Certificate of No Birth Record: Attachment from the civil registrar certifying no previous birth registration exists
4. Baptismal Certificate: If available, copy of religious documentation of birth
5. Medical Records: Copies of any available medical records relating to the birth or post-natal care
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Civil Registrar
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Birth Registration Clerk
Social Services Coordinator
Citizenship Processing Officer
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