I, Nithya Balakrishnan, aged 20 years, daughter of Balakrishnan Nair, residing at Nithya Nivas, Pala, Kottayam, Kerala 686575, do hereby solemnly affirm and declare as under:
1. I was born on 5 March 2006 at Pala, Kottayam district, Kerala, and I have been continuously residing in the State of Kerala since birth.
2. I studied from Class I to Class XII at St. Thomas Higher Secondary School, Pala, Kerala (2011-2024), as shown by my school certificates.
3. My parents are permanent residents of Kerala and own the house at the above address, assessed under Pala Municipality property tax no. 7/1234.
4. I have not obtained a domicile or nativity certificate from any other state.
5. This affidavit is made for obtaining a Nativity Certificate from the Tahsildar, Meenachil Taluk, for admission under the Kerala state quota.
Verification: Verified at Pala on 2 November 2026 that the above contents are true and correct.
Signed
Nithya Balakrishnan, Deponent · attested by Notary Public
Names, numbers and dates above are examples. Replace them with yours.
Stamp paper, notary and signing
Rs. 10–100 stamp paper by state, notarised. In Kerala apply on e-District with this affidavit; the certificate itself is issued by the Village Officer or Tahsildar, not by the notary. A minor's affidavit is sworn by a parent.
Common questions
What is the difference between domicile, nativity and residence certificate?States use different names. Kerala issues a Nativity Certificate (born in Kerala / parents from Kerala) and a Residence Certificate (living in Kerala for a period). Karnataka and others call it a Domicile Certificate. The affidavit covers whichever is asked.
How many years are needed?Varies: Kerala nativity is by birth or parentage; residence certificates typically need 5–10 years; some NEET state quotas need schooling in the state for a set number of years.
Can I get it online?Yes, in most states via the e-District portal; the affidavit is uploaded as a supporting document.
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.