State of __________ Rev. 133C90C

AFFIDAVIT OF IDENTITY
 
State of __________
County of __________
 
I, the undersigned, being duly sworn, hereby affirm on __________, that: 

  1. My legal name is __________. My date of birth is __________.

  2. My social security number is:  

  3. I currently reside at the following address: __________, __________, __________ __________. 

  4. My telephone number is: __________. 

  5. I have presented to my Notary public, as proof my identity, the following valid  ID: __________ 

  6. The purpose of this affidavit is to provide, establish, and verify my identity for: __________ 

  7. I understand that falsification of this affidavit may be a criminal offense and could lead to
prosecution to the fullest extent of the law.
 
 

Signature

__________
Printed Name

  

Affidavit of Identity (Rev. 133C90C) 1/1

 
  
NOTARY ACKNOWLEDGEMENT
 
 
State of __________      )
                                                            )           (Seal)
County of __________       )
 
 
The foregoing instrument was acknowledged before me this _______ day of __________________,
20_____, by the undersigned, __________, who is personally known to me or satisfactorily proven to me
to be the person whose name is subscribed to the within instrument.
 
 
_____________________________________
Signature
 
 
_____________________________________
Notary Public
 
My Commission Expires: ________________

Affidavit of Identity (Rev. 133C90C) 2/1

This page intentionally left blank.
GENERAL INSTRUCTIONS ·         Law enforcement agencies; and
·         Dealing with creditors

WHAT IS AN AFFIDAVIT OF Due to the wide variety of circumstances where this
IDENTITY? type of affidavit is required, one can expect most
institutions to notify them if one is needed for a
An affidavit of identity is a legal document which affirms certain transaction or event.
someone is who they say they are.  Sometimes, the
identity of an individual is essential to a transaction.  Due to the wide variety of circumstances where this
Because of concerns about fraud and identity theft, a type of affidavit is required, one can expect most
person’s word is not always considered sufficient.  In institutions to notify them if one is needed for a
those cases, people take certain, universally agreed certain transaction or event.
upon steps to establish proof of identity.  These steps,
once completed, result in a piece of paper containing THE CONSEQUENCES OF NOT
relevant information, called an affidavit of identity.  This
affidavit is considered legal proof a person is who they
HAVING ONE
say they are.
There are two key purposes of an affidavit of
identity. The first is to authenticate identity, and the
WHEN DO I NEED ONE? second is to verify the signature. Not having this
affidavit can result in a lack of confidence in either
There are a number of different circumstances that identity or the legitimacy of a signature. More
may require an affidavit of identity. Below are just a few specifically, not having one can result in certain
examples of times where an affidavit of identity is or transactions being blocked or not allowed. 
may be required: 

·         Certain court proceedings;

·         Some banking transactions;
WHAT SHOULD BE INCLUDED?
·         Sole proprietors doing business under
a business name in certain At a minimum, an affidavit of identity should
jurisdictions, such as Los Angeles include the following information:
County, Kern County, and San Diego
County; ·         State issued identification card;
·         When running for elected office, in ·         State issued driver's license;
some states, such as Michigan; ·         United States passport;
·         When running for elected office, in ·         United States military identification
some states, such as Michigan; card;
·         Business owners may request one ·         Resident alien identification card
from customers or clients in certain (sometimes referred to as a "green
circumstances; card")
·         Working with title companies;
·         Drafting temporary guardianship papers; Some states also allow the use of foreign
and; passports, and driver’s licenses from Mexico and
·         Creating power of attorney Canada. Other government issued identification
is not considered acceptable.  This includes
When someone is a victim of identity theft, affidavits of things such as:
identity are used in multiple circumstances, including:
·         Social security cards;
·         When filing state income tax returns in ·         Birth certificates;
some states; ·         School identification cards; and
·         With credit bureaus; ·         City, County, or State employee
identification cards.

Affidavit of Identity (Rev. 133C90C)