Free Affidavit Verification of Residency Form Template

Affidavit Verification of Residency Form

For verifying an individual's place of residence.

I, [Your Name], residing at [Your Address], being of legal age and competent to make this affidavit, declare under penalty of perjury the following:

AFFIANT INFORMATION

Name

    Date of Birth

      RESIDENCY INFORMATION

      Current Residential Address

        Length of Residency at This Address

        Start Date

          Present Date

            Purpose of Affidavit

            Check all that apply.

              • School Enrollment

              • Employment Requirement

              • Government Benefits

              • Legal Purposes

              Supporting Documentation

              Upload a file that provides a proof of your residency at the given address.

                AFFIRMATION & SIGNATURE

                I certify under penalty of perjury that the information provided in this affidavit is true and correct. I understand that false statements made in this affidavit may be punishable by law.

                Name:

                Date:

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