PROFORMA OF AFFIDAVIT FOR OBTAINING DEATH CERTIFICATE
Affidavit to be submitted alongwith the application of Rs.2/- Non judicial
stamp paper duly attested by Oath Commissioner/Notary Public.
I ________________________ S/o , D/o, W/o ______________________
R/o _____________________________ do hereby solemnly affirm and
declare as under:
That Sh./Smt./Ku. _____________________ expired on ___________
That the deceased is my ____________________________.
That due to inadvertance, I did not register the date of death of
_________________________ with the concerned department.
That it is my true statement.
Verification: Verified on _________________ at Delhi that the contents of
the affidavit are true & correct to the best of my knowledge and belief and
nothing has been concealed therein.