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AFFIDAVIT
AFFIDAVIT
FURTHERMORE,
This Affidavit of Birth is being prepared and executed on behalf of the following individual:
SAID MZEE SAID was born on 11/12/2000 at MWANANYAMALA HOSPITAL in the City
of DAR-ES SALAAM in the State of DAR-ES-SALAAM located in the Country of
TANZANIA for the purpose and reason of verification of living birth and living.
______________
(Affiant Signature)
______________
(Date)
STATE OF _______________________)
COUNTY OF _____________________ )
NOTARY ACKNOWLEDGMENT
On __________________ the aforementioned Affiant did personally appear before me, and who
is personally known to me (or proven to me on the basis of satisfactory evidence) to be the
person whose name is subscribed to the within instrument and acknowledged to me that he/she
executed the same in his/her authorized capacity, and that by his/her signature on the instrument
above, or the entity upon behalf of which the person acted, executed the instrument.
WITNESS my hand and official seal.
_________________
(NOTARY SIGNATURE)