Residency Form

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Town of Thornton NH
Town Clerk
16 Merrill Access Road
Town of Thornton
Thornton NH, 03285
603.726.4232
603.726.8168
RESIDENCY FORM
Must Show Photo ID along with two Proofs of Residency
I , ______________________________________________, declare and sign under penalty of unsworn falsification
that I am a resident of Thornton, New Hampshire, and of no other state and I reside at:
Street & Number_____________________________________________
With a mailing address of______________________________________
Town______________________________________________________
Telephone number________________________________________
I (We) do _______/do not _________ have a dog(s). (Please check one)
st.
NH RSA (466:1) Dogs need to be licensed each year before May 1
Bring current rabies certificate and spaying or neutering Certificate.
Resident Signature:__________________________________________
________________
Signed under penalty of unsworn falsification
Date
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
FOR CLERK USE ONLY
The following was presented as proof of identity (to be completed in Clerks Office):
__________ Photo driver’s license issued by (State) ___________ (license #) _______________________
__________ Military or Government photo identification issued by US Government
__________ Passport (country) ____________________ (number) ________________________________
__________ Other. ______________________________________________________________________
Residency Documentation Presented:
___Lease Agreement
___Envelope with postal forwarded address (30 days)
___Form A Landlord Affidavit
___Utility Bill (30 days)________________________
___Form C Property Owner Affidavit
Other _________________________________
Verified by: _________________________________
Town Clerk/Deputy Town Clerk
(SEAL)
NH RSA 263:35 Non Resident Who Establishes A Residency In A State
…any non-resident driver of a motor vehicle who holds a valid driver’s license in another jurisdiction, upon the
establishment of a bona fide residency in this State, shall have a maximum of 60 days from the date his residency was
established to obtain a drivers license issued by the state of New Hampshire.
FORM B

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