Indiana Affidavit of Residency
This Affidavit of Residency is made in accordance with the laws of the State of Indiana. It is intended to affirm the residence of the undersigned individual.
Affiant Information:
- Name: ___________________________
- Address: _________________________
- City: ____________________________
- State: Indiana
- Zip Code: ________________________
- Date of Birth: ____________________
Affidavit Statement:
I, the undersigned, do hereby declare and affirm that I am a resident of the State of Indiana and that my current residence is as stated above. I have lived at this address since ___________________________.
Additional Information:
- Previous Address (if applicable): ______________________
- Duration of Stay at Current Address: __________________
- Reason for Residency: ________________________________
Affirmation:
I understand that this affidavit may be used for legal purposes and that any false statements made herein could result in legal penalties. I affirm that the information provided is true and accurate to the best of my knowledge.
Signature: _______________________________
Date: _______________________________
Notary Public:
State of Indiana
County of ____________________________
Subscribed and sworn to before me this _____ day of ____________, 20__.
Notary Signature: _______________________________
My Commission Expires: _________________________