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.

AFFIDAVIT

I ________________________ S/o , D/o, W/o ______________________

R/o _____________________________ do hereby solemnly affirm and
declare as under:

1. That Sh./Smt./Ku. _____________________ expired on ___________

___________________________________.

2. That the deceased is my ____________________________.

3. That due to inadvertance, I did not register the date of death of

_________________________ with the concerned department.

4. That it is my true statement.

Deponent

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.

Deponent