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Affidavit of Identity
STATE OF __________
 COUNTY OF __________
I, the undersigned, being of sound mind and body, do attest and confirm the following facts:

  1. My legal name is __________.

  2. My current legal address _____________.

  3. My date of birth is __________.

  4. My telephone number is __________.

  5. My social security number is __________.

  6. I provided the following form of identification to the Notary Public to prove my identification: _____________.

  7. This Affidavit of Identity is being sworn for the following reason: _____________

  8. I am aware that any false information on this Affidavit of Identity is punishable to the fullest extent of the law, up to and including monetary fine or imprisonment.

  9. The below is my true and correct signature.



Oath or Affirmation of Affiant:
 I certify under penalty of perjury under __________ law that I know the contents of this Affidavit signed by me and that the statements are true and correct to the best of my knowledge.

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__________

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Date



STATE OF __________
 COUNTY OF __________

On this _ _ _ _ day of _ _ _ _ _ _, _ _ _ _, before me, _ _ _ _ _ _ _ _ _ _ _ _, personally appeared __________, known to me (or satisfactorily proven) to be the persons whose name is subscribed to the within affidavit and being first duly sworn on oath according to law, deposes and says that he/she has read the foregoing Affidavit subscribed by him/her, and that the matters stated herein are true to the best of his/her information, knowledge and belief.

In witness whereof I hereunto set my hand and official seal.

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Notary Public

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Title(and Rank)

My commission expires: _ _ _ _ _ _ _ _ _