Form G-900 - Affidavit Verifying Lawful Presence In The United States - 2011

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Form Number G-900
Revised 1-2011
Affidavit Verifying Lawful
Presence in the United States
All sole proprietors applying for a business permit or license with the Oklahoma Tax Commission are required,
by the provisions of 56 O.S. Supp 2007 Section 71, to provide the Commission with verification of lawful
presence in the United States by executing the Affidavit below before a notary public or other officer authorized
to notarize affidavits under State law.
This affidavit must be returned with your license/permit application.
State of Oklahoma
County of:
I,
being of lawful age, state under penalty
print name
of perjury, as follows:
Please check the appropriate box(es)
My Social Security Number is:
My Individual Tax Identification Number is:
I am a United States Citizen.
I am a qualified alien under the Federal Immigration and Nationality Act and am lawfully present
in the United States.
My Alien Registration Number (A#) or I-94 Number is: *
Date of Birth: *
I state under penalty of perjury under the laws of Oklahoma the foregoing is true and correct and I have read
and understand this form and executed it in my own hand.
Signature of Applicant
Subscribed and sworn to or affirmed before me this _____ day of _____________________, 20_____ ,
by_________________________________________ (applicant name - please print).
Notary
My Commission Expires:
My Commission Number:
*Either the A# or the I-94 number, and date of birth must be provided. The Alien Registration Number (A#) and
the I-94 (arrival/departure) numbers are issued by the U.S. Citizenship and Immigration Service.
Official Use Only: Verified: ___________________________ Date: _____________ Initials: _________

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