"My name is ________________________________, my
date of birth is _________________, and my address is
_____________, ____________, _________, ____________,
(Street) (City) (State) (Zip Code)
__________________. I declare under penalty of
(Country)
perjury that the foregoing is true and correct.
Executed in _______ County, State of ________, on the ________ day of ________, ________.
(Month) (Year)
____________________
Declarant".
Tex. Gov't. Code § 2252.908