Affidavit of Citizenship Evidence

I, [Your Name], solemnly declare and affirm under penalty of perjury that the following statements are true and correct to the best of my knowledge and belief:

1. I am a citizen of [Country Name], having been born on [Birthdate] in [Birthplace].

2. My citizenship status is as follows:

• I was born a citizen of [Country Name].

• I have never renounced my citizenship.

• I have never been deprived of my citizenship by any legal action or decree.

3. I understand that providing false information on this affidavit is a criminal offense and may result in legal consequences.

4. I hereby authorize any government agency or entity requiring proof of citizenship to verify the information provided in this affidavit through official channels.

5. I understand that this affidavit is being provided for the purpose of applying for government benefits or services that require proof of citizenship, and I affirm that I meet all eligibility requirements for such benefits or services.

[Your Name]
[Date]

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Sworn to and subscribed before me this [Date] by [Your Name], who is personally known to me or who has provided [identification type and number] as identification.

[Notary Public Name]
[Date]

My Commission Expires: [Date]

[Notary Seal]

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This affidavit is provided in good faith and to the best of my ability to assist in verifying my citizenship status for the purpose stated above.

[Your Name]

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