Name:
Address:
Date:
To whom this may concern,
I, (hereinafter the "Affiant"), formally acknowledge living at , since .
I also confirm that the following persons reside with me at the aforementioned address:
The following documents for your consideration have been attached as evidence of my residency:
The purpose of this Letter is to confirm the Affiant's place of residence.
I swear and affirm, under penalty of perjury, that the information and facts set forth in this statement are true and accurate to the best of my knowledge.
Sincerely,
Signature: ____________
Notary Acknowledgment
Sworn to and subscribed before me on ____________________________
____________________________
Place for signature
Notary public's name and seal