Form DS-72 template
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Official Proof of Domicile Affidavit
This document is an affidavit of domicile for Mississippi's Driver Service Bureau, filled out by a homeowner or resident and notarized by a Notary Public. It states that the named individual resides at the given address with the person listed as a co-resident. The signatories affirm and acknowledge the accuracy of this statement under penalty of law, and note the potential consequences for providing false information.
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