Notarized Proof Of Address Form

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Notarized Proof of Address
Date_____________________________
I ____________________________________________, certify the following person(s):
______________________________________________________________
______________________________________________________________
______________________________________________________________
____________________________________________________________ live(s) with
me at the following address:
______________________________________________________________
______________________________________________________________
If you have any questions please call me at ___________________________
______________________________
__________________________
Owner or Lessee Signature
Parent/Guardian Signature
Sworn to and subscribed before me.
This is ________ day of _____________,20____.
_________________________________________
Notary Public
My commission expires: _____________________

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