I, __________, __________, resident of __________, holding __________, do hereby solemnly affirm and declare as follows:
THE RESIDENCE CLAIMED
1.1 I claim domicile within __________.
1.2 My native place is __________.
1.3 I am __________.
PURPOSE
2.1 This affidavit is sworn in support of my application for a Domicile Certificate, needed for: __________.
DECLARATION
3.1 Every statement made above is true to my own knowledge and belief, and I have concealed nothing material to this application. I am aware that making a false declaration in an affidavit is an offence, and that the certificate may be cancelled if any statement made here is found false.
VERIFICATION
Verified at __________ on __________ that the contents of paragraphs 1 to 3 above are true and correct to my own knowledge, that no part of it is false, and that nothing material has been concealed.
Solemnly affirmed and signed before me on __________ at __________, the Deponent having been identified to my satisfaction by __________.
Notary Public / Oath Commissioner Registration No. and seal: ____________________
DOMICILE CERTIFICATE SUPPORTING AFFIDAVIT
Executed at __________ on __________.
I, __________, __________, resident of __________, holding __________, do hereby solemnly affirm and declare as follows:
THE RESIDENCE CLAIMED
1.1 I claim domicile within __________.
1.2 My native place is __________.
1.3 I am __________.
PURPOSE
2.1 This affidavit is sworn in support of my application for a Domicile Certificate, needed for: __________.
DECLARATION
3.1 Every statement made above is true to my own knowledge and belief, and I have concealed nothing material to this application. I am aware that making a false declaration in an affidavit is an offence, and that the certificate may be cancelled if any statement made here is found false.
VERIFICATION
Verified at __________ on __________ that the contents of paragraphs 1 to 3 above are true and correct to my own knowledge, that no part of it is false, and that nothing material has been concealed.