A sworn statement confirming your identity and any other names you've been known by. Commonly used when names don't match between documents (maiden name, anglicized name, typos on records, etc.).
This is what your final document will look like. The watermark is removed after payment.
STATE OF _______________
COUNTY OF _______________
I, [Affiant Name], being of legal age and being duly sworn, hereby declare under penalty of perjury that:
My full and correct legal name is [Affiant Name]. I was born on [DOB].
My current residence address is:
[Street]
[Apt]
[City], [ST] [ZIP]
Telephone: [Phone]
Government-issued identification:
I have also been known, or have appeared on records, under the following names. I affirm that I am the same person identified by each name listed below for all legal and identification purposes.
This affidavit is provided for the following purpose:
I declare under penalty of perjury under the laws of the State of _______________ that the foregoing is true and correct to the best of my knowledge and belief.
Executed on this [Date].
AFFIANT
Signature
[Name]
Printed Name
Date:
State of _______________________, County of ______________________
Sworn to (or affirmed) and subscribed before me by means of [ ] physical presence or [ ] online notarization, this _______ day of ____________________, 20_____, by ______________________________________, who is personally known to me or who has produced ______________________________________ as identification.
Notary Public Signature
Printed Name: ______________________________________
Commission No.: _________________ Expires: _________________
[ AFFIX NOTARY SEAL HERE ]
Prepared via YYMA Documents · yymanotary.com · Self-help document preparation · Not legal advice
ESTADO DE _______________
CONDADO DE _______________
Yo, [Nombre del Declarante], siendo mayor de edad y debidamente juramentado(a), declaro bajo pena de perjurio lo siguiente:
Mi nombre legal completo y correcto es [Nombre]. Naci el [Fecha de Nacimiento].
Mi direccion de residencia actual es:
[Calle]
[Apt]
[Ciudad], [ST] [ZIP]
Telefono: [Telefono]
Identificacion oficial:
Tambien he sido conocido(a), o he aparecido en registros, bajo los siguientes nombres. Declaro que soy la misma persona identificada por cada nombre listado abajo para todos los propositos legales y de identificacion.
Este affidavit se proporciona para el siguiente proposito:
Declaro bajo pena de perjurio bajo las leyes del Estado de _______________ que lo anterior es verdadero y correcto.
Ejecutado en este [Fecha].
DECLARANTE
Firma
[Nombre]
Nombre Impreso
Fecha:
Estado de _______________________, Condado de ______________________
Juramentado (o afirmado) y suscrito ante mi, en este dia _______ de ____________________, 20_____, por ______________________________________.
Firma del Notary Public
Nombre impreso: ______________________________________
No. de Comision: _________________ Vence: _________________
[ COLOCAR SELLO NOTARIAL AQUI ]
Preparado por YYMA Documents · yymanotary.com · Preparacion autoservicio · No es asesoria legal
