Self Affidavit of Birth

Self Affidavit of Birth

I, [Your Name], being of sound mind and legal age, do hereby solemnly affirm and declare the following:

Statement of Facts

  1. I was born on [Your Birthdate] in [Your Birthplace], [Your Address].

  1. My parents' names are [Father's Name] and [Mother's Name], both of whom were citizens of the United States at the time of my birth.

  1. I have never been known by any other name than [Your Name].

I declare that the information provided in this affidavit is true and correct to the best of my knowledge and belief.

Sworn Oath

I understand that this affidavit is being executed to serve as proof of my birth for employment purposes.

Executed on this [Date].

[Your Name]


Subscribed and sworn to before me this [Date].

[Notary Public]

[Your County]

My commission expires [Date].

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