जन्म तिथि अद्यतन हेतु शपथ पत्र अभिभावक द

G-B

Annexure IA- For children

Affidavit for date of birth updation

1-I, ....................................., aged about ......... years, S/o,D/o,W/o ........................................, resident of Village/Mohalla-....................................................................................., Tehsil-..........................., District-..........................., State-…………………….. Pin-………….. holding Aadhaar number-………………………………………………. do hereby solemnly affirm and declare as under:-

2.That I am the resident of the above said address.

i)That I am the resident of the above said address.

ii) That I am parent/legal guardian of the………………………………………………………… holding Aadhaar number………………………………………………………………..

iii) That correct date of birth of my child/ ward is………………………………………………

iv) That the earlier recorded date of birth in Aadhaar of my child/ward is…………………………………. based on………………………………………………………………………………. document submitted by me.

v) That I have………………………………………. (never/once/more than once) updated my child/ward date of birth in Aadhaar.

vi) That birth certificate of my child/ward is being provided in support of Doß update request.

vii) That I wish to get my child/ward date of birth updated in the Aadhaar as……………………………………………………………………….. for which I am submitting his/her birth certificate as proof of date of birth.

viii) That I further undertake that my child/ward shall not be eligible for any further updation of date of birth in Aadhaar.

3-I undertake that if the document submitted as proof of date of birth is found to be fraudulent/false/forged/non-genuine or my child/ward was not entitled for the said document, the Aadhaar number of my child/ward may be deactivated as per Regulation 28 of the Aadhaar (Enrolment and Update) Regulations, 2016 and I shall be liable to be prosecuted under provisions of the applicable law.

4-I hereby declare that all the information mentioned above is true to the best of my knowledge. In case of any discrepancies, the undersigned will be held responsible.

DATE-

PLACE-

Name & Signature of Parent /Guardian of Minor (Deponent)

NAME-……………………………………….