New Mexico Affidavit of Identity
State of New Mexico
County of [County Name]
Introduction:
I, [YOUR NAME], of [YOUR ADDRESS], being duly sworn, depose and say:
Statement of Facts:
I, [YOUR NAME], hereby affirm under penalty of perjury my personal identification details as required.
I was born on [Date of Birth] in [Place of Birth].
My Social Security Number is [Social Security Number], which is provided for the purpose of confirming my identity.
This information is true and accurate to the best of my knowledge and is provided to aid in the verification of my identity and the replacement of my lost or stolen identification document.
I hereby declare under penalty of perjury that I am the individual legally recognized as [YOUR NAME] and that I am commonly identified by the name stated above.
I report that my original [Specify Document]
a. Issued by: [Issuing Authority]
b. Identification Number: [ID Number]
c. Date of Loss/Theft: [Date]
d. Place of Loss/Theft: [Place]
e. If applicable, Police Report Number: [Report Number]
Purpose:
This Affidavit is made for the purpose of obtaining a replacement for the said lost/stolen identification document and for verifying my identity in the absence of the primary identification document.
Non-Duplication:
I affirm that, to the best of my knowledge, the lost/stolen identification document is not in the possession of any unauthorized person or used for fraudulent purposes.
Indemnification:
I hereby indemnify and hold harmless any entity relying on this affidavit for any claims, damages, or losses incurred as a result of accepting this affidavit as proof of my identity.
Oath:
I understand that this affidavit is given under oath and subject to the penalties of perjury under the laws of the State of New Mexico.
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 who appeared before me.
[NOTARY PUBLIC NAME]
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