Diocese of Sacramento
The Tribunal
2110 Broadway, Sacramento CA 95818
(916) 733-0225
www.tribunal.scd.org
Witness Affidavit Regarding Baptismal Status of
________________________________________________
(First, Middle, Last Name; include Maiden if applicable)
A certified copy of the baptismal certificate is not possible because: (please check reason)
The baptism was not entered into the sacramental register book. This has been verified by the parish.
The parish’s records were destroyed by fire or other natural disaster. This has been verified by the
parish and/or diocese.
Other: ___________________________________________________________________________.
Oath: “Do you solemnly swear before Almighty God to tell the whole truth and
nothing but the truth in answering the following questions?” ________
Witness Name _______________________________________________________________________
Address/City/State/ZIP ________________________________________________________________
Your relationship to the above-named person ______________________________________________
I hereby attest that I have known the above-named person for _______ years and that: (check one)
He/She is a baptized Catholic. Date of Baptism ___________________________________________
Name of Church and Address/City/State/ZIP _______________________________________________
He/She is a baptized Christian. Date of Baptism ___________________________________________
Name of Church and Address/City/State/ZIP _______________________________________________
He/She has never been baptized, sprinkled, christened, or initiated into any Christian religion.
If you are not a parent or the godparent of the above-named party, what is the source of your
knowledge about his/her baptism and religious background?
_________________________________________________________________________
TO BE COMPLETED BY CATHOLIC PASTOR OR HIS DELEGATE:
I know the witness personally or
I have verified his/her government-issued identification.
Type and Number: __________________________________________________________________
(Driver’s license, Passport, etc.)
_____________________________________________ ___________________
Witness Signature Date
_____________________________________________ ___________________
Pastor or Delegate – Signature Date
_____________________________________________
Pastor or Delegate – Print Name
Affix parish seal or stamp here.
