Form Ds-5507 - Affidavit Of Parentage, Physical Presence And Support Page 4
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5PART III
(Oath: To be completed by all applicants)
PLEASE STOP HERE!
Part III of the document must be signed before a Consular Officer or other authorized individual at the
time the oath is sworn.
WARNING: False statements made knowingly and willfully in applications for citizenship documentation or affidavits and other supporting
documents are punishable by fine and/or imprisonment under the provisions of 18 USC 1001 and other applicable criminal statutes.
A U.S. consular officer may require additional evidence of one's blood relationship to one's child and/or evidence of one's physical
presence or residence in the United States.
I solemnly swear (or affirm) that all the statements contained in this affidavit are true and complete to the best of my knowledge and belief,
and that this affidavit is for the purpose of establishing my relationship to the aforementioned child/children and his/her/their claim to U.S.
citizenship.
Signature of affiant
Present Street Address
City
State
Country
Zip Code
Telephone Number
SUBSCRIBED AND SWORN TO (AFFIRMED) before me this
day of
,
,
at
,
[SEAL]
Signature and Title of Administering Officer
Page 4 of 5
DS-5507
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