PARENT / GUARDIAN AFFIDAVIT
State Form 46538 (R / 2-96)
PARENT / GUARDIAN AFFIDAVIT
State Form 46538 (R / 2-96)
State of Indiana County of ______________________________
State of Indiana County of ______________________________
______________________________________________________________
Name of parent/legal guardian
______________________________________________________________
Name of parent/legal guardian
Deposes and says upon his/her oath that: ______________________________________________________________
Name of applicant
Deposes and says upon his/her oath that: ______________________________________________________________
Name of applicant
is my natural or legal child and that the signature below is his/her true and valid signature.
Signature of applicant
is my natural or legal child and that the signature below is his/her true and valid signature.
Signature of applicant
Applicant's Driver License /SS number (voluntary)
Applicant's date of birth (month, day, year)
Applicant's Driver License /SS number (voluntary)
Applicant's date of birth (month, day, year)
I swear or affirm that the information I have entered on this form is correct. I understand that making a false statement on this form may constitute the crime of perjury.
Signature of parent/ legal guardian
I swear or affirm that the information I have entered on this form is correct. I understand that making a false statement on this form may constitute the crime of perjury.
Signature of parent/ legal guardian
Date signed (month, day, year)
Parent/legal guardian Driver's license number/ State I.D. number
Date signed (month, day, year)
Parent/legal guardian Driver's license number/ State I.D. number