LAWFUL PRESENCE 
                                                                                            AFFIDAVIT 
 
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 City of Longmont:  
(check one): 
                 ____  Sales and use tax license 
                 ____  Contractors License 
                 ____  Business License obtained from City Clerk’s Office 
 
I understand that state law requires me to provide proof that I am lawfully present in the United States 
prior to receipt of the above noted City of Longmont license.  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. 
 
Print Name: _____________________________  Signature: _________________________________ 
 
Date: _______________________  Business Name: ________________________________________ 
____________________________________________________________________________________ 
NOTARY (not required if affidavit is signed in the presence of a City of Longmont employee) 
 
____________________________________________________________________________________ 
APPLICANT IDENTIFICATION