West Virginia Affidavit of Identity

I, [YOUR NAME], residing at [YOUR ADDRESS], State of West Virginia, do solemnly affirm and declare under penalty of perjury:

Statement of Facts

1. That I am the individual named herein.

2. That I am applying for government benefits from [GOVERNMENT AGENCY NAME] and am required to provide proof of my identity.

3. That the information provided herein is true and correct to the best of my knowledge.

4. That I understand the consequences of providing false information and affirm the authenticity of the documents submitted herewith.

5. That I am aware that this Affidavit of Identity may be used by [GOVERNMENT AGENCY NAME] to verify my identity and process my application for government benefits.

Signature

[YOUR NAME]

Sworn to and subscribed before me this [DATE].

[NOTARY PUBLIC'S NAME]

Notary Public

My Commission Expires:                               

Please ensure to provide any additional documentation or information required by [GOVERNMENT AGENCY NAME] to support your application for government benefits.

This Affidavit of Identity is intended to facilitate the application process for government benefits and should be submitted along with any other required documentation to the relevant government agency. It attests to the applicant's identity and verifies the accuracy of the information provided.

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