Affidavit of Residence

State: Alabama
County: ________

I, the undersigned, being of lawful age, do attest and confirm the following facts under penalty of perjury:

1. My legal name is as follows: ________.

2. My date of birth is ________.

3. I currently reside at the following address:

________

4. I have resided at the above address for a period of: ________.

5. The following individuals also reside at the address above:

________

6. I provided the following form of identification to the Notary Public to prove my identification:

________

7. This Affidavit of Residence is being sworn for the following reason:

________

8. I am aware that any false information on this Affidavit of Residence is punishable to the fullest extent of the law, up to and including monetary fine or imprisonment.

9. The below is my true and correct signature.

I swear under penalty of perjury that I am the party described above and that all statements in this Affidavit of Residence are true and correct.

________

Signature: _____________________

Date:_________________________

State of Alabama Notarization:

State: Alabama
County: ________

On the following date: ________________________ before me personally appeared the above signatory. I am a Notary Public in and for the state of Alabama and the signatory above is personally known to me or proved to me on the basis of satisfactory evidence to be the person(s) whose name is signed herein and acknowledged that he/she/they executed the same.

WITNESS my hand and official seal:

Seal:

Name: __________________________________

Signature: _______________________________

My commission expires: ____________________