Nevada Affidavit of Residency
This document certifies that the undersigned individual is a resident of the State of Nevada, in compliance with all relevant state residency requirements.
Section 1: Affiant Information
Full Name: ____________________________
Date of Birth: ____________________________
Nevada Address: __________________________________________________
City: ___________________ State: NV Zip Code: ___________
Phone Number: ____________________________
Email Address: ____________________________
Section 2: Residency Information
1. Length of Residency in Nevada:
_____ Years _____ Months
2. Purpose of Residency Declaration:
- Employment
- Education
- Voter Registration
- State Benefits
- Other (Please specify): ________________
Section 3: Declaration
I, _______________ (the "Affiant"), declare under penalty of perjury under the laws of the State of Nevada that the foregoing is true and correct to the best of my knowledge. I understand that providing false information can result in penalties under state law.
Executed on this ______ day of ________________, 20____.
_____________________________
Signature of Affiant
_____________________________
Printed Name of Affiant
Section 4: Notarization (If Applicable)
This section should be completed by a notary public if required for the intended use of this affidavit.
State of Nevada )
County of _______ )
Subscribed and sworn to (or affirmed) before me on this ____ day of ____________, 20____, by __________________________, who is personally known to me or who has produced __________________________ as identification.
_____________________________
Notary Public
My Commission Expires: ___________
