Affidavit Form

1065 Pinehurst Drive | PO Box 4717 | Rocky Mount, NC 27803
Phone: 252.977.3141
Fax: 252.977.2587
Emergency After-Hours: 252.977.6223
Office Hours: Monday - Friday | 8:30 am - 5:00 pm

Complete the form online, print the form, and submit to the Housing Office after Notarization. DO NOT submit this form online.

Take the form to a Notary to be notarized. After Notarization, drop off or mail the form to our office: Rocky Mount Housing Authority - 1065 Pinehurst Drive • PO Box 4717 • Rocky Mount, NC 27803