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  • Form A.1 Statement of Residence

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    Abdul Rochman Saleh
    21K views1 page
    This document is a statement from an individual verifying that another person named resides at their address. It includes fields for the name and contact information of the person making the statement, the name and passport number of the person whose residence is being verified, and a signature. It also notes that proof of residency documentation must be attached, such as a driver's license, lease, or other proof showing that the address listed matches that of the statement maker.

    Original Description:

    contoh surat pernyataan dalam bahasa inggris

    Original Title

    surat pernyataan inggris

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    This document is a statement from an individual verifying that another person named resides at their address. It includes fields for the name and contact information of the person making the statement, the name and passport number of the person whose residence is being verified, and a signature. It also notes that proof of residency documentation must be attached, such as a driver's license, lease, or other proof showing that the address listed matches that of the statement maker.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    21K views1 page

    Form A.1 Statement of Residence

    Uploaded by

    Abdul Rochman Saleh
    This document is a statement from an individual verifying that another person named resides at their address. It includes fields for the name and contact information of the person making the statement, the name and passport number of the person whose residence is being verified, and a signature. It also notes that proof of residency documentation must be attached, such as a driver's license, lease, or other proof showing that the address listed matches that of the statement maker.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Form: A.1.

    STATEMENT
    The undersigned,
    Full Name

    :....................................................................................................

    Address*)

    :..........................................................
    ...

    Phone Number

    (..............)...........................................................................................

    stated that,

    Full Name

    :.........................................................................................................

    Passport Number

    :..........................................................................................................

    is truly resided with me at the above mentioned address.


    I herewith attach the copy of Driver License/Apartment Lease Agreement/ proof of Residency**).
    This statement is truly made to be utilized as deemed.

    ..................................., .............................................
    Sincerely,

    (....................................................................)

    *)

    Address of the undersigned must be match with the address in the copy of Driver License/
    Apartment Lease Agreement/ Proof of Residency.

    **)

    Please circle or underline one of the choices.


    H.L.

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