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Sample Affidavit of One and the Same Person

Under some circumstances, names of the same individual may vary in different documents. If you are in the process of filing a petition with the USCIS, an affidavit explaining that you are one and the same person may be required. This may require an Affidavit which contains your current full name, your religion, birth date, birthplace along with your old full name and the reason why is it different on some of your documents.


One and The Same Person


I,__[insert name]___ , of ___[insert place origin]________, born on __[insert birthdate]______, solemnly declare that I am the same individual as stated in the following documents:  

  • List the names used and the type of document 

I make this Affidavit to declare the inconsistencies with the names indicated on my documents. AND I make this solemn declaration, conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath. I understand giving false testimony under oath in connection with an immigration application is a federal criminal offense that can attract severe terms of imprisonment (18 U.S.C. § 154).


_________________________                                         _____________

Signature of Deponent Date                                                 Date

Verification of a Statement on Oath or Affirmation

State of _____________________________________________County of  _____________________________Subscribed and Sworn to (affirmed) before me this  _______   day of  ________ , 20___by ____________________________ (name(s) of individual(s) making statement, personally appeared before me in __ [insert state]_____________, proved to me on the basis of satisfactory evidence to be the person (s) whose name is subscribed to the within Affidavit and acknowledged to me that he/she executed the same in his/her authorized authority, and who being first duly sworn on oath according to law, deposes and says that he/she has read the foregoing Affidavit subscribed by him/her, and that the matters stated herein are true to the best of his/her information, knowledge, and belief.

I certify under PENALTY OF PERJURY under the laws of  the state of _________________ that foregoing paragraph is true and correct. ?


Identifying Document Submitted:  

Type: ____________________________________________________

Date of Issuance/Expiration: __________________________________

Document Number: _________________________________________


WITNESS my hand and official seal

__________________________________   (Notary Seal)

Signature of Notarial Officer

My commission expires: _________________________________

The sample documents provided here are for informational purposes only and to be utilized at the user’s discretion. These act as a guide only and the content within these are to be customized as per requirement. While Lawbench covers general guidelines, it does not guarantee access to visas or ensure entry into the United States of America or assure any other form of privileges. Lawbench and its affiliates are not responsible for any losses or damages that may arise from having used these sample documents.