Affidavit Template

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									Affidavit Template
An affidavit is a sworn statement made by an individual under the penalty of perjury.
The Affiant, the person that will sign the affidavit, will certify the truth of certain stated
facts. The Affiant must have personal, firsthand knowledge of the facts stated. In
addition, the Affiant will certify that they are over the age of eighteen (18), of sound and
competent mind, and not being unduly coerced to make the sworn statements. This
affidavit can be used to certify any type of statement of fact, from witnessing a car
accident, to witnessing the execution of a will. This document is ideal for individuals that
want to certify the truth of certain statements under the penalty of perjury.
                                        AFFIDAVIT TEMPLATE

STATE OF _________________ [Instructions: Insert the state where this affidavit will be
signed]

COUNTY OF _________________ [Instructions: Insert the county where this affidavit will
be signed]



_______________________, [Instructions: Insert the name of the individual executing this
affidavit, hereinafter referred to as the “Affiant”] being duly sworn according to law, deposes
and attests under penalty of perjury to the following:

I, _________________________, [Instructions: Insert the Affiant’s name] of
_____________________________________________ [Instructions: Insert the Affiant’s
address] being first duly sworn on oath, state that:

    1. I am over 18 years of age and competent enough to testify of my own knowledge of the
       facts stated herein.

    2. All the facts stated by me herein are true, correct and complete to the best of my
       knowledge and understanding.

    3. ________________________________________________________________________
       ________________________________________________________________________
       ________________________________________________________________________
       [Instructions: Briefly describe the statement of facts which the Affiant swears to be
       true]

    4. ________________________________________________________________________
       ________________________________________________________________________
       ________________________________________________________________________
       [Instructions: Briefly describe the statement of facts which the Affiant swears to be
       true]

    5. ________________________________________________________________________
       ________________________________________________________________________
       ________________________________________________________________________
       [Instructions: Briefly describe the statement of facts which the Affiant swears to be
       true]

I swear that to the best of my knowledge, the information contained in this affidavit is true and
correct as of _________________. [Instructions: Insert the date that Affiant will sign this
affidavit]


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Printed Name of Affiant: _________________ [Instructions: Insert the Affiant’s name]

Signature of Affiant: _________________________________________ [Instructions: Insert
the Affiant’s signature]
Signed on _________________ [Instructions: Insert the date that Affiant will sign this
affidavit]

Address of Affiant: _____________________________________________ [Instructions:
Insert the Affiant’s address]




© Copyright 2013 Docstoc Inc. registered document proprietary, copy not         3
Notary Form

STATE OF                                       }
COUNTY OF                                      }

On ________________________________ before me, __________________________,
personally appeared ___________________________________________________, personally
known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose
name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they
executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s)
on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed
the instrument.

WITNESS my hand and official seal.


_____________________________
Signature


Affiant: _____Known _____Unknown

ID Produced: __________________________


[Seal]




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