Birth affidavit - 20092017 State 2025

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The document outlines the use of a Birth Affidavit form (DS-10) for individuals born in the U.S. without a birth certificate or with a delayed filing. It details the responsibilities of the affiant, who must be a close blood relative or attending physician, to provide personal knowledge about the applicant's birth. The form must be signed in front of an authorized agent and submitted with a passport application, along with other supporting documents. It also includes warnings about false statements and privacy information regarding data collection.

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Click ‘Get Form’ to open the birth affidavit in the editor.
Begin by entering the name of the passport applicant in the designated fields, including last name, first name, middle name, and suffix if applicable.
Fill in the passport applicant's date of birth and place of birth (city and state) accurately.
Provide the current home address of the passport applicant, ensuring all details are correct, including street address, apartment/unit number, city, state/country, and zip/postal code.
Indicate how long you (the affiant) have known the passport applicant and your relationship to them (e.g., older sibling, parent).
In detail, describe everything you remember about the passport applicant’s birth. Include specifics such as date/time/location of birth and individuals present. If more space is needed, attach a separate document.
Sign the form in front of a passport agent or notary. Remember to submit a clear photocopy of your valid ID as required.

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What does birth certificate affidavit mean?

A birth affidavit must be made by an individual who has personal knowledge of the facts of the birth of the applicant whose birth in the United States is to be proved. The affidavit shall state briefly how the affiants knowledge was acquired.

What is the affidavit for date of birth?

I submit that the mis-recording of my date of birth/name is caused due to over-sight, hence the same deserves to be corrected. If my date of birth is not corrected in the Secondary School Certificate I will be put to irreparable loss, which cannot be compensated in terms of money.

What is an example of an affidavit statement?

It is preferred that the affidavit be made by an older blood relative, although it may be made by the attending physician, or any other person who has personal knowledge of the birth.

Can you use a birth affidavit for a passport?

When submitting this letter, provide: An early public record or document, or. One early public record/document and one early private record/document with Form DS-10: Birth Affidavit.

What is an example of a birth affidavit?

I have direct knowledge of the birth of [applicants name first, middle, last] as I am [his] [her] [description of the relationship between the author and the applicant father, mother, uncle, aunt, older sibling, etc. Note: the author must have personal knowledge of the birth. ].

birth affidavit ds 10

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What is the most common use of an affidavit of birth?

An affidavit of birth is a sworn statement that serves as a substitute for a birth certificate when an individual does not possess one. This document is often necessary for immigration applications, including those for green cards and visas.

How to write an affidavit of birth?

Sample Affidavit of Birth I , residing at , , , , docHub under penalty of perjury that I was born on at. Name: Gender: Age: Citizen of: Marital Status: Relationship to Sponsor: Current Address: City: State: Country: Name Before Marriage: I further declare, was born on in , , to and ,