STATE OF _____________

COUNTY OF ____________


______________, being duly sworn, or having duly affirmed to tell the truth, stated personally before me:







That they are competent under the law to give this affidavit and unless stated have personal knowledge of the facts stated herein:




Sworn or affirmed before me on _____________________.








Notary Public

Commission Expires




Review List

This review list is provided to inform you about this document in question and assist you in its preparation.  This document can be used to gather information or an “affidavit” from witnesses or parties to some circumstance you wish to document.  You can use this form to take the first step towards legalizing their testimony or evidence in a legal matter such as witnessing an accident, saying what the parties “meant” by an agreement, or other such matters.


  1. Make multiple copies and get a notary to witness the assertions so they can be revised easily, by the witness, at a later date.
  2. Make multiple original copies for presentation in whatever legal matter you may have pending.
  3. Use these statements or affidavits in settlement talks.  They can be quite useful to pry loose a settlement in your favor.