State Of South Carolina - Affidavit Of Residence

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STATE OF SOUTH CAROLINA
)
AFFIDAVIT OF
)
RESIDENCE
COUNTY OF GREENVILLE
)
PERSONALLY appeared before me, _____________________________________,
residing at_________________________________________________________________,
who does solemnly swear that_________________________________________________,
(adult)
_________________________________________________________________________,
(children)
Are lawfully residing with me at my resident address stated above as of ________________.
(date)
I understand that if it is found that I have willfully and knowingly sworn to false information in
this affidavit, that pursuant to Section 16­9­30 of the South Carolina Code of Laws, I may be
found guilty of a felony and, upon conviction must be fined at the discretion of the court of
imprisoned for not more than five years, or both.
___________________________  
(Signature)
Sworn to before me this
____day of _____________________, 20____
___________________________________(I.S.)
Notary Public for South Carolina
My Commission Expires:_____________________
1/23/2012 ­

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