North Carolina General Affidavit
STATE OF NORTH CAROLINA
COUNTY OF [County Name]
Introduction:
Before me, the undersigned Notary Public, on this day personally appeared [YOUR NAME], who being duly sworn, deposes and says:
Statement of Facts:
- Identification of Affiant: - Name: [Affiant’s Full Name] 
- Address: [Affiant’s Full Address] 
- Date of Birth: [DOB] 
- Identification Number: [Driver’s License/State ID/Passport Number] 
 
- I, [YOUR NAME], hereby declare and affirm the following facts under the penalty of perjury: 
- I am the legal holder in possession of the document titled [Document Title], dated [Document Date], and related to [Brief Description of the Document or Information's Purpose]. 
- I affirm that to the best of my knowledge and belief, the document is authentic and the information contained within, as submitted to [Name of the Government Agency], is accurate and true. 
- This affidavit is executed for the purpose of verifying the authenticity of the above-mentioned document and the accuracy of the information provided to [Name of the Government Agency] for personal information and circumstances for the purpose of updating my driver's license records with the Department of Motor Vehicles. 
Acknowledgment:
I understand that providing false information within this affidavit constitutes an offense under the laws of the State of North Carolina, and I declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge, information, and belief.
Executed on this [DAY] of [MONTH], [YEAR], in the County of [County Name], State of North Carolina.
Signature:

[YOUR NAME]
Subscribed and sworn to (or affirmed) before me on this [DAY] of [MONTH], [YEAR], by [YOUR NAME].

[Notary Public’s Printed Name]
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