STATE OF NORTH CAROLINA
IN THE GENERAL COURT OF JUSTICE __________ COURT DIVISION
___________________ COUNTY
[court docket #]
_________________________ V. _________________________
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AFFIDAVIT
The undersigned affiant, ________, being first duly sworn, hereby deposes and says: 1. I am over the age of eighteen, suffer no legal disabilities, have personal knowledge of the facts set forth below, and am competent to testify. I am employed as __________________________ at North Carolina State University. As part of my job, I have custody over ________ records of _____________________. I hereby certify that the attached records are true and accurate copies of all the ________________ records that are kept under my custody or the custody of persons in my office, and that pertain to ____________________ from ________ through _________. These records were made and kept in the regular course of business by my office at or near the events reflected therein. These records are being produced pursuant to subpoena (attached hereto).
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This the _______ day of _______, 200_. ______________________________ ____________, Custodian of records Sworn and subscribed before me this the ______ day of _______, 200_. _____________________________________ Notary Public My Commission expires: _____________________