Full Text
Community Development Department [PHONE REDACTED] 1290 S. Public Road, Lafayette, Colorado 80026 Fax [PHONE REDACTED] City of Lafayette Contractor License Lawful Presence Affidavit License _____License Renewal I, as applicant for (Business Name) Swear or affirm under penalty of perjury under the laws of the State of Colorado that (check one): am a United States citizen, or am a Permanent Resident of the United States, or 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 Form of ID Presented: Valid Colorado Driver’s License, Colorado ID card, Military ID, Coast Guard Mariner, or Native American Tribal Documents are acceptable forms of identification. *Include copy of ID if you are mailing this form.