STATE OF [State]
COUNTY OF [County]

I, [NAME OF SIGNATORY], being duly sworn, do hereby declare and affirm as follows:

1. Personal Information

   • Full Name: [NAME OF SIGNATORY]

   • Date of Birth: [DATE OF BIRTH]

   • Place of Birth: [PLACE OF BIRTH]

   • Nationality: [CURRENT NATIONALITY]

   • Address: [CURRENT ADDRESS]

   • Passport Number: [PASSPORT NUMBER]

2. Declaration of Citizenship
   I am a citizen of [COUNTRY OF CITIZENSHIP] and hold a valid passport issued by [COUNTRY OF ISSUANCE]. I have not renounced my citizenship in any country, and I am not a citizen of any other country except [COUNTRY OF CITIZENSHIP].

3. Declaration of Residency
   I currently reside at the address stated above and have been a resident of [CURRENT COUNTRY OF RESIDENCE] since [DATE OF MOVING TO CURRENT COUNTRY]. My residency status is lawful, and I am not subject to any restrictions or conditions that might affect my application for OCI status.

4. Purpose of Affidavit
   This affidavit is being submitted in support of my application for Overseas Citizen of India (OCI) status. The information provided herein is accurate and complete to the best of my knowledge and belief.

5. Verification
   I understand that any false statement or misrepresentation made in this affidavit may result in the denial of my OCI application or other legal consequences.

Signature:

[NAME OF SIGNATORY]

Date:

NOTARY PUBLIC SECTION

Subscribed and sworn to before me this [DAY] day of [MONTH], [YEAR].

Signature of Notary Public:

Printed Name of Notary Public:

Notary Public Seal:
[SEAL]

My Commission Expires:

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