Affidavit of Residence

AFFIDAVIT OF RESIDENCE

Before you use this: Confirm the recipient accepts an affidavit. Complete the factual statements, then sign before an authorized notarial officer who will complete or attach the certificate required where the oath or affirmation is administered.

State of [STATE]
County of [COUNTY]

I, [AFFIANT'S FULL LEGAL NAME], being duly sworn or affirmed, state from personal knowledge:

1. I am ☐ the person whose residence is described below ☐ a person with firsthand knowledge of [RESIDENT'S FULL LEGAL NAME]'s residence. My relationship to that person is [________________________________].

2. The person whose residence is described is [RESIDENT'S FULL LEGAL NAME].

3. The residence address is [STREET ADDRESS, UNIT, CITY, STATE, ZIP CODE].

4. The person began residing at this address on or about [__/__/____] and ☐ resides there now ☐ resided there until [__/__/____].

5. My firsthand basis for these statements is [EXPLAIN HOW YOU KNOW: OWN OCCUPANCY, SHARED HOUSEHOLD, PROPERTY MANAGEMENT RECORDS YOU MAINTAIN, OR DIRECT OBSERVATION].

6. The person's occupancy arrangement, if known, is ☐ owner ☐ tenant ☐ member of my household ☐ other: [________________________________].

7. The following documents are attached and identified by me: [NONE / EXHIBIT A: __________ / EXHIBIT B: __________]. They support the facts stated in paragraphs [____].

8. I make this affidavit for [RECIPIENT AND PURPOSE]. The statements above are true to the best of my personal knowledge.

Affiant's signature: [________________________________]

Printed name: [________________________________]

Date signed: [__/__/____]

Contact address: [________________________________]

Phone or email: [________________________________]

Notarial certificate

The notarial officer shall complete or attach the certificate required for an oath or affirmation in the place of notarization.

Notarial officer's signature and seal, or attached certificate: [________________________________]