Download - DACA Basic Affidavit
7/17/2019 DACA Basic Affidavit
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AFFIDAVIT OF __________________
1. My name is __________________________. My address is _______________
_______________________________. My telephone number is _____________.
2. I personally know ene Vas!ue" be#ause ___________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
$. I know ene Vas!ue" was in the %nited &tates at the 'ollowin( times)
_______________________________________________________________.
I know this be#ause_______________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________.
I de#lare under penalty o' per*ury that the #ontents o' this statement are true
and #orre#t to the best o' my knowled(e and belie'.
si(nature) _________________________
date) ____________________
+rint ,ame)