APPLICATION FOR THE GRANT OF NATIONALITY CERTIFICATE

I ________________________ S/o , D/o, W/o ______________________ R/o _____________________________ do hereby solemnly affirm and declare as under:

1. That the exact and correct date of Birth of my son/daughter __________________ is ____________________________ who born at ___________________.

2. That the name of the mother of may above said son/daughter is Smt._______________________.

3. That due to inadvertence, I did not register the date of birth of my above said daughter/son _________________ with the concerned department at the time of birth.

Deponent

Verification: Verified at Delhi, this _____________ day ___________ that the contents of the affidavit are true & correct to the best of my knowledge and belief and nothing has been concealed therein.

Deponent

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