Affidavit of Citizenship - California
AFFIDAVIT OF CITIZENSHIP
I _________________________________, solemnly swear that I am a
(Name of Affiant)
citizen of the United States of America
[ ] I was born in the U.S.A.
[ ] I became a citizen on Date____________Approximate Date______________ and I was
born in City__________________Country of Birth_______________________
[ ] State driver’s license [ ] State Identification [ ] U.S.A. Military ID [ ] U.S.A. Passport
number is_________________________and expires on ______________
[ ] Other Identification-please specify________________________________
______________________________________
(Signature of Affiant)
State of California
County of __________________
Subscribed and sworn to (or affirmed) before me on this ________ day of
______________________, 20_____ by ___________________________________________,
proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.
________________________________________
Notary Public Signature
(Seal)
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