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If the applicant cannot provide two acceptable residency documents, the affidavit serves as evidence of Arizona residency and explains applicable domicile rules. The applicant completes Section A with name and residence address, then certifies statements under penalty of perjury and acknowledges potential criminal penalties for misrepresentation. 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If the applicant cannot provide two acceptable residency documents from the list found on the Arizona Voluntary Travel ID Identification Requirements, \\# 40-5144 , this affidavit may be used as evidence of residency in Arizona .  \n*Arizona domicile rules are in the Arizona Administrative Code (R17-4-407) .  \n\n| A. Applicant Information | The applicant for an Arizona driver license or identification card must complete Section A. |  |  |  |\n| --- | --- | --- | --- | --- |\n| Name |  |  |  |  |\n| Residence Address |  | City | State | ZIP Code |\n\nI hereby certify under penalty of perjury that all statements in this application are true and correct. I agree and understand that any misstatement of material facts may cause cancellation and/or denial of my driver license or identification card. I further understand that it is a Class 2 Misdemeanor (ARS 28-3478) to knowingly falsify information, make a false statement, conceal a material fact or otherwise commit fraud in an application on a driver license application, or non-operating identification license or falsify information required by ARS 28-3165.  \n\n| Applicant’s Signature | Date |\n| --- | --- |\n\nA representative who provides services to the applicant at the address in Section A must complete Section B certifying that the applicant resides or receives services at that address .  \nThe individual who resides at the address in Section A must complete Section B certifying that the applicant resides at that address and provide two acceptable documents establishing proof of residency.  \n\n| B. Individual or Representative Information | The individual or representative must sign Section B. |  |  |  |\n| --- | --- | --- | --- | --- |\n| Name of Individual or Representative |  |  |  |  |\n| Residence Address |  | City | State | ZIP Code |\n\nThe individual or representative for the applicant must certify and sign the following section . I certify under penalty of perjury the information submitted on behalf of the above applicant is true and correct. The applicant does live at my residence or receives services at the location listed above . I understand that according to Arizona law, it is a crime to knowingly make any false statement relating to application for a driver license or identification card.  \n\n| Certifier’s Signature | Date |\n| --- | --- |\n\n\n| Acknowledged before me this date . |  | Notary or MVD Agent Signature |  |  |\n| --- | --- | --- | --- | --- |\n| Date | County |  | State | Commission Expires |","cbCainS04vZGnVKW","https://ap.wps.com/l/cbCainS04vZGnVKW","pdf",72432,"English","# Applicant Information\n## Section A: Applicant Details\n# Individual or Representative Information\n## Section B: Certifier Details\n## Notary or MVD Agent Acknowledgement","[{\"question\":\"When can this affidavit be used in place of residency documents?\",\"answer\":\"It can be used when the applicant cannot provide two acceptable residency documents from the required Arizona list.\"},{\"question\":\"What must the applicant complete and certify?\",\"answer\":\"The applicant completes Section A with personal and residence information and certifies that statements are true under penalty of perjury.\"},{\"question\":\"What does the certifying individual or representative need to do?\",\"answer\":\"The individual or representative must complete and sign Section B, certifying the applicant resides at the listed address or receives services there, and provide relevant acknowledgement details.\"}]","Arizona Residency Affidavit - Evidence of Arizona Residency | PDF"]