I, Mohammed Rafi, aged 58 years, son of Abdul Khader, residing at Rafi Manzil, Kottakkal, Malappuram, Kerala 676503, do hereby solemnly affirm and declare as under:
1. I was born on 2 June 1968 at Kottakkal, Malappuram district, Kerala.
2. My birth was not registered with the Registrar of Births and Deaths and no birth certificate is available.
3. My date of birth as recorded in my SSLC certificate (register no. 123456, March 1984) is 2 June 1968.
4. This affidavit is made for submission to the Regional Passport Office, Kozhikode, in lieu of a birth certificate.
Verification: Verified at Kottakkal on 26 October 2026 that the contents are true and correct.
Signed
Mohammed Rafi, Deponent · attested by Notary Public
Names, numbers and dates above are examples. Replace them with yours.
Common questions
Is this enough for a passport?Born before 26 January 1989: the affidavit plus SSLC/school leaving certificate is usually accepted. Born after that: Passport Seva expects a birth certificate; get a late registration or NABC and attach this affidavit.
Can I use it to correct a wrong date of birth?No. That needs a correction in the primary record (school/municipality) with supporting evidence, sometimes a court order.
Does EPFO accept it?EPFO accepts a notarised DOB affidavit only together with another listed proof such as the school certificate.
This page is a template and general guidance for a common situation, not legal advice. Rules differ by state and office; check with the office that asked for the document. Last reviewed October 2026.