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Get CA Affidavit of Homeless Status for Fee Exempt Certified Copy of Birth Certification 2015

S person or a homeless child or youth. This affidavit must be used for the purpose of requesting a fee exempt certified copy of a Certificate of Live Birth. SECTION I. To be completed by the person making the request for the certified birth record (hereafter: “requestor”) I, _________________________________ swear or affirm, to the best of my knowledge and belief, Printed Name of Requestor that on the date listed below in this section, I am: ____ a homeless person, or homeless child or yo.

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