Connecticut Affidavit for Residence

STATE OF CONNECTICUT

COUNTY OF [County Name]

Introduction:

I, [YOUR NAME], being duly sworn, depose and say:

Statement of Facts:

1. I, [YOUR NAME], born on [DATE OF BIRTH], currently reside at [YOUR ADDRESS].

2. I can be reached at [YOUR TELEPHONE NUMBER] or via email at [YOUR EMAIL ADDRESS].

3. This affidavit is to declare and confirm my residency within the state of Connecticut for the purposes of obtaining a public library membership.

4. I hereby declare that I am a resident of the State of Connecticut, residing at the address stated above. I have lived at this address since [Date You Started Living at the Address].

5. This affidavit is made for the purpose of providing proof of residency within the municipality/state of Connecticut for obtaining a public library membership.

Additional Statements:

I affirm that the information provided in this affidavit is true and correct to the best of my knowledge and belief. I understand that providing false information on this affidavit can result in penalties under the law.

Documentation Attached (Optional):

Attached herewith are [Number of Documents] documents as proof of my residency, including a utility bill, lease agreement, and a copy of my driver's license.

Sworn to (or affirmed) and subscribed before me this [Day] of [Month], [Year].

Signature:

[YOUR NAME]

[NOTARY PUBLIC NAME]

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