AFFIDAVIT OF BIRTH

I Karla Smith, residing at 123 25th St., Pleasent City, California, 94902, certify under penalty of perjury that I was born on February 06, 1991 at San Francisco and as follows: This affidavit is executed on behalf of the following person: Name: Bobby Smith Gender: Boy Age: 12 Citizen of: United States of America Marital Status: Single Relationship to Sponsor:Brother Current Address: 8 Hayes St. City: Pleasent City State: CA Country: United States of America I further declare, I am closely related to Bobby Smith. I am Bobby Smith's Sister, Bobby Smith was born on February 15, 2000 in San Francisco, California, United States of America to Janet Smith and James Smith, I have direct personal knowledge of the event and circumstances concerning the birth of Bobby Smith because I was present during Bobby Smiths birth, and I have known the applicant since February 15, 2000, This affidavit is being submitted because There is no official record of applicant's birth. Oath or Affirmation of Affiant: I certify under penalty of perjury under California law that I know the contents of this affidavit signed by me and that the statements are true and correct. ___________________________________ Karla Smith STATE OF CALIFORNIA COUNTY OF Marin County _________________________ Date

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On ____________________ before me, ________________________________, personally appeared Bobby Smith, proved to me on the basis of satisfactory evidence to be the person(s) whose name is subscribed to the within Affidavit and acknowledged to me that he/she executed the same in his/her authorized capacity, and who, being first duly sworn on oath according to law, deposes and says that he/she has read the foregoing Affidavit subscribed by him/her, and that the matters stated herein are true to the best of his/her information, knowledge and belief. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal.

________________________________________ (Notary Seal) Signature of Notary Public

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