Affidavit of Domicile
This Affidavit of Domicile is executed in accordance with the laws of the State of [Insert State Name], to affirm the residence of the undersigned.
Affiant Information:
- Full Name: _______________________________________
- Address: __________________________________________
- City: ______________ State: ____ Zip Code: ________
- Email Address: ____________________________________
- Phone Number: _____________________________________
Statement of Domicile:
I, the undersigned affiant, do hereby declare that I am a resident of the State of [Insert State Name], and I maintain my domicile at the address stated above. This domicile is my principal and permanent residence.
Affiant Declaration:
If requested, I am prepared to provide additional information or documentation to verify my residency. Furthermore, I understand that this affidavit may be used for legal proceedings related to my domicile.
Signed under penalty of perjury:
Date: _______________
Signature: __________________________________________
Witness Statement:
Witnessed by:
- Name: ___________________________________________
- Address: _________________________________________
- City: ______________ State: ____ Zip Code: ________
Witness Signature: ___________________________________
Date: _______________
Notarization:
State of [Insert State Name]
County of _____________________
On this _____ day of _______________, 20__, before me, a notary public, personally appeared [Affiant's Full Name], known to me to be the person whose name is subscribed to this document.
Notary Public Signature: ____________________________
My Commission Expires: _____________________________