1. (a) Any person making an affidavit under Section 7-57 of the Connecticut General Statutes for the preparation and filing of a belated certificate of birth shall include the following information on the individual whose certificate is being requested:

   1. (1) first, middle, and last name;
   2. (2) sex;
   3. (3) date of birth;

   4. (4) place of birth;

      1. (A) town;
      2. (B) county; and(C) hospital name or address of out-of-hospital birth;
   5. (5) mother's maiden name; and(6) father's full name.
2. (b) A belated registration of birth shall not be prepared for any deceased person.

(Adopted effective March 4, 1996)