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Fill out and mail to: Voter Registration Integrity Project 11816 Inwood Dr. Suite 231, Dallas TX 75244

AFFIDAVIT

STATE OF TEXAS §

§

COUNTY OF DALLAS §

BEFORE ME, the undersigned, on this date personally appeared __________________________________, known to me to be the person whose name is subscribed to the following Affidavit and who, after being duly sworn by me, stated upon his or her oath as follows:

“My name is: _______________________. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________.”

Signature:

Printed Name:_________________________________

SUBSCRIBED AND SWORN to before me on the ____ day of _______________, 2020.

(S E A L) _________________________________________

Notary Public in and for the

State of Texas

My Commission Expires:

__________________________

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