Get Affidavit Maternity

AFFIDAVIT OF RESIDENCE AND PATERNITY/MATERNITY I solemnly swear or affirm that the following statements are true and complete to the best of my knowledge and belief. I acknowledge that the purpose of this Affidavit is the establishment of my relationship to persons claiming U.S. citizenship entitlement to visas or federal benefits. Name Date of Birth Last First Middle Social Security No* Month/Day/Year Local telephone No* If you are a U*S* citizen please complete the following I became a U*S* citizen by Birth in the U*S* Born American outside of the U*S* Naturalization Passport or Naturalization Certificate No* Date Issued Place What is your occupation Have you ever been outside of the United States as an employee or as the dependent of an employee of the U*S* government or an international organization Yes No If Yes list the agency or organization and the dates abroad as an employee or Organization Name Have you worked as a seafarer Dates Abroad If Yes provide all of your discharge slips and fill in the blank below. I have been working as a seafarer since I have been physically present in the United States as follows Please bring your current and all previous passports or other evidence of physical presence such as cancelled passports tax returns letters from former employers with specific dates of employment and vacation time old pay stubs cancelled checks school transcripts report cards medical records discharge slips receipts or any other type of documentation that shows the date and required your signature plane tickets boarding passes etc*. Page 1 of 3 From Type of Evidence For office use List present and all previous spouses Spouse s Name To Spouse s Date of Birth Has any one of your spouses previously been married If yes please complete the table below Name of his or her previous spouse Date of Divorce or Date of Death Date of Marriage date of birth Reason and date of termination Please list ALL of your children including biological step and adopted children whether living or deceased* Child s first name Father s name Gender M/F Date of Place of Birth Warning False statements made knowingly and willfully in passport applications affidavits or other supporting documents are punishable by fine and/or imprisonment under the provisions of U*S*C. Sections 1001 and 1542. Signature of Affiant Subscribed to and sworn before me on the day of 20 at. Name Date of Birth Last First Middle Social Security No* Month/Day/Year Local telephone No* If you are a U*S* citizen please complete the following I became a U*S* citizen by Birth in the U*S* Born American outside of the U*S* Naturalization Passport or Naturalization Certificate No* Date Issued Place What is your occupation Have you ever been outside of the United States as an employee or as the dependent of an employee of the U*S* government or an international organization Yes No If Yes list the agency or organization and the dates abroad as an employee or Organization Name Have you worked as a seafarer Dates Abroad If Yes provide all of your discharge slips and fill in the blank below. I have been working as a seafarer since I have been physically present in the United States as follows Please bring your current and all previous passports or other evidence of physical presence such as cancelled passports tax returns letters from former employers with specific dates of employment and vacation time old pay stubs cancelled checks school transcripts report cards medical records discharge slips receipts or any other type of documentation that shows the date and required your signature plane tickets boarding passes etc*.