Purpose: To request domicile verification from a nonrelative who is familiar with the household's situation. Please list all of the persons living in the home, including the client named on the front of this form: Name.Relationship to Client. The IRS provides this residency certification on Form 6166, a letter of U.S. residency certification. Residence Address: Street Address and Apartment Number, City, State, and Zip. If none, describe where you live. An affidavit of domicile is a legal document that verifies the primary place of residency of someone after their death. You rented out your residence and put your truck and belongings in storage in California. Obtain a Driver's License in the New State and Register Cars and Boats in the New State. A utility bill, credit card statement, lease agreement or mortgage statement will all work to prove residency.