How to Write an Affidavit of Religious Exemption From Vaccination

A religious exemption from vaccination affidavit is a sworn written statement in which you declare that a sincerely held religious belief prevents you from receiving one or more vaccines. To write one that will be taken seriously, you need five things on the page: who you are, which vaccines you are declining, what you believe and why vaccination violates that belief, how long you have held it, and a declaration under penalty of perjury with your signature. Federal law does not require the request to be in writing at all, and the EEOC has said no “magic words” are necessary,¹ but a sworn affidavit creates a paper trail and satisfies the documentation most employers and schools demand through their own policies. If your employer or school hands you a form, use it. If not, draft your own covering the elements below.

What the Affidavit Must Contain

Every affidavit, whether on an institutional form or drafted from scratch, should include the following:

Your full legal name, date of birth, contact information, and your relationship to the institution (employee ID, student enrollment number, or similar identifier).
The specific vaccines you are declining, named one by one. A blanket refusal looks less considered than a list that shows you have thought about each shot in question.
The religious belief that creates the conflict, described in your own words. This is the heart of the document.
How long you have held the belief. If it predates the current mandate, say so. If it is newer, explain the spiritual change that led to it.
A declaration under penalty of perjury. Federal law allows an unsworn written declaration signed under penalty of perjury to carry the same legal weight as a sworn oath. Use the language: “I declare under penalty of perjury that the foregoing is true and correct,” followed by the date and your signature.²

Keep the writing specific to you. Templates copied from the internet are one of the fastest routes to a denial, because reviewers see the same boilerplate repeatedly and it reads as borrowed conviction rather than your own.

Writing the Belief Statement

The belief section is where affidavits succeed or fail. Reviewers are not supposed to judge whether your theology is correct, only whether you actually hold the belief you describe. Title VII defines religion broadly to cover all aspects of religious observance, practice, and belief,³ and the EEOC has confirmed that protected beliefs “need not be confined to traditional concepts of religion.”¹ You do not have to belong to an organized church, cite scripture, or follow a mainstream faith. What you do have to show is that your belief addresses deep questions of life, morality, or purpose and functions like a religion in how it shapes your decisions.

Write about the specific tenet or conviction at issue, then connect it directly to the act of being vaccinated. “My religion forbids it” is too thin. A reviewer needs to see what you believe and why receiving the vaccine would violate that belief. If your faith has a text, teaching, or tradition that bears on the question, name it. If your conviction is personal and not tied to a congregation, describe how you came to it and how it governs other choices in your life.

Objections That Do Not Qualify

The EEOC draws a firm line: social, political, or economic philosophies, and mere personal preferences, are not protected religious beliefs under Title VII.⁴ Keep these out of your affidavit, even as supporting color, because they weaken the religious character of the request:

Health or safety concerns about the vaccine itself. A court found that objecting to a flu vaccine on the view that “one should not harm their own body” and that the vaccine “may do more harm than good” was not religious, because it did not address deep or ultimate questions.
Political or ideological opposition to mandates or government authority.
Distrust of pharmaceutical companies or the medical system.
Personal preferences, however strongly held.

Your objection has to flow from a belief system that addresses moral or spiritual obligations in a comprehensive way, not from skepticism about the shot.

How Sincerity Gets Tested

The EEOC lists several factors that can undermine the credibility of a request:⁴

Inconsistent behavior, such as voluntarily receiving similar vaccines in the past without objection.
Suspicious timing, such as a religious request appearing only after a secular request for the same benefit was denied.
Seeking an accommodation that happens to be a benefit many employees would want for non-religious reasons.
Other evidence suggesting the request is not actually motivated by religion.

None of these are automatic disqualifiers. They prompt follow-up questions. The strongest affidavits name the inconsistency and explain it. If you received vaccines in the past and your beliefs have since changed, say when the change happened and what caused it. A candid account of evolving faith reads as more honest than a story that pretends the conflict has always been there.

Signing and Notarizing

Do not sign the affidavit before the notary sees it. A notary public witnesses your signature and verifies your identity, which converts the document into a sworn statement. Bring a government-issued photo ID such as a driver’s license or passport.

Notarization is not required by federal law for a Title VII accommodation request, but many employers and school districts require it through internal policy. Most states cap notary fees by statute, and for a standard acknowledgment or jurat you can expect to pay between $5 and $15 in the majority of jurisdictions.⁵ Remote online notarization, where available, often carries a higher maximum fee. Banks, shipping stores, and public libraries commonly offer notary services, and some employers have one on staff.

Submitting the Affidavit and Keeping a Record

Submit through the channel your institution specifies. Many employers accept scanned uploads through an HR portal. If you need to mail a physical copy, certified mail with a return receipt gives you a delivery confirmation that includes the date, the recipient’s signature, and the delivery address.⁶ If you hand-deliver, ask for a date-stamped copy.

Processing times vary. Some employers respond within a week, others take a month or longer, particularly when a committee reviews the request. If you hear nothing within a reasonable period, follow up in writing. Save every email, letter, and portal screenshot. That file matters if you later need to prove when you submitted or that the employer never engaged with your request.

School and Childcare Enrollment: A Different Framework

If you are writing the affidavit for a child’s school or daycare rather than for yourself as an employee, you are not operating under Title VII at all. These exemptions are governed by state law, and the rules vary considerably. Roughly 44 states allow some form of non-medical exemption, whether labeled religious, philosophical, or personal belief. A small number of states, including California, Connecticut, Maine, and New York, have eliminated all non-medical exemptions.

Where religious exemptions are available, required documentation ranges from a simple signed statement to a notarized affidavit with a detailed explanation of beliefs, and some states require annual renewal. Check with your state’s health department or school district for the specific form, because an affidavit that satisfies one state’s requirements may not meet another’s.

If the Request Is Denied

A sincere, religious belief does not guarantee that your preferred accommodation will be granted. Employers can deny a request if granting it would impose an undue hardship, which the Supreme Court in Groff v. DeJoy defined as “substantial increased costs in relation to the conduct of its particular business.”⁷ Before denying, the employer is expected to engage with you about alternatives such as periodic testing, masking, reassignment, or remote work.⁸

If you believe a denial was unlawful, you can file a charge of discrimination with the EEOC. The deadline is 180 calendar days from the discriminatory act, extended to 300 days where a state or local agency also enforces religious discrimination law in employment.⁹ Federal employees have 45 days to contact an EEO counselor within their agency.¹⁰ Title VII also prohibits retaliation for requesting a religious accommodation or filing a charge.

Consequences of a False Affidavit

An affidavit is a sworn statement, and submitting one with information you know to be false exposes you to criminal liability. Federal perjury law punishes willfully stating something material you do not believe to be true in a declaration under penalty of perjury with up to five years in prison, a fine, or both.¹¹ A separate statute makes it a crime to submit a materially false document to any branch of the federal government, with the same five-year maximum.¹²

Prosecution for a fraudulent vaccination affidavit is uncommon, but the professional consequences come faster. An employer that discovers a fraudulent accommodation request can terminate you for dishonesty, which is harder to challenge than a denied exemption. Schools can revoke enrollment. And a future accommodation request at a new employer starts from a credibility deficit if prior fraud is on the record. Treat the affidavit as what it is: a legal document with your name and your honesty on every line.

1
U.S. Equal Employment Opportunity Commission. Fact Sheet: Religious Accommodations in the Workplace
2
Office of the Law Revision Counsel. 28 USC 1746 – Unsworn Declarations Under Penalty of Perjury
3
Office of the Law Revision Counsel. 42 USC 2000e
4
U.S. Equal Employment Opportunity Commission. Section 12: Religious Discrimination
5
National Notary Association. 2026 Notary Fees By State
6
United States Postal Service. Return Receipt – The Basics
7
Supreme Court of the United States. Groff v. DeJoy, 600 U.S. 447 (2023)
8
U.S. Equal Employment Opportunity Commission. Fact Sheet: Religious Accommodations in the Workplace
9
U.S. Equal Employment Opportunity Commission. How to File a Charge of Employment Discrimination
10
U.S. Equal Employment Opportunity Commission. Religious Discrimination
11
Office of the Law Revision Counsel. 18 U.S. Code 1621 – Perjury Generally
12
Office of the Law Revision Counsel. 18 USC 1001 – Statements or Entries Generally