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AFFIDAVIT TO BE SWORN BY FATHER OR A MOTHER WHO CLAIMS
TO BE THE SOLE GUARDIAN OF THE CHILD

I (full name) __________________________________________________________
of (full address) _______________________________________________________
_____________________________________________________________________
aged ________ years and upwards, make oath and say as follows:-

1) I am the father/mother of (full names of child) _______________________________
born the ____ day of ________________ in the year of __________ . I beg to refer to the birth
certificate of the said child upon which, marked with the letter “X”, I have signed my name prior to the
swearing hereof.

2) I say that I am the sole guardian of the said child and that:

a)

there is no Court Order giving the father/mother or any other person Guardianship over the said
child:

b) that I have not entered into any arrangement or agreement which has the effect of making, or
purports to make the father/mother or any other person