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Affidavit of Residence
STATE OF __________
COUNTY OF __________

I, the undersigned, being of lawful age, do attest and confirm the following facts under penalty of perjury:

  1. My legal name is as follows: __________.

  2. My date of birth is: __________.

  3. I currently reside at the following address: __________.

  4. I have resided at the above address for a period of __________ year(s).

  5. My social security number is __________.

  6. The following people can attest to my residency at this location:
    Name: __________
    Relationship to me: __________
    Name: __________
    Relationship to me: __________



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.

___________________
__________

Date
__________



NOTARY ACKNOWLEDGMENT

STATE OF __________
COUNTY OF __________
Please select a valid state for the notary acknowledgment template.