Free affidavit of domicile 25Free affidavit of domicile 25Free affidavit of domicile 25
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(Member District Employer)
I, _________________________ (print name of Employee) certify that I and
________________________ (print name of Domestic Partner) presently reside together
at _______________________________________________ (address) as a non-married
domestic partnership and we intend to continue our domestic partnership and reside in a
common residence indefinitely and mutually obligate ourselves to the welfare and
support of the other.
We hereby affirm that:
neither is married, legally separated, or a domestic partner to another
we have shared a common residence for six (6) months prior to the date of
the execution of this Affidavit and intend to share a common residence
and engage in an exclusive domestic partnership indefinitely
the effective date of this domestic partnership is _____________
we are both at least eighteen (18) years of age and capable of consenting
to a domestic p