Affidavit for Death certificate

Affidavit for Obtaining Death Certificate

To be submitted along with the application on Rs. 2/- Non-Judicial Stamp Paper, duly attested by Oath Commissioner/Notary Public.

I, [Full Name], S/o, D/o, W/o [Parent/Spouse’s Name], resident of [Full Address], do hereby solemnly affirm and declare as follows:

1. That Sh./Smt./Ku. [Deceased’s Name], expired on [Date of Death].
2. That the deceased was my [Relation with the Deceased].
3. That due to inadvertence, I did not register the date of death with the concerned department.
4. That the above statements are true and correct to the best of my knowledge and belief.

Deponent

Verification

Verified on [Date] at Delhi that the contents of this affidavit are true and correct to the best of my knowledge and belief and nothing has been concealed therein.

Deponent

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