Sworn Statement Template
SWORN STATEMENT
I, [Full Legal Name], of [Address], being duly sworn, do hereby declare and state under oath the following:
1. Declarant Information
Full Name: [Full Legal Name]
Date of Birth: [MM/DD/YYYY]
Address: [Full Address]
Identification Number (if applicable): [ID / Passport No.]
2. Statement of Facts
I affirm the following facts to be true and accurate to the best of my knowledge:
[Insert numbered list of facts being declared.]
3. Purpose of Statement
This sworn statement is provided for the purpose of [Describe reason, e.g., legal proceedings, insurance claim, financial verification, administrative requirement].
4. Affirmation
I declare under oath and penalty of perjury that the facts stated herein are true and correct. I understand that false statements may result in criminal or civil liability.
5. Execution
Executed this [Day] of [Month, Year], at [City, State/Country].
Declarant Signature: _______________________________
Printed Name: ___________________________________
6. Notary / Authorized Officer Acknowledgment
On this [Day] of [Month, Year], before me, [Name of Notary/Officer], personally appeared [Declarant’s Full Name], known to me (or satisfactorily proven) to be the individual who executed the foregoing Sworn Statement, and acknowledged it to be true and correct.
Notary / Officer Signature: __________________________
Printed Name: ____________________________________
Commission No.: _________________________________
My Commission Expires: ___________________________