Proof of Home Address

___________
Date

Name: _______________
Address: _______________
City, State: _______________

To whom it may concern:

My name is __________________ and I am a landlord at the property located at ___________________

______________________. I am writing this letter to confirm that ______________________ is
currently living at this property. Their lease term began on _________________ and ends on
_________________.

I was also asked to confirm the following information:

☐ The following people also live at this property with the tenant: _______________________________.

☐ This individual pays $_______ each month for rent on the ____ of the month.

☐ Other: ____________________________________________________________________________.

I swear and affirm that the statements made above are true and accurate. This proof of home address is
further verified by the attached lease agreement signed by me and the above individual. If you have any
questions about the above representations, please do not hesitate to contact me at ________________.

Sincerely,

________________________ ___________________________
Signature Landlord Name

Witness Acknowledgement

As witness, I attest to the claims made in the above instrument and acknowledge witnessing the
signature of the undersigned for this Proof of Home Address affidavit.

________________________ ___________________________
Signature Name
 Proof of Home Address
Notary Acknowledgement

State of _________________

County of ___________________

On this _____ day of _______, in the year of ______, before me, _________________________, the
undersigned notary public, personally appeared _______________________, personally known to me or
proved to me on the basis of satisfactory evidence to be the individual whose name is affixed to the
within instrument and acknowledged to me that they executed the same in their capacity and that by
their signature on this instrument, the individual executed this instrument.

__________________________________ Notary Public