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Affidavit Format for Obtaining Death Certificate of the Deceased

The concerned government authority may require an affidavit from you along with the application for issue of death certificate of any of your relatives.

affidavit format for obtaining death certificate
An affidavit specifying name of the deceased, date and location of death and name of the deponent is a written statement by mostly legal heir(s) declaring and confirming the death details of the deceased. It can be used as evidence in the court in case the matter goes to court of law.

Hence, make sure all the statements you mention in the affidavit is true.

Here is an affidavit format for obtaining a death certificate.

TEMPLATE


IN THE COURT OF EXECUTIVE MAGISTRATE: .......................
............... DISTRICT: (Name of the State) 

AFFIDAVIT

I, Shri/Smt. (Name of the Applicant), son/daughter/wife of Shri (Name of the Father/Husband), permanent resident of (Name of the Village) village, P.O. .............., P.S. (Police Station Name), Dist. (District Name), State of ............... and presently residing at ward no. ...., (Name of the Village) village, P.O. .............., P.S. (Police Station Name), Dist. (District Name), State of ............... , do hereby solemnly affirm and declare as under:

1. That Late (Name of the Deceased), son/daughter/wife of Shri (Name of the Father/Husband), expired on (Date);
2. That his/her place of death was at (location);
3. That Late (Name of the Deceased) was my (Relation of the Deceased to the Applicant);
4. That (Name of the Deceased) was issued Aadhar in his/her name and its number is .......................;
5. That the above said death was not registered in the Death Register of the records of ............. Panchayat / Municipal in the District of ............;
6. That no death certificate for Late (Name of the Deceased) has been obtained from any authority in India; and
7. That this affidavit is sworn into in order to obtain the Death Certificate from the competent authority;
 
DEPONENT

DECLARATION

I, Shri/Smt. (Name of the Applicant) declare that the statements from Para 1 to 7 in the above-mentioned affidavit are true to the best of my knowledge and belief and that nothing material has been concealed therefrom. I am aware that in case the information furnished above is found to be incorrect, I shall be liable for prosecution under the relevant law for the time being in force.
 
DEPONENT


Executed and signed before me by Shri/Smt ............................. in my court on this ....th day of (Month), 20xx.

EXECUTIVE MAGISTRATE

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