Residence / Address Proof Affidavit - sample
Executed on non-judicial stamp paper of Rs. 100/- (value as required by the authority concerned)
AFFIDAVIT OF RESIDENCE
I, Ramesh Kumar Sharma, son of Mohan Lal Sharma, aged about 35 years, a citizen of India, residing at House no., street, area, city, state - PIN (holding Aadhaar no. XXXX XXXX 4821), do hereby solemnly affirm and state on oath as under:
1. That I am a major, of sound mind and fully competent to swear this affidavit, and I am the deponent in this matter. I have personal knowledge of the facts stated below, unless I have said that a statement is based on a document or on information.
2. That I am residing at the above address since 2015 and my permanent / present address is the same as stated above. I live there with my family and it is my place of ordinary residence.
3. That the said house / premises is owned by Shri Gopal Das, who has allowed me to reside in it, and I have no objection from the owner to use the address for official purposes. The owner is my father-in-law / landlord / friend.
4. That I do not have, at present, any other document in my own name which shows this address, such as a rent agreement, electricity or water bill, bank passbook or a voter card, and therefore this affidavit may be accepted as proof of my address.
5. That my identity is established by Aadhaar no. XXXX XXXX 4821, and the photograph and signature on it are mine. The address shown on it, if different, is my earlier address.
6. That I shall inform the concerned authority within thirty days if I change my address, and I understand that an address proof obtained on a wrong statement may be cancelled.
7. That this affidavit is submitted for a new gas connection, and I request that it be accepted as proof of my residence at the address given above.
8. That I have not concealed any material fact and no part of this affidavit is false. I understand that making a false statement on oath, or using a false affidavit before an authority, is an offence and can lead to penal action and to cancellation of any benefit obtained on its basis.
9. That I shall produce the original documents referred to in this affidavit for inspection whenever the concerned authority asks for them, and I shall inform the authority at once if any fact stated here changes.
10. That this affidavit is made in good faith for a new gas connection and for no other purpose, and I request the authority to accept it as true.
VERIFICATION
Verified at City on 13/11/2026 that the contents of this affidavit are true and correct to the best of my knowledge and belief, that nothing material has been concealed therefrom and that no part of it is false.
DEPONENT
Ramesh Kumar Sharma
| Attestation Identified by me and solemnly affirmed before me on ____________ at Jaipur by the deponent, who has signed in my presence after the contents were read over and explained to him / her in a language that he / she understands. Notary Public / Oath Commissioner Seal and registration no.: ____________ |