Utah Affidavit of Residence
STATE OF UTAH
COUNTY OF [County Name]
Introduction:
I, [YOUR NAME], being duly sworn, declare and affirm under penalty of perjury that the following statements are true and accurate to the best of my knowledge:
Statement of Facts:
I, [YOUR NAME], born on [Date of Birth], hereby submit this affidavit for the purpose of establishing my residency in the State of Utah.
My Social Security Number is [SSN], provided here for identification purposes. I am currently residing at [YOUR ADDRESS], which serves as my permanent address.
For any communications regarding this affidavit, I can be reached at my telephone number, [YOUR TELEPHONE NUMBER], or via email at [YOUR EMAIL ADDRESS].
This information is provided to affirm my intent and to fulfill the necessary criteria for establishing my residency as per the requirements set forth by the relevant Utah authorities and institutions.
I hereby affirm that as of [Date], I have established and maintained a domicile in the State of Utah for a continuous period of not less than twelve (12) months immediately preceding the date of this affidavit.
I have not resided in the State of Utah solely for educational purposes but have established significant ties indicating my intent to reside in Utah indefinitely.
I understand that proof of residency may include, but is not limited to, a Utah driver's license or state ID, Utah voter registration, employment in Utah, ownership of property in Utah, rental agreements, or utility bills in my name at a Utah address.
Purpose:
This affidavit is executed for the purpose of establishing my eligibility for in-state tuition rates at [Name of College/University] in the State of Utah.
Declaration:
I understand that providing false information on this affidavit can result in penalties, including, but not limited to, repayment of tuition differences, dismissal from [Name of College/University], and legal action.
I hereby certify under penalty of perjury under the laws of the State of Utah that the foregoing is true and correct.
Executed on this [Day] of [Month], [Year].
Signature:
[YOUR NAME]
Subscribed and sworn to (or affirmed) before me this [Day] of [Month], [Year], by [YOUR NAME], proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.
[NOTARY PUBLIC NAME]
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