AFFIDAVIT OF CHARACTER REFERENCE
STATE OF NEVADA )
) ss.
COUNTY OF WASHOE )
The undersigned hereby swears or affirms under penalty of perjury as follows:
4. I __________________________________________, have personally known
(Print Name of Person Providing Reference)
______________________________________ for ________years.
(Print Name of Applicant)
5. The nature of my relationship with the applicant is:
Employer / employee Family member Friend / neighbor Other __________________
6. I can personally attest that _______________________________ is a person of
(Print Name of Applicant)
good moral character who will be responsible and conscientious in his/her duties as a Marriage
Officiant granted the privilege of performing a marriage ceremony.
4. My contact information is as follows:
________________________________________________________________________
Residence Physical Address City State Zip
________________________________________________________________________
Mailing Address City State Zip
________________ _________________ _________________________________
Residence Phone # Alternate Phone # E-Mail Address
___________________________________________
Signature of Reference
SUBSCRIBED AND SWORN TO (OR AFFIRMED) BEFORE ME
this _______ day of _______________, 20 ______
__________________________________________
Signature of Notary Public or Deputy Clerk
(Affix County Seal or Notary Stamp)
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