Affidavit of Residency
This Affidavit of Residency is made pursuant to the laws of the State of [State Name], specifically referring to [relevant state law if applicable]. The purpose of this document is to declare the residency status of the affiant, who affirms the truth of the statements made herein.
I, [Your Full Name], residing at [Your Address], hereby declare and affirm under penalty of perjury that the following is true and correct:
- I have resided at the above address since [Date of Move-In].
- The address listed above is my permanent residence.
- I do not maintain any other residence.
In support of this affidavit, I provide the following information:
- Date of Birth: [Your Date of Birth]
- Social Security Number: [Your SSN or the last four digits]
- Phone Number: [Your Phone Number]
- Email Address: [Your Email Address]
Additional documentation that may be included to support this affidavit could consist of:
- Utility bills
- Lease agreements
- Government-issued identification with the current address
By signing below, I confirm that the statements provided are accurate and reflect my true residency status. I understand that this affidavit will be used for [specific purpose, if applicable, e.g., applying for a government benefit, school enrollment, etc.], and false statements can lead to criminal penalties.
Signed this ____ day of __________, 20____.
_________________________
[Your Signature]
[Your Printed Name]
Witnessed by:
_________________________
[Witness Signature]
[Witness Printed Name]
Notary Public:
_________________________
[Notary Signature]
[Notary Printed Name]
My commission expires: ____________