Figure: 25 TAC 139.41(a)(8)(A)

Affidavit

 

I, ______________________________, swear or affirm that my date of birth is

___________________, ______ , and that I do not have appropriate identification that

states my date of birth.

 

 

                                               Signature:       _____________________________

                                               Printed name: _____________________________

 

 

Witness: ________________________________________

Printed name of witness: ____________________________