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1.

AFFIDAVIT OF LEGAL PRESENCE IN THE U.S.

I,_____________ , swear or affirm under penalty of
perjury under the laws of the State of Colorado that (check one):
___I am a United States citizen, or
___I am a Permanent Resident of the United States, or
___I am lawfully present in the United States pursuant to Federal law.
I understand that this sworn statement is required by law because I have applied for a public benefit. I understand that state law requires me to provide proof that I am lawfully present in the United States prior to receipt of this public benefit. I further acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the criminal laws of Colorado as perjury in the second degree under Colorado Revised Statute 18-8-503 and it shall constitute a separate criminal offense each time a public benefit is fraudulently received.

___________________
Signature

___________________
Date

2.

PROOF OF IDENTIFICATION I,_______________________, who reside at ____________________ in the County of ,____________________________ State of ____________________, do hereby swear and affirm that attached hereto is a true and accurate copy of the following form of identification,* properly issued to me:

__________________________________________________________________
__________________________________________________________________
(Specify form of identification including, without limitation, the title, the issuing state or country or governmental agency, identification number, and date of expiration)
The original of the above-referenced identification was produced to me by the person named above and this Proof ofIdentification was subscribed and sworn to before me in the County of _____________________, State of________________________this _______ day of________________, 20___.

NOTARY PUBLIC
My Commission expires:
____________________________ For purposes of this Proof ofIdentification, the following forms of identification are acceptable: a)a Colorado driver's license or Colorado identification card; b) a U.S. military card or military dependent's card; c) a U.S. Coast Guard Merchant Mariner card; or d) a Native American Tribal Document. Moreover, the following forms of identification are acceptable until March 1,2007: e) a certificate verifying naturalized status issued by an authorized agency of the U.S. bearing the applicant's intact photograph impressed with the raised embossed seal of the issuing agency; f) a certificate verifying U.S. citizenship issued by an authorized agency of the U.S. bearing the applicant's intact photograph impressed with the raised embossed seal of the issuing agency; g) a valid driver's license or identification card bearing the applicant's photograph issued by one of the following states: Alabama, Arizona, Arkansas, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New York, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Virginia, West Virginia, and Wyoming; or h) valid immigration documents demonstrating lawful presence and verified through the Systematic Alien Verification for Entitlement (SAVE) program administrated by the Department of Homeland Security.

Valid driver's license or State identification cards are not acceptable proof from the following States: Alaska, Hawaii, Illinois Maryland, Massachusetts, Michigan, Nebraska, New Mexico, North Carolina, Oregon, Tennessee, Texas, Utah, Vermont, Washington, and Wisconsin. U.S. Territories and Protectorates; i.e. Guam, American Samoa, Puerto Rico, the Mariannas, etc., are also not included on the Regulation's list of acceptable IDs, OCPO cannot accept identification issued by these entities.