West Virginia Affidavit of Residency
This West Virginia Affidavit of Residency is provided to certify the residency of the individual named within. It is to be completed in accordance with the relevant state legal requirements, specifically those set forth under the West Virginia Code. By completing this affidavit, the affiant attests under penalty of perjury that the information provided is true and accurate to the best of their knowledge.
Please complete the following information:
- Full Legal Name: _______________________________
- Residential Address: ___________________________
- City: _____________________ State: WV Zip: ________
- Date of Birth: _______________
- West Virginia Driver’s License or State ID Number: ____________
- Duration of Residency in West Virginia: _______________
By signing below, I, _______________ (the "Affiant"), hereby swear and affirm that all the information provided above is accurate and true. I understand that providing false information on this affidavit can lead to penalties as per West Virginia law.
Date: _____________
Affiant's Signature: ___________________
State of West Virginia
County of ___________________
Subscribed and sworn to (or affirmed) before me this ___ day of ____________, 20___, by ________________________ (Affiant’s name), proving to be the person whose name is subscribed to the within instrument.
Witness my hand and official seal:
Notary Public Signature: ______________________
My commission expires: ________________________