CHANDIGARH ADMINISTRATION GOVERNMENT REGISTAR BIRTH & DEATH e-JAN SAMPARK AFFIDAVIT SPECIMEN OF REGISTRATION OF DEATH I-----------------S/O resident of H.NO-----------------do hereby affirm and decline as under:1.That my father /mother /wife/sh./ smt.----------------------- s/o/w/o sh.-----------------------r/o-------------------------------------------died on ------------ 2. That the death event of sh./ smt .-------------------------s/o/w/o sh.-----------died on-------------couldn't be reported Registered, Births& death ,Chandigarh due to some unavoidable circumstances 3 That sh./Smt ----------------------------------------------------------------s/o/w/o sh.-------------------------------------------------------was suffered from 4. That body of sh./ smt .---------------------------------------------s/o/w/o sh --------------------------------------------was cremated at cremation ground sector ---------------on-------------------------- 5.That is prayed the death event of sh./ smt .----------------------------------- may be registered in the record of death of Chandigarh. DEPONENT VERIFICATION: -verified that the contents of this affidavit are true and correct to the best of knowledge and belief and nothing has been concealed therein. DEPONENT CHANDIGARH DATED---------/-----------/------------ e -JAN SAMPARK : Information Gateway of Chandigarh Administration Page :1 of 1
