Affidavit Of Age Of Child

STATE OF ----------)

) s.s.:

COUNTY OF ---------)

[Name] (Affiant), being duly sworn, deposes and says:

1. That Affiant is the [relationship] of the minor child [name].

2. That Affiant is well acquainted with the child and states that to the best of Affiant's knowledge the child was born on or about [date], and is now [number] years of age.

[signature]

Affiant

*** If Required By FederaL or State Law ***

This Section for Notary:

ACKNOWLEDGMENT

State of _________

County of ________ [COUNTY]

On [DATE] before me, [NAME OF NOTARY], notary, personally appeared [NAME OF PERSON(S) INVOLVED], personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.

Witness my hand and official seal.

Signature ________
Notary

My commission expires: _____

(Seal)