Person Who Cannot Supply Executed Lease Agreement Form printable pdf download

Town of Thornton NH

Town Clerk

16 Merrill Access Road

Town of Thornton

Thornton NH, 03285

603.726.4232

603.726.8168

Landlord’s Affidavit for Tenant

Person Who Cannot Supply Executed Lease Agreement

Used As One Proof of Residency

Tenant(s)/Resident: Take this form to your landlord and have him/her completely fill out all the information needed to

verify that you do reside at the property.

You must show Photo ID, and one other piece of evidence and complete the

Residency Form B.

To the Landlord: This form is used to document that this person presenting this form is living in the household/property.

Complete this form and return it to the resident, this form must be notarized (see below).

TENANTS INFORMATION

Tenants Name: ______________________________________________ Contact #:___________________

Legal Address:

______________________________________________Unit/Apt#___________________

Mailing Address:

_____________________________________________________________________

Tenants Signature:

______________________________________________

The penalty for perjury is a class B felony with a maximum sentence of imprisonment not to exceed seven (7) years

and/or a fine not to exceed $4,000

LANDLORD’S INFORMATION

Landlords Name:

__________________________________________________

Legal Address: _________________________________________________Contact Number: ___________________

Mailing Address if different from legal: ___________________________________________

The above listed person(s) are legal residents of my property in Thornton listed

above.

Landlords Signature

: ______________________________ Dated: ___________

*****The penalty for perjury is a class B felony with a maximum sentence of imprisonment not to exceed seven (7) years

and/or a fine not to exceed $4,000*****

Landlord’s signature must be notarized. If no notary available, a photocopy of landlord’s driver’s license must be

attached.

Notary Signature: _____________________________ Expiration Date: _____________________

FORM A

Person Who Cannot Supply Executed Lease Agreement Form