This certification will be accepted as one form of evidence for your principal residence address. Customer Information. Name.Affidavit of Resident Witness. The following forms are available for download: English, Español. The undersigned declares and acknowledges, under penalty of perjury, pursuant to. Customer Service is available Monday thru Friday, a.m. Este formulario sirve para solicitar asilo en Estados Unidos y para la exención de expulsión (anteriormente llamado. "exención de deportación"). Si solicita una copia certificada, DEBE proporcionar una declaración jurada notariada (consulte la página. I wish to obtain an Exemption from Immunizations for Reasons of Conscience Affidavit Form.