Free Illinois Affidavit of Identity Template
Illinois Affidavit of Identity
STATE OF ILLINOIS
COUNTY OF [County Name]
Introduction:
I, [YOUR NAME], born on [Date of Birth], currently residing at [YOUR ADDRESS], being duly sworn, depose and say:
Statement of Facts:
-
I am the individual named in the documents presented in support of the application for [Type of License] License.
-
My Social Security Number is [SSN] (if applicable).
-
I have been a resident of [City/Town Name], Illinois, for [Number of Years/Months] prior to this affidavit's date.
-
I affirm that I am not impersonating, nor have I impersonated, any other individual for the purpose of misleading, defrauding, or any other unlawful act.
-
To the best of my knowledge, all information provided in this affidavit, and all documents submitted in support of my [Type of License] License application, are true, accurate, and complete.
-
I understand that providing false information within this affidavit may result in legal penalties, including but not limited to fines, denial of application, or criminal prosecution.
-
This affidavit is executed for the sole purpose of applying for a [Type of License] License as required by the State of Illinois and [Relevant State Department or Agency].
Acknowledgement:
I hereby authorize [Agency or Department Name] to verify the information provided in this affidavit.
Signed this [Day] of [Month], [Year].
Signature:
[YOUR NAME]
Subscribed and sworn to (or affirmed) before me this [Day] of [Month], [Year], by [YOUR NAME], who is personally known to me or has produced passport ID as identification.
[NOTARY PUBLIC NAME]
