Vermont Affidavit of Residence
STATE OF VERMONT
COUNTY OF [County Name]
Introduction:
I, [YOUR NAME], under penalty of perjury, hereby declare and affirm the following:
Statement of Facts:
I, [YOUR NAME], born on [Date of Birth], hereby affirm under penalty of perjury the following.
I am a resident of Vermont, living at [YOUR ADDRESS].
This has been my physical residence for [Number of Months/Years], a tenure beginning [Date of Moving In].
Should my mailing address differ from my residence, it is as follows: [YOUR ADDRESS].
For any necessary contact, I can be reached at my phone number, [YOUR TELEPHONE NUMBER], or at my email address, [YOUR EMAIL ADDRESS].
Purpose of Affidavit: This affidavit is made for the purpose of obtaining a Vermont State Driver's License or State Identification Card.
Additional Information:
In addition to the information provided, I hereby declare that I have not held a driver's license in any other state within the past two years.
I understand that providing false information on this affidavit can result in penalties under the law. I affirm that the information provided in this affidavit is true and accurate to the best of my knowledge and belief.
Signature:
[YOUR NAME]
Subscribed and Sworn to before me this [Date of Notarization].
[NOTARY PUBLIC NAME]
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