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AFFIDAVIT OF IDENTITY
)
)
)
STATE OF HAWAII
being first duly sworn,
deposes and says: I am the [
father/mother
spouse
guardian
other _____________________] of
SSN
(FULL LEGAL NAME OF APPLICANT)
That this affidavit has been made in connection with the desire of Applicant to secure a state civil identification
card or driver license;
That the Applicant resides with Affiant and documents for proof of principal residence address is under Affiant’s
name.
That Affiant is submitting the number of required documents in support of proof of principal residence address
as indicated under the List of Acceptable Documents for Proof of Principal Residence Address displaying name
and Hawaii address of Affiant and;
Further Affiant sayeth naught.
Dated:
________________________________________
SIGNATURE OF FATHER/MOTHER/SPOUSE/GUARDIAN/OTHER
PRINTED NAME
IDENTIFICATION PRESENTED
EXP. DATE
________________________________________
SIGNATURE OF EXAMINER
DATE
FOR NOTARY USE ONLY:
Subscribed