HomeMy WebLinkAboutAFFADAVIT FOR SID- MINOR (2) FORM: VRL -L (SID) 40 1 REV. 01/03/2013 AFFIDAVIT ) STATE OF HAWAII ) ) being first duly sworn, d eposes and says: I am the [ father mother guardian] of born on (FULL LEGAL NAME OF CHILD) (DATE OF BIRTH OF CHILD) That this affidavit has been made in connection with the desire of Affiant to secure a state civil identification card on behalf of the minor child; That the minor ch ild is at least 10 years of age and under the age of fourteen (14) and requires Affiant’s signature; That Affiant is submitting two (2) documents in support of proof of principal residence address as indicated under the List of Acceptable Documents for Pr oof of Principal Residence Address displaying name and address of Affiant and ; Further Affiant sayeth naught. Dated: ________________________________________ SIGNATURE OF FATHER/MOTHER/GUARDIAN PRINTED NAME IDENTIFICATION PRESENTED EXP. DATE ________________________________________ SIGNATURE OF EXAMINER DATE FOR NOTARY USE ONLY: Subscribed and sworn before my this __________ day NOTARY CERTIFICATION (Hawaii Administrative Rules 5 -11 -8) of __________________________ , 20___________ . Document Date:_____________No. Pages:________ ____________________________________________ Notary Public Document Description:_________________________________ State of ___________________, _______Judicial Circuit ________________________ _________________ Notary Printed Name Circuit My commission expires: ___________________________ ________________________ _________________ Notary Signature Date (Stamp or Seal) (Stamp or Seal)