Sworn Statement Template: Declaration, Facts & Signature

Sworn Statement Template: Declaration, Facts & Signature

Sworn Statement Template: Declaration, Facts & Signature

Sworn Statement Template: Declaration, Facts & Signature

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Length: 4-6 pages

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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: ___________________________

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: ___________________________

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Sworn Statement Template: Declaration, Facts & Signature

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For quick answers, scroll below to see the FAQ.

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For quick answers, scroll below to see the FAQ.

Frequently asked · Sworn declarations

Sworn Statement · Six use cases, federal §1746, RON in 40+ states

Eight questions before you sign a sworn statement. Below the FAQ: six use-case variants (insurance proof of loss, construction loan, military Article 138, court motion, immigration, employment HR) each with sample opening, the federal §1746 / state notarization matrix, and a clear callout on what a sworn statement is NOT (vs affidavit, vs witness statement, vs declaration).

01Basics

What is a sworn statement?

A sworn statement is a written document setting out facts the signer declares to be true, signed under oath or under penalty of perjury, that is admissible as evidence in legal proceedings and many administrative processes. It functions as a self-contained piece of testimony in writing.

The document does three jobs: it puts specific facts on the record from a named, identifiable person; it commits the signer to the truth of those facts under criminal penalty; and it gives the receiving body (court, insurer, agency, employer, military commander) a document they can rely on without calling the signer in to testify. Compared with a casual letter, a sworn statement is admissible, weighted, and consequential.

02Why it matters

Why is a sworn statement important?

It is often the difference between getting a claim paid, a motion granted, a benefit approved, or being told "we need more than your word for it".

Three places sworn statements carry decisive weight in 2026:

  • Insurance claims. Most US property and auto insurers require a Sworn Statement in Proof of Loss before paying a contested claim. Without it, the insurer can refuse to release funds.
  • Court motions. Federal courts under Fed. R. Civ. P. 56 (summary judgment) accept sworn statements under 28 U.S.C. §1746 in place of in-person testimony for many procedural motions.
  • Administrative agencies. USCIS, the IRS, state benefits agencies, professional licensing boards all accept sworn statements as primary or secondary evidence depending on the procedure.
03Use case

When should you use a sworn statement?

Whenever a decision-maker needs first-person facts on the record and you will not be available (or are not required) to testify in person. See the BONUS section for the six most common variants; the universal triggers:

  • Insurance Sworn Statement in Proof of Loss (property damage, fire, theft, auto)
  • Construction-loan sworn statements (itemising payments to contractors, suppliers, subs)
  • Military Article 138 complaints, Article 15 statements, command investigations
  • Court motions (summary judgment, family law, probate, small claims)
  • Immigration filings (USCIS, immigration court, asylum, consular)
  • Employment / HR investigations (workplace incidents, harassment claims, whistleblower)
  • Probate and estate matters (heir attestation, asset inventories)
  • Government benefits and licensing applications
04What to include

What should a sworn statement include?

Seven elements, in this order. Receiving bodies (especially courts and insurers) frequently reject sworn statements that depart from this structure.

  1. Signer identification. Full legal name, age or date of birth, address, occupation, relationship to the matter.
  2. Source of knowledge. One sentence on how the signer knows the facts ("I am the policyholder named on the attached insurance policy"; "I was present at the meeting on [date]").
  3. Statement of facts. Numbered paragraphs, chronological, in the signer's own words. First-person, past tense, specific dates, times, places, amounts.
  4. Exhibits or attachments. Documents, photos, receipts, or records referenced in the statement, labelled and attached.
  5. Truth attestation. Either the §1746 federal declaration ("I declare under penalty of perjury under the laws of the United States that the foregoing is true and correct") or a notarised jurat ("Sworn to and subscribed before me this day").
  6. Date and signature. Wet-ink or qualified electronic signature, with the date.
  7. Notary block (if notarised): notary's seal, commission expiration, jurisdiction.
05Compare

Is a sworn statement the same as an affidavit?

Functionally similar, technically different. The difference is who witnesses the signature and under what formal mechanism.

  • Affidavit. Sworn statement signed before a notary public, commissioner for oaths, or judicial officer with a formal oath ("I swear"). The notary's jurat seals the document.
  • Sworn statement (federal §1746 form). Written declaration under penalty of perjury, signed by the declarant alone, no notary required. Created by 28 U.S.C. §1746 as a federal equivalent to the affidavit. Accepted in federal court and most federal agencies.
  • Sworn declaration / statutory declaration. Similar to §1746 but used at the state level under state-specific statutes.
  • Witness statement (CPR Part 32, UK civil). Written witness testimony with a statement of truth, used to replace oral testimony in English civil courts.

Pick the format the receiving body requires. Federal court and USCIS will almost always accept §1746 declarations; state courts vary; foreign jurisdictions usually require a notarised affidavit with apostille or consular authentication.

06How-to

How do I write a sworn statement?

Write in first person, chronologically, in numbered paragraphs, using past tense and the active voice. Keep statements about your own observations; quote what others said in direct speech in quotation marks; avoid opinions or characterisation.

Universal rules across all variants:

  • Number every paragraph (1, 2, 3...) so receiving body can reference specific facts
  • One topic per paragraph; do not combine multiple events
  • Use specific dates, times, places, amounts; "around 3pm" is weaker than "between 2:50pm and 3:10pm"
  • Distinguish what you saw, what you were told, and what you inferred
  • Refer to documents as exhibits ("see Exhibit A"), do not paste images inline
  • Close with the exact sworn-statement language for your jurisdiction (see matrix in BONUS section)
  • Sign on the date you actually sign; do not backdate
07Legal effect

What legal effect does a sworn statement carry, and what happens if it's wrong?

It carries the same evidentiary weight as testimony given in court, AND the same criminal exposure for falsity.

  • Evidentiary weight. In US federal court under Fed. R. Civ. P. 56, sworn statements are evidence at the summary judgment stage on the same footing as deposition testimony. In USCIS filings, sworn statements carry weight in the officer's discretionary decision.
  • Criminal exposure. A knowingly false sworn statement is perjury under 18 U.S.C. §1621 (federal) or the equivalent state statute. Sentences include imprisonment (typically up to 5 years federal). Even an honest mistake the signer later corrects can damage credibility on the entire matter.
  • Civil consequences. A false sworn statement that injures a third party can give rise to fraud, defamation, or tortious interference claims.

Treat every sentence as if you will be cross-examined on it. "I do not recall" is always safer than a wrong specific. Mark estimates as estimates ("I estimate the speed at approximately 45 mph"). Do not sign anything you have not personally read and verified.

08Customise

Need a customized sworn statement?

Use AI Lawyer to generate one tailored to your use case. Pick the variant (insurance proof of loss, construction loan, military, court motion, immigration, HR investigation), set the matter; the assistant produces a statement with the right format, the correct sworn-statement language (§1746 or notarised jurat), and the structure the receiving body expects. For matters involving criminal exposure, court filing, or insurance claims above $10,000, have an attorney review before signing.

Draft a sworn statement that holds up where it counts

Free template, six use-case variants, with federal §1746 declaration language built in and the right structure per receiving body.

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