witness statement by t2aaSB

VIEWS: 0 PAGES: 1

									Statement of Witness

(CJ Act 1967, s9; MC Act 1980, ss5A (3) (a) and 5B; MC Rules 1981, r70)



Name:

Address:

Date of Birth:

Occupation:

Telephone:

Email Address:

WITNESS MUST BE OVER 18

Your Statement

     1. On [enter date], I bought [enter full product name] from [enter reseller name and address].

     2. The product key number for this product is: [enter the 5 x 5 alpha numeric number which
        should be located on the certificate of authenticity (COA) label that came with the product,
        or which was supplied by the reseller].

     3. The COA number for this product is: [enter the 14 digit number which should be located on
        the certificate of authenticity label that came with the product, or which was supplied by the
        reseller]

     4. I paid [enter total amount] for the product.

     5. I enclose the product with this statement

     6. I also enclose the original invoice and any correspondence supplied to me by [enter reseller
        name]

Optional Clauses

     7. [enter any additional information here – delete if not required]



This statement is true to the best of my knowledge and belief. If it used in evidence I understand
that I will be liable for prosecution if I have wilfully stated in it anything which I know to be false
or do not believe to be true.

Signed....................................................   Date........................................................

								
To top