60   No. 41970 GOVERNMENT GAZETTE, 12 OCTOBER 2018 L0000000001 C2. DETAILS OF THE CHILD Surname as at birth Forenames in full Date of birth (YYYYMMDD) Y Y Y Y M M M M M M M M M D D Sex Place of birth Contact number C3. COMPULSORY FOR THE NOTICE GIVEN AFTER 30 DAYS I, ................................................................................................................................. parent/legal guardian/next of kin of ................................................................................................................................. declare that I wish to register the birth of the above mentioned child after 30 days because of the following reason(s): The deponent and the Commissioner of Oaths to initial each page of the Affidavit. C4. DECLARATION NOTE: Commissioner of Oaths must be an authorised DHA official at the office where application is submitted I,..................................................................................................................................................., hereby declare under oath/affirm that the information submitted in this Affidavit and the Notice of Birth is true and correct, and I understand that a false statement is punishable under section 31 of the Births and Deaths Registration Act 51 of 1992. Date Signature of deponent Y Y Y Y M M M M M M M M M D D I certify that before administering the oath I asked the deponent the following questions and wrote down his or her answers in his or her presence: (1) Do you know and understand the contents of this declaration? Answer: (2) Do you have any objection to taking the prescribed oath? Answer: (3) Do you consider the prescribed oath as binding on your conscience? Answer: I certify that the deponent has acknowledged that he or she knows and understands the contents of this declaration which was sworn to/affirmed before me and that the deponent’s signature or mark was affixed to the declaration in my presence. Signature of the Commissioner of Oaths Surname Forenames Designation (rank) Persal number Business Address Area code Departmental Stamp Place Date Y Y Y Y M M M M M M M M M D D Page 8 of 9 This gazette is also available free online at www.gpwonline.co.za