Notary For Affidavit Of Social Security
NOTARY FOR AFFIDAVIT OF SOCIAL SECURITY
I, [Your Full Name], of legal age, residing at [Your Address], being duly sworn, depose and say as follows:
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I am fully familiar with the facts contained herein and competent to make this affidavit.
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I am the holder of Social Security Number 123-4567-89, which was issued to me by the Social Security Administration (SSA) under federal law.
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I obtained my Social Security Number to accurately report my earnings and ensure eligibility for Social Security benefits, as mandated by the Social Security Act.
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I certify that the Social Security Number provided above is my correct and accurate Social Security Number, and it has not been altered, misused, or obtained fraudulently.
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I have never been issued any other Social Security Number, nor have I applied for or obtained a replacement Social Security Number, except as required by law or due to legitimate circumstances such as name changes or administrative corrections.
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I understand the importance of safeguarding my Social Security Number and agree to use it only for lawful purposes as authorized by the SSA, such as employment, tax reporting, and benefit eligibility verification.
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I acknowledge that providing false information regarding my Social Security Number may result in penalties under state and federal law, including but not limited to fines, imprisonment, and loss of benefits.
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I further affirm that I am not a minor or otherwise legally incapacitated, and I am fully competent to make this affidavit under penalty of perjury.
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I swear under penalty of perjury that the foregoing statements are true and correct to the best of my knowledge, belief, and understanding.
Executed on [Date] at [Location].
[Your Name]
State of [Your State]
County of [Your County]
Subscribed and sworn to before me on this [Day] of [Month], [Year].
[Notary Public Name]
[Notary Public Title]
My Commission Expires: [Commission Expiration Date]
[Notary Seal, if applicable]
