PFBC L 101 – Affidavit of Pennsylvania Residency and-or Affidavit Pertaining to Social Security Number

Jurisdiction: Country: United States | Province or State: Pennsylvania

What is a PFBC L 101 – Affidavit of Pennsylvania Residency and-or Affidavit Pertaining to Social Security Number?

This form is a sworn statement you use to prove two things to the Pennsylvania Fish and Boat Commission (PFBC). First, that you are a Pennsylvania resident for licensing or registration purposes. Second, that the Social Security number information attached to your record is complete and accurate, or that you do not have a Social Security number and are declaring that fact.

PFBC uses this affidavit when you apply for a benefit or transaction that depends on your residency status or your Social Security number status. Typical examples include a resident fishing license, a boat registration or title action, a replacement credential when your account data does not match, or a correction to your customer record. The affidavit lets PFBC accept your sworn declarations and any attached proof in one place.

Typically use of this form

• If you cannot easily prove residency with standard documents at the counter, or
• If you need to resolve a Social Security number flag in the system.
• When your name or address changed and PFBC needs a clear, signed record to update your account.
• For a minor child when you act as the parent or legal guardian.

Residents and nonresidents use it for different reasons. A Pennsylvania resident uses it to qualify for resident rates or benefits when proof is missing or disputed. A nonresident without a Social Security number uses it to certify that status under oath, so PFBC can process the request consistent with state and federal rules. New residents use it to establish when they moved to Pennsylvania and that the state is their primary home.

The form matters because PFBC must verify who receives resident privileges and must comply with laws that require the collection of Social Security numbers for certain licenses or registrations. The affidavit gives PFBC what it needs to review your claim and file it alongside your application. It becomes part of your official PFBC record.

Typical usage scenarios

• You moved to Pennsylvania last month and want a resident fishing license, but your new Pennsylvania driver’s license has not arrived. You complete the residency affidavit with your move date and attach a lease and utility bill.
• You are registering a used boat you bought from a private seller. Your customer record is missing an SSN, and the system will not complete the transaction. You complete the SSN section, or, if you do not have a number, you declare that fact under oath and provide supporting details.
• A name change after marriage. The name on your license application does not match your old PFBC record. The affidavit lets you certify the change and attach your proof, so staff can update your record and issue your credential.

Parents and guardians use the form for minors. You certify the child’s Pennsylvania residency and your relationship to the child, and you address the SSN status for the child. If the child does not yet have a number, you state that fact under oath, and you agree to update the record when it becomes available.

Businesses and organizations may interact with PFBC for boat registrations or titles. However, this affidavit concerns individual residency and Social Security number status. If you are acting on behalf of a sole proprietorship, you may use your individual details. If you act for a corporation or nonprofit, PFBC will generally rely on entity information rather than this affidavit for residency. You may still need to sign as an authorized representative.

In short, the PFBC l 101 is the Commission’s tool to capture sworn proof of Pennsylvania residency and to confirm or clarify Social Security number status when you apply for PFBC-regulated privileges.

When Would You Use a PFBC L 101 – Affidavit of Pennsylvania Residency and-or Affidavit Pertaining to Social Security Number?

You would use this affidavit when the Commission needs stronger confirmation than routine application fields provide. One common case is buying a resident fishing license when the system does not recognize you as a resident. This can happen if your PFBC customer profile lists an old address from another state, or if your Pennsylvania identification is very recent. The affidavit lets you swear to your Pennsylvania domicile and show when it began, so PFBC can approve resident pricing and privileges.

Another frequent case is a boat title or registration. If your record is missing an SSN, or if PFBC’s data match fails because the name on your application differs from what is on file, the transaction may pause. The SSN section of the affidavit resolves the mismatch. You either provide the correct SSN and certify it, or you declare that you do not have one and explain your status. You may also use the affidavit when your legal name changed. You swear to the change and attach proof, which allows PFBC to align your SSN, name, and customer account.

You may also use the form for a minor child. If you are purchasing a youth license, or you need to update the child’s PFBC profile, the affidavit lets you certify the child’s residency and SSN status. This helps when the child does not yet have a Social Security number or you cannot locate it.

New residents use the form to bridge gaps in documentation. If you recently moved, you might not yet have a Pennsylvania driver’s license, voter registration, or tax record showing your Pennsylvania domicile. The affidavit lets you declare your move date and the fact that Pennsylvania is your permanent home. You attach current proofs like a lease, deed, or utility bill.

Noncitizens or foreign nationals sometimes apply for PFBC services but do not have a Social Security number. The SSN portion of the affidavit addresses this. You declare that you do not have a number and are ineligible for one. PFBC can then process your transaction as permitted by law.

Students and active-duty military often face residency questions. A full-time student living in Pennsylvania may or may not be a resident for licensing purposes, depending on intent and domicile. If you qualify as a resident, the affidavit documents your claim. Active-duty military stationed in Pennsylvania, or Pennsylvania residents stationed elsewhere, can use the affidavit with supporting orders to clarify their status for PFBC purposes.

You may also use this form when you submit by mail or through an agent and cannot present original proof on the spot. The affidavit allows you to include certified statements and copies, which PFBC can evaluate without an in-person visit. It is useful for address corrections as well. If you need to update your PFBC record to a new Pennsylvania address and the system flags the change, the affidavit provides a sworn basis for the update.

If you are co-owning a boat with another person, the Commission may need residency or SSN details for each owner. Each co-owner can complete an affidavit if needed to clear record issues. If you act under a power of attorney for an owner, you can use the affidavit to certify facts about the owner, while also attaching the power of attorney.

In any of these cases, the form serves the same function. It supplies a sworn statement that PFBC can rely on to finish your transaction, apply resident rules, and keep its records accurate.

Legal Characteristics of the PFBC L 101 – Affidavit of Pennsylvania Residency and/or Affidavit Pertaining to Social Security Number

The PFBC L 101 is a legal affidavit. When you sign it, you declare that the information is true and complete to the best of your knowledge. Your signature is typically made in front of a notary public or an authorized issuing agent. The affidavit is legally binding because you make it under oath or under penalty of law for false statements. False statements can lead to administrative action and criminal penalties.

Enforceability rests on a few pillars. First, PFBC has legal authority to determine residency for its licenses and registrations and to require accurate customer identity information. Second, PFBC is required to collect Social Security numbers for certain transactions to support government enforcement programs. The affidavit puts your statements into an evidentiary format that PFBC can file and rely on in making a decision. Third, the affidavit includes a certification clause that warns you of penalties for false swearing. This warning supports enforceability if PFBC later discovers a misrepresentation.

The Commission can verify your statements. PFBC can request additional documentation, compare your declaration to other state records, or deny a claim that lacks credible support. If the Commission finds that you claimed residency without basis, it can reverse the benefit, charge the nonresident rate, or take other action allowed by law. If your affidavit contains a false SSN or a false claim that you do not have a number, PFBC can void your transaction and refer the matter for enforcement.

Your privacy rights still apply. PFBC limits access to your Social Security number to uses allowed by law. It will store your affidavit in your customer record. Front-line staff may review the number only as needed to complete your transaction. You should provide your number only in the field designated for it. Do not write it elsewhere on the form.

The affidavit is durable but not permanent in effect. It documents your status as of the date you sign. If your residency changes, or you later receive a Social Security number, you must update PFBC before your next transaction. The Commission can require a new affidavit if circumstances have changed or if your prior declaration is outdated. If you signed as a parent or guardian, your authority to act ends when the child becomes an adult, unless you have legal authority to continue acting. PFBC may require the now-adult individual to sign their own affidavit.

The form’s legal purpose is not to replace other proof. It complements documents like a driver’s license, lease, or orders. PFBC can accept the affidavit with attachments, but it can also ask for more. Submitting an affidavit does not guarantee approval. It gives PFBC a clear basis to evaluate your claim and issue the decision.

How to Fill Out a PFBC L 101 – Affidavit of Pennsylvania Residency and/or Affidavit Pertaining to Social Security Number

Confirm your need for the form

• You need the affidavit if PFBC asked you to prove residency, to correct SSN information, or to resolve a data mismatch. You can also use it when you apply for a resident license without standard proof, or when you must certify that you do not have a Social Security number.

Gather your documents

• Collect your Pennsylvania driver’s license or ID, current lease or deed, recent utility bill, and any name change documents. If you are military, have your orders. If you are a parent or guardian, have proof of your relationship to the minor. If you do not have an SSN, gather documents that show your immigration or ineligible status, if you have them.

Complete the applicant information section

• Print your full legal name as it appears on your government ID. Include any prior names if PFBC records use them. Enter your date of birth and your PFBC Customer ID if you know it. Provide your Pennsylvania driver’s license or state ID number, if you have one. Write your physical Pennsylvania address, not a P.O. Box. If you receive mail at a different address, add that as your mailing address. Include a phone and email so PFBC can contact you.

Provide prior address details if requested

• If the form asks, list your previous address and the dates you lived there. This helps PFBC confirm when you established Pennsylvania residency. Be accurate with dates. If you moved more than once in the last year, include all relevant moves if space permits.

Complete the Affidavit of Pennsylvania Residency section

• Read the residency definition on the form. It will focus on domicile and your intent to maintain a permanent home in Pennsylvania. State the date you became a Pennsylvania resident. Affirm that you live at the listed address and consider Pennsylvania your permanent home. If the form asks, state your reasons, such as moving employment, buying a home, or relocating family. Do not over-explain, but be clear and consistent. If you are a student claiming residency, state your ties to Pennsylvania beyond school attendance. If you are active-duty military, note your orders and whether Pennsylvania is your home of record.

Attach residency proof

• The form may have a checklist or space to list attachments. Attach copies of documents that show your name and Pennsylvania address, such as a lease, deed, mortgage statement, current utility bill, Pennsylvania vehicle registration, or a pay stub with address. If you recently moved, include documents that show the move date, such as a lease start date or closing documentation. If your Pennsylvania ID is very new, attach it and one or two supporting proofs. Write the number of pages attached in the space provided.

Complete the Affidavit Pertaining to Social Security Number section

• If you have a Social Security number, enter it in the designated field. Confirm that your name and date of birth on the form match your Social Security record. If you do not have an SSN, check the box that states you have never been issued a number or are not eligible for one. Provide a brief explanation if the form asks. Do not write an ITIN in the SSN field. If your number is pending for a newborn or recent applicant, state that it is pending, and agree to update PFBC once issued. If you changed your name, attach the legal name change document so PFBC can match your SSN to your current name.

Address minor applicants if applicable

• If you are signing for a minor, fill in the child’s information in the applicant section. Then complete the residency and SSN sections on the child’s behalf. In the parent or guardian area, write your name, relationship to the child, and your contact information. Attach proof of guardianship if you are not the parent.

Review the certification and penalty statement

• Read the declaration. It will state that your statements are true, and it will reference penalties for false statements. Make sure every field is complete and consistent. Confirm that attachments support what you wrote. Check dates and spellings. Correct any errors before signing.

Sign in front of a notary or authorized agent

• Do not sign until the notary or agent instructs you to sign. Bring government-issued photo ID. The notary will verify your identity, witness your signature, and complete the notarial certificate. If the form allows an issuing agent to witness instead of a notary, follow the agent’s directions. If you are signing for a minor, the parent or guardian signs. The minor may also sign if the form requires, depending on age.

Complete any agent or office-use sections

• Leave office-use areas blank unless directed to fill them in. If a clerk or agent needs to certify document copies, allow them to do so.

Make copies for your records

• Keep a full copy of the signed affidavit and all attachments. If you later need to update PFBC or respond to a question, your copy will help you avoid inconsistencies.

Submit the form as instructed

• Follow the submission directions printed on the form. You may submit through a licensing agent, mail it with your application, or include it with your boat title or registration paperwork. If you are submitting with another application, keep the documents together. If the form lists a transaction number or customer ID, write it on the top right corner of your affidavit for cross-reference.

Respond to any follow-up

• PFBC may contact you to request more information or clearer copies. Respond quickly. If PFBC approves, you will receive your credential or a confirmation of the update. If PFBC cannot approve based on the affidavit, you may receive a letter explaining what is missing.

Update PFBC if your status changes

• If you later move out of Pennsylvania, or if you receive a Social Security number after declaring you did not have one, inform PFBC before your next transaction. You may need to file a new affidavit or submit an update form.

Common mistakes are easy to avoid

• Do not sign before you are in front of a notary or agent.
• Do not use a P.O. Box for your physical address.
• Do not leave the move-in date blank when claiming residency.
• Do not write an ITIN in the Social Security number field.
• Do not forget to attach name change proof if your name differs from the record.
• Avoid mismatched dates across your documents.
• Make sure the name on your attachments matches the name on the affidavit or explains the change.

If you prepare carefully and support your statements with clear documents, the PFBC L 101 will do its job. It will give PFBC the sworn facts it needs to process your license, title, registration, or record update without delay.

Legal Terms You Might Encounter

• Affidavit: A signed statement of facts that you swear or affirm are true. On this form, you are swearing to your Pennsylvania residency and/or your Social Security Number status.
• Affiant: The person who signs the affidavit. That’s you. Your name on the form must match your identification and any attached proof of residency.
• Notary Public: An official who verifies your identity and witnesses your signature. If your version of the form has a notary block, sign it only in front of the notary.
• Sworn and Subscribed: Language that confirms you swore or affirmed the truth of the statement and signed it on a specific date. This appears in the notary section to lock in the date and your identity.
• Penalty of Perjury: A warning that false statements can bring legal consequences. By signing this affidavit, you promise your statements are true. Do not guess or omit important information.
• Domicile: Your true, fixed home where you intend to remain and return. For residency, the form looks at where you actually live, not a temporary school or work location.
• Residency: Your physical presence in Pennsylvania as your primary home. The form helps establish that you qualify as a resident for agency records and licensing.
• Physical Address vs. Mailing Address: Your physical address is where you live. Your mailing address is where you receive mail. The form may ask for both, but residency is based on your physical address.
• Social Security Number (SSN): Your federal taxpayer identification number. If you have one, enter it exactly. If you don’t, complete the affidavit section stating your SSN status.
• Ineligible for SSN: A person who cannot get an SSN. If this applies, you use the affidavit portion to explain that you have no SSN. Follow the form’s exact prompts and attach any requested proof.
• Supporting Documentation: Items that help prove your statements, like a driver’s license, lease, utility bill, pay stub, or tax document. Provide clean copies that clearly show your name and address.
• Identification (ID): A government-issued photo ID used by the notary and to verify your identity on the form. Bring valid ID when you sign with a notary.

FAQs

Do you need to notarize the PFBC L-101?

If your form includes a notary section, yes. You must sign in front of a notary, and the notary will complete the certificate. If your version includes a certification under penalty of perjury without a notary block, follow those signing instructions instead. Do not sign before you meet the requirement stated on your specific form.

Do you need to complete both the residency and the SSN sections?

Only complete the sections that apply. If you are proving Pennsylvania residency, complete that portion and attach the requested evidence. If you need to address your SSN status, complete that portion as well. Read the headings carefully and check the correct boxes to show what you are affirming.

Do you need a Pennsylvania driver’s license to prove residency?

It helps but is not the only option. You can also use documents like a lease, mortgage statement, recent utility bill, pay stub, or state tax record that shows your name and Pennsylvania physical address. Use recent documents. If the form lists preferred documents, follow that list first.

Do you need to provide your full SSN?

If you have an SSN, yes. Enter it clearly and accurately. If you do not have an SSN, complete the affidavit section stating that fact. Do not leave the SSN field blank without addressing your status in the affidavit portion.

Do minors need to complete the SSN portion?

If the minor has an SSN, enter it as instructed. If the minor does not have an SSN, complete the affidavit section for “no SSN.” A parent or legal guardian can sign if the form instructs. Follow the form’s signature rules for minors.

Do you need a physical address, or is a P.O. Box enough?

You need a physical Pennsylvania address to prove residency. You can include a mailing address such as a P.O. Box if you use one, but residency is based on where you actually live.

Do you file this form every year?

Not usually. You file when asked to establish or correct your residency status or to address your SSN status. If your residency changes, submit an updated affidavit with new documents. If the agency asks for a fresh copy, follow that request.

Do you need to attach copies or originals?

Attach clear copies unless the instructions require originals. Keep your originals. Copies should be legible and show your full name and address. Avoid cutting off dates or account details.

How long does processing take?

Timelines vary by how you file. In-person filing may be immediate if accepted on the spot. Mail or batch processing takes longer. If you have a deadline tied to licensing, file early and keep proof of submission.

What if you made a mistake after submitting?

Prepare an amended affidavit that corrects the error. Include updated supporting documents if needed. Clearly label the filing as a correction and reference the original submission date. Follow any instructions you receive for corrections.

Checklist: Before, During, and After the PFBC L-101

Before signing

• Confirm your legal name and date of birth as they appear on your ID.
• Gather proof of Pennsylvania residency:
• State driver’s license or ID showing your PA address.
• Lease or mortgage statement with your name and PA address.
• Recent utility bill or bank statement (same name and address).
• Recent pay stub or state tax document with your PA address.
• If you have an SSN, have it ready. You do not need your SSN card.
• If you do not have an SSN, gather any letter or record that supports your status if the form asks for it.
• Verify your physical address (street, unit number, city, county, ZIP).
• Check the form version and read the instructions from start to finish.
• Confirm whether a notary is required.
• If a notary is required, bring valid photo ID and plan where you will sign.
• Use black or blue ink. Print legibly if the form is handwritten.
• If you are signing for a minor, bring proof of parental or guardian status if requested.

During signing

• Enter your name exactly as on your ID. Include any suffix (Jr., Sr., II).
• Provide your physical Pennsylvania address. Add your mailing address only if requested.
• Complete the residency section fully. Do not leave required fields blank.
• Complete the SSN section:
• If you have an SSN, enter it accurately.
• If you do not have an SSN, complete the affidavit portion affirming that status.
• Check the right boxes. Avoid stray marks or crossed-out entries.
• Review dates. Use the correct current date throughout the form.
• If a notary is required:
• Do not sign until you are in front of the notary.
• Show your ID to the notary.
• Sign exactly as your name is printed on the form.
• Make sure the notary completes the venue (county/state), date, seal, and commission expiration.
• Attach clear copies of supporting documents in the order the form requests.
• Make a complete copy or scan for your records before you submit.

After signing

• Submit the form as instructed: in person, by mail, or through the specified channel.
• If mailing, use a trackable method and keep the receipt.
• If filing in person, ask for a stamped copy or written acknowledgment.
• Verify you included all pages, attachments, and the notary page if required.
• Watch for confirmation or follow-up requests. Respond promptly.
• Store your copy in a secure location. Do not email your SSN unless the instructions say to and the method is secure.
• If you move or your status changes, prepare and file an updated affidavit with new documents.

Common Mistakes to Avoid

Leaving the SSN field blank without completing the affidavit section

• Consequence: Rejection or delay. Your record remains incomplete.
• Don’t forget: If you have no SSN, you must affirm that status on the form.

Using only a mailing address or a P.O. Box

• Consequence: Residency cannot be confirmed. You may be treated as a nonresident.
• Don’t forget: List your physical Pennsylvania address, including apartment number.

Signing before a notary review

• Consequence: The notary may not accept your signature. You might have to redo the form.
• Don’t forget: Sign only in front of the notary if your form requires notarization.

Submitting outdated or mismatched proof of residency

• Consequence: Processing holds until you provide current, consistent documents.
• Don’t forget: Use recent documents that show the same name and address as the form.

Illegible handwriting or corrections without initials

• Consequence: Data entry errors or rejection. Extra time to fix.
• Don’t forget: Write clearly. If you must correct something, follow the notary’s guidance and initial the change.

What to Do After Filling Out the Form

1. File the form through the method the instructions specify. If in person, bring your ID and originals in case they need a quick look. If by mail, send clean copies only, include all pages, and use a trackable service. If an online portal is allowed, upload clear scans and confirm the upload status.
2. Confirm receipt. If you filed in person, ask for a stamped copy or written confirmation. If you mailed it, monitor tracking and allow time for processing. If you used an online portal, save the submission confirmation page or email.
3. Watch for follow-up. You may be asked for an additional document if something is unclear. Respond quickly to keep your record moving. Keep your phone and email current.
4. Update when your status changes. If you move to a new Pennsylvania address, file an updated affidavit with fresh proof. If you later obtain an SSN after filing as “no SSN,” submit an amended form to update your record.
5. Correct errors with an amended affidavit. If you discover a mistake after filing, complete a new form that corrects the error. Label it as a correction and attach any corrected proof. Reference the date of your original filing.
6. Share copies only when needed. If a licensing agent or office requests proof you already filed, provide a copy of the affidavit and any receipt or confirmation. Do not share your SSN casually. Use secure channels when you must provide it.
7. Store your records securely. Keep a clean copy of the signed affidavit, the notary page, and all supporting documents. Save digital scans in a secure, password-protected folder.
8. Set reminders. Put a note on your calendar to revisit your residency documents before the next license cycle. If your lease renews or you change addresses, refresh your proof so you can update quickly.
9. Keep names identical across documents. If you change your name, update your identification and your affidavit at the same time. Consistent records reduce delays.
10. Ask before you refile. If you are unsure whether you need a new affidavit, contact the office that requested it and ask what is on file. This avoids duplicate submissions and confusion.