DOMICILE AFFIDAVIT

I
Mr______________________________
adult,
Indian
inhabitant
of
Mumbai,
(Address)____________________________________
_____________________________________________
____________________________________________ ;
do hereby state on solemn affirmation as
under;
I
say
that
my
son/daughter
_______________________
was
born
on
_________ at _______________________ in the
state of _________________________.
I say that I rely on following documents to
show my residence in __________________.
(i)

I have Birth Certificate of my daughter/son.

(ii)

I have School Leaving Certificate of myself &

my daughter & son.

(iii)

I have a school report of my son/daughter.

(iv)

I have a Ration Card No.:______________

(v)

I have Light bill

I say that all above documents shows my

residence in State of _______________ since my
birth.
I am making this affidavit to produce before
the concerned authority for obtaining Domicile
certificate for my son/daughter namely
________________________________________
for
his/her education.
Whatever stated herein above is true and
correct to the best of my knowledge & if
anything found to be false then I shall be
liable
for
prosecution
under
section
199,200(13)(2) of I.P.Code
Solemnly affirmed at Mumbai
On ___ Day of ____________

Deponent
Before me.