Affidavit of Birth
State of [State]
County of [County]
I, [Affiant’s Name], residing at [Address], [City], [State] [ZIP Code], social tax number [Tax ID], being duly sworn, testify and state as follows:
Reason for Affidavit. This Affidavit is being submitted because [Reason].
I further declare that [Applicant’s Name], [Applicant Gender], residing at [Address], [City], [State] [ZIP Code], social tax number [Tax ID](the "Applicant"), was born on [Date of Birth], in the city of [Birth City], [Birth County] County, State of [Birth State].
I have known the Applicant since [Date], and I possess knowledge of the Applicant’s birth details because [Proof of Awareness].
The Applicant’s parents are:
- Father: [Father’s Name]
- Mother: [Mother’s Name]
Legal acknowledgment. I declare under penalty of perjury that the above information I gave is true and correct to the best of my knowledge. I understand that any false statements may have legal consequences.
This Affidavit was made on [Signing Date].
____________________________
[Affiant’s Name]
(Affiant’s Signature)
Official Acknowledgment
Identifying document presented. The following document was provided by the Affiant for verification:
[Id Document Type]
- ID number: [ID Number]
- Issuing authority: [Place of Issue]
- Issue date: [Issue Date]
- Expiration date: [Expiration Date]
On [Signing Date], the Affiant listed above, who is not related to me, personally appeared before me and is known to me to be the person whose name is subscribed to and acknowledged that the Affiant executed the same for the uses and purposes therein contained. I have appropriately verified the identity of the Affiant by personally viewing the aforementioned identification document and matching photocopy.
State of [State]
Acting in the county of [County]
___________________________________
([Certifier Type]’s Signature)
______________________________________
[Certifier Type]’s Full Legal Name
Party 1
________________
Signature
Date: ________________
Party 2
________________
Signature
Date: ________________
What Is a Affidavit of Birth?
An Affidavit of Birth in the United States confirms specified facts through a signed declaration sworn before a commissioner for oaths or notary.
Affidavits of birth derive their legal authority from state evidence codes and administrative regulations. Under 18 U.S.C. 1621, making a false statement in a sworn affidavit constitutes perjury, a federal crime punishable by up to five years' imprisonment. This criminal penalty gives affidavits significant evidentiary weight, as courts presume that individuals making sworn statements understand the consequences of falsification.
The U.S. Department of State accepts affidavits of birth as secondary evidence for passport applications under 22 CFR 51.42 when a birth certificate is unavailable. USCIS (U.S. Citizenship and Immigration Services) accepts them in immigration proceedings when primary documents cannot be obtained. Many state vital records offices also accept affidavits of birth as supporting documentation when applying for a delayed birth certificate registration -- particularly for individuals born at home, in rural areas, or before modern birth registration systems were established.
When Do You Need a Affidavit of Birth?
An Affidavit of Birth is most commonly needed when applying for a U.S. passport and the applicant cannot obtain a certified birth certificate. The State Department requires the affidavit to be from someone with personal knowledge of the birth, typically a parent, relative, or attending midwife, and it must be accompanied by a letter from the vital records office confirming that no birth record exists.
Immigration proceedings frequently require an Affidavit of Birth when applicants from countries with incomplete vital records systems cannot produce an official birth certificate. USCIS Form I-485 (Adjustment of Status) and consular processing applications accept this affidavit as secondary evidence.
Individuals born at home without medical attendance -- which was common in rural areas before the mid-20th century -- often need this affidavit to establish their birth for Social Security benefits, Medicare enrollment, or veteran's benefits applications. School enrollment for children whose birth certificates are delayed or lost may also require a birth affidavit.
Correcting errors on an existing birth certificate, such as misspelled names or incorrect dates, often requires a supporting affidavit from someone who can attest to the correct information. Without this documentation, individuals face significant barriers to obtaining identity documents, government benefits, and legal recognition of their birth facts.
What to Include in Your Affidavit of Birth
The affiant's full legal name, address, date of birth, and relationship to the individual whose birth is being attested must be clearly stated. The affiant must have personal knowledge of the birth -- secondhand information or hearsay is not sufficient for a legally valid birth affidavit. Courts and government agencies will scrutinize whether the affiant was actually present at the birth or has direct knowledge of the circumstances.
The child's full name at birth, exact date of birth (month, day, year), time of birth (if known), and precise place of birth (city, county, state, and hospital name if applicable) are essential facts. The more specific the information, the more weight the affidavit carries with reviewing agencies. If the birth occurred at a private residence, the street address should be included.
The full legal names of both parents, including the mother's maiden name, must be included. This information is necessary for establishing parentage and is cross-referenced by vital records offices when processing delayed birth registration applications.
A sworn statement (jurat) confirming that the affiant is making the declaration under penalty of perjury under the laws of the applicable state is required. The specific language of the jurat may vary by state. The affidavit must be signed by the affiant in the presence of a notary public, who verifies the affiant's identity through government-issued identification and administers the oath.
The notary's signature, seal, and commission expiration date must appear on the document. Some government agencies, including the U.S. Department of State, require the affidavit to have been executed within a specific timeframe (typically within the past year) to be accepted as current evidence.
Sources & Citations
Statutory citations link to official government sources.
- 18 U.S.C. 1621US – Cornell LII
- 22 CFR 51.42US – eCFR
Cite this page
Reference this free template in an article, syllabus, or research note:
Forms Legal. (2026). Affidavit of Birth (United States) [Legal document template]. Forms Legal. https://forms-legal.com/usa/government/declarations/affidavit-birth
"Affidavit of Birth (United States)." Forms Legal, 2026, https://forms-legal.com/usa/government/declarations/affidavit-birth.
@misc{formslegal-affidavit-birth,
author = {{Forms Legal}},
title = {Affidavit of Birth (United States)},
year = {2026},
howpublished = {\url{https://forms-legal.com/usa/government/declarations/affidavit-birth}},
note = {Free legal document template. Based on 28 U.S.C. §1746}
}Also available for these jurisdictions:
Frequently Asked Questions
An Affidavit of Birth is a sworn statement used to establish a person's date and place of birth when an official birth certificate is unavailable, and it is legally valid once signed before a notary public and based on the affiant's personal knowledge. Government agencies, including the Social Security Administration, state DMVs, and U.S. passport offices, accept Affidavits of Birth as secondary evidence under their own documentation rules, often requiring statements from two people who have known the individual since early childhood. The affidavit derives its legal force from the oath: the affiant swears under penalty of perjury (28 U.S.C. 1746) that the birth facts are true. Because it is secondary evidence, an Affidavit of Birth rarely outranks a delayed or amended birth certificate when one can be obtained, but it bridges the gap for older individuals, foreign-born applicants, and those whose original records were lost or never filed.
An Affidavit of Birth should be signed by someone with direct, personal knowledge of the subject's birth, such as a parent, an attending physician or midwife, an older relative, or a long-time family friend present at or near the time of birth. Most agencies that accept these affidavits, including the Social Security Administration and U.S. Department of State for passport applications, prefer two affiants who are not the applicant and who have known the person since infancy. The affiant must be an adult competent to swear an oath and must base the statement on what they personally witnessed or know, not on hearsay. Each affiant signs before a notary public, who verifies identity and administers the oath. When the only people with firsthand knowledge are deceased, applicants typically must rely on a delayed birth certificate procedure through the state vital records office instead.
An Affidavit of Birth is needed when a person must prove their date or place of birth but cannot produce an official birth certificate, a situation common for individuals born at home, born before universal birth registration, or born abroad without consular records. Typical triggers include applying for a Social Security card, obtaining a REAL ID-compliant driver's license, securing a U.S. passport, enrolling in school, or claiming benefits where age must be documented. Each requesting agency sets its own evidentiary standard, so an applicant should confirm whether one or two affidavits are required and whether additional secondary evidence, such as a census record or baptismal certificate, must accompany them. The affidavit supplements rather than replaces the official record, so applicants should also pursue a delayed birth certificate from the state vital records office when eligible.
An Affidavit of Birth must be notarized to be accepted by most government agencies, because notarization is how the affiant's sworn oath is formally administered and authenticated. The notary public verifies the affiant's identity with valid photo identification, witnesses the signature, confirms the affiant swore the contents are true, and then completes a jurat with a seal. Without notarization, the document is an unsworn statement and the Social Security Administration, DMV, and passport offices will generally reject it. Some agencies accept a federal unsworn declaration under 28 U.S.C. 1746 in place of notarization, but for birth-evidence purposes the safer practice is full notarization for each affiant. Because requirements differ by agency and state, applicants should confirm the exact format, including how many witnesses must sign and whether the agency provides its own affidavit form.
An Affidavit of Birth should include the full legal name of the person whose birth is being attested, their date and place of birth, and the names of the parents, along with the affiant's full name, address, relationship to the subject, and the basis of their personal knowledge. The statement must explain how the affiant knows the birth facts, for example by being present at the birth or by being a close relative who has known the person since infancy. Accuracy is essential because the affidavit is sworn under penalty of perjury under 28 U.S.C. 1746, and false statements can result in criminal charges and denial of the benefit sought. Each affiant signs and dates the document before a notary public. Agencies frequently require two separate affidavits from different witnesses, so applicants should prepare and notarize each one independently to satisfy the documentation standard.
This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer
Found an error? Let us knowRelated Documents
You may also find these documents useful:
Affidavit of Identity
Create a professional Affidavit of Identity with our free online generator. This sworn legal document verifies a person's identity when official identification documents are unavailable, contain errors, or need supplemental confirmation. It is commonly used for name discrepancy issues, lost identification replacement, banking requirements, and government filings. The affidavit includes the individual's full legal name, date of birth, address, identifying details, and the affiant's sworn statement confirming the identity. Fill out the interactive form, preview in real time, and download as PDF or Word. Includes notary section and electronic signature support. Valid in all US jurisdictions.
Affidavit of Residency
Create a professional Affidavit of Residency with our free online generator. This sworn legal document provides a written declaration confirming that an individual resides at a specific address. It is commonly used for school enrollment, voter registration, tax filings, and situations where proof of residence is required beyond utility bills or lease agreements. The affidavit includes the resident's full name, current address, duration of residency, and the affiant's sworn statement. Fill out the interactive form, preview in real time, and download as PDF or Word. Includes notary section and electronic signature support. Valid in all US jurisdictions.
Affidavit of Marriage
Create a professional Affidavit of Marriage with our free online generator. This sworn legal document provides a written declaration confirming the marital status or marriage of two individuals. It is commonly used for immigration applications, insurance enrollment, spousal benefits, and situations where an official marriage certificate is unavailable or requires supplemental verification. The affidavit includes the names of both spouses, date and place of marriage, and the affiant's relationship to the couple. Fill out the interactive form, preview in real time, and download as PDF or Word. Includes notary section and electronic signature support. Valid in all US jurisdictions.
Affidavit
Need to swear to something in writing? An affidavit is basically a written statement you sign under oath, saying “everything here is true to the best of my knowledge.” Courts, banks, government agencies, and attorneys use them constantly — for everything from proving your identity to confirming where you live. The key is getting the format right: your personal details, a clear statement of facts, a jurat or notary section, and your signature under penalty of perjury. Our free template covers all of that. Fill in your details, preview the document, and download as PDF or Word.
Affidavit of Domicile
Create a professional Affidavit of Domicile with our free online generator. This sworn legal document establishes a person's permanent legal residence for tax, estate, and legal purposes. It is commonly required when settling an estate, transferring securities of a deceased person, or resolving tax jurisdiction questions. The affidavit includes the individual's full name, address of domicile, duration of residency, and the affiant's sworn statement confirming the domicile. Often required by transfer agents, brokers, and tax authorities. Fill out the interactive form, preview in real time, and download as PDF or Word. Includes notary section and electronic signature support. Valid in all US jurisdictions.