Sample Affidavit for Same Person with Different Names

When difference documents may have different names due to typographical errors or reason of marriage, the discrepancy may have to be explained to the USCIS with an Affidavit. The following is a sample affidavit for the one and the same person for reference purposes.


Affidavit

One and the Same Person


I, the undersigned, ________[insert your name]______________ aged ______________ years, _____[insert religion]_______ by religion, presently residing at ____[insert address]_____, do hereby solemnly affirm and declare on oath that:

  1. I am the deponent herein and a citizen of ______[insert country]_________.
  2. I was born on __[insert birthdate]__ at __[insert place of birth]__.
  3. It is customary, in our religion/country to: _________________________

____________[insert customs related to alternate names]_______________

________________________________________________________________________

  1. Therefore, the tag _____ was added to my name in some documents. My father’s first name was used as mt middle name in some documents. The tag _______ were/are interchangeably added in my father’s first name.
  2. I was married to __[insert spouse__] on __[insert marriage date]__ in __[insert place of marriage]__.
  3. After marriage, I changed my name to __[insert marital name]_____.
  4. Therefore, the following names refer to the one and the same person:

[list name variations]

  1. (Name after birth)
  2. (Name recorded in school)
  3. (Name after marriage)

The above are the variations of the same name and should not be considered name changes.


So I do hereby solemnly affirm that foregoing are true and correct statements. 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]_____


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.