AFFIDAVIT FOR DOMICILE CERTIFICATE
AFFIDAVIT
I, {{full_name}}, S/o / D/o / W/o {{father_s_husband_s_full_name}}, aged {{age}} years, residing at {{complete_residential_address}}, do hereby solemnly affirm and declare as follows:
1. That I am the deponent herein and am fully acquainted with the facts stated in this affidavit.
2. That I am a permanent resident of {{village_town_city_district_state}} and my permanent residential address is {{complete_residential_address}}.
3. That I have been ordinarily residing at the above-mentioned address for the past {{number_of_years}} years.
4. That I am a domiciled resident of the State of {{state_name}}.
5. That this affidavit is executed for the purpose of obtaining a Domicile Certificate from the competent authority.
6. That the statements made herein are true and correct to the best of my knowledge and belief, and nothing material has been concealed therefrom.
Place: {{place}}
Date: {{date_in_dd_mm_yyyy_format}}
DEPONENT
(Signature)
VERIFICATION
I, the above-named deponent, do hereby verify that the contents of this affidavit are true and correct to the best of my knowledge and belief and that nothing material has been concealed therefrom.
Verified at {{place}} on this {{day}} day of {{month}}, {{year}}.
DEPONENT
(Signature)
Attested before me
(Signature & Seal of Notary Public / Executive Magistrate)