If the affidavit is a statement given under oath, then the name and address of the individual giving the information or testifying must be included in the title. For example, Affidavit of Jane Doe.

  1. Sample Statement Affidavit Form
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  3. Sample Statement Affidavit Template Easysitekiosk Template
  1. The word affidavit stemmed from a Medieval Latin verb affidare, meaning, to pledge. Moreover, the Latin term affidavit directly translates to “he or she has made a pledge.” The statement that an individual has sworn can be anything. It may be about his or her marriage, finances, residence, and others. And you would never know when an.
  2. Mar 13, 2017 - Affidavit Form template Free Word Templates - affidavit templates. Business And Advertising. Word Template Design. Saved from londonmedarb.com. Affidavit Templates - Free Printable Documents. Saved by Greg y Reyna Dunaway. People also love these ideas.

Sample affidavit: witness of couple living separately under the same roof

An affidavit by another person, who is not your spouse, serves to confirm your story that you have lived separately under the same roof.

This person could be a family member, friend, neighbour or professional who is familiar with the circumstances of your relationship and is over 18.

What should the witness include in an affidavit?

Generally, an affidavit should not set out the opinion of the person making the affidavit; that is, it must be based on facts not their beliefs or views.

Where possible you should avoid referring to facts that are based on information received from others (known as hearsay evidence).

You should not include in your affidavit, what you think another person was feeling or thinking unless you have evidence of them telling you what they thought or felt at the time, such as a one on one conversation, letter or email.

Any affidavit you file must be served on all parties. Read more about serving documents: Serving divorce papers: A quick how to guide

Formatting an affidavit

The affidavit must be divided into paragraphs. Each paragraph must deal with only one aspect of the subject matter. It is suggested that each paragraph contain no more than about 6 lines.

  • Each paragraph must be numbered.

  • Each paragraph should be confined to a distinct part of the subject matter.

  • The affidavit must be typed. Handwritten affidavits will be accepted only in circumstances of urgency, usually involving some immediate threat of harm to a child.

  • Text should be printed on only one side of white A4 paper.

  • Documents in support of your affidavit should be referenced as an annexure in the format required by the appropriate court (see below).

  • The address for service of the documents (the address the court can contact the deponent) must be included in the footer of page 1.

Their affidavit should be formatted in the same way as the sample below:

SAMPLE AFFIDAVIT

(For independent witness to person living separately under the same roof)

Top of page

FILED IN: (Mark with X the court that applies)

FAMILY COURT OF AUSTRALIA

FAMILY COURT OF WESTERN AUSTRALIA

FEDERAL MAGISTATE’S COURT OF AUSTRALIA

OTHER: _______________________________

REGISTRY: Location

File Number: Enter if existing

Parties to the matter:

Applicant’s name (Applicant)

and

Respondent’s Name (Respondent)

AFFIDAVIT

Filed on behalf of:

Full name:The person who requested they write the affidavit

Name of deponent: Name of person making the affidavit on your behalf

Date sworn/affirmed: ____/____/______ .

I, Witness Name of witness' address make oath and say, as follows:

Sample Statement Affidavit Templateeasysitekiosk

(Write the paragraphs that apply to you)

  1. I, witness’s name, born Xday Xmonth, 19XX, make this affidavit at the request of full name of person who requested affidavit, (“First Name”). I understand this affidavit will be used in court.

  2. l have known First Name, and Name of other party (“OP”) for XXX years , because I was/am ….. for example – a neighbour and family friend.

  3. Before I learned that the couple had separated, we would … explain the relationship – for example – often go out for dinner with our spouses and other friends, spend time with each other’s families at sporting events, social gatherings and camping holidays. During the time we spent together, I considered first name and OP to be a couple in a marriage/defacto relationship.

  4. I recall becoming aware that the couple had separated on or about Xday Xmonth, 19XX when …. explain how witness knew of the separation – for example - First name came to my house at around XX:XXam/pm and told me that they had ended the relationship with OP and asked if they could stay the night as things were uncomfortable at home. During the evening first name told me they would have to stay in the house because they could not afford to move out but they would be moving to the spare room.

  5. Since first name and OP separated, I have observed when I visited their home that … explain anything that reinforced the couple were living separately? For example - Did they see that you didn't share a bedroom with your spouse anymore? Did they see that your spouse's things were now in a different room?

  6. I had a conversation with OP on or about Xday Xmonth, 19XX when ... for example ... they phoned me/I saw them at and event and they confirmed to me that they were still living under the same roof but had separated by saying words to the effect. “what did they say that confirmed they had separated…..”

  7. Since the couple separated, they no longer … explain things that have changed - for example - did you stop going to social events and family holidays together? Did you start to spend more time with the witness as a single person. Did they notice that you no longer spoke to each other unless it was essential, shared household chores, finances, or, you say, stopped preparing meals and eating together?

  8. Anything else that is evidence the two parties have lived separately under the same roof and have not been in a marriage relationship.

End of Affidavit

Attach supporting documents:

If you have any evidence that supports the information you have written in your affidavit, you should attach them to your affidavit. For example, an email, screenshot of a text or letter you sent your spouse about your separation and subsequent arrangements, a letter from Centrelink confirming your change of relationship status.

You should check the website of the court you are filing in to confirm how it requests supporting evidence to be filed.

Generally, to attach a document, for example a letter, you should write in the affidavit: 'annexed to this affidavit and marked 'A' is a copy of the letter '. You should then write 'A' at the top of the front page of the letter you are attaching.

On the first page of each annexure, you should include the parties to the matter, the file number and the words,

“This is the annexure marked with the letter “A” referred to in the Affidavit of deponent’s name affirmed XDay of XMonth 20XX before me:

Below this phrase is where the authorised person should sign that they have witnessed.

The deponent must also sign each page of the document.

If you have more than one document, mark each one A, B, C, D etc. in the order that you refer to them in your affidavit and attach them in that order to the back of your affidavit.

Source: Family Court of Australia.

Attaching documents

Federal Circuit Court

If you refer to a document in your affidavit, you must attach a copy of it to the back of your affidavit (known as an annexure). Examples of an annexure are a contract of sale or a child’s school report. If there is more than one annexure, you need to refer to each one by a number or letter; for example, Annexure 1 or Annexure A. You also need to number the annexures consecutively, that is, from the first page of the first annexure to the last page of the last annexure. Each annexure must have a statement signed by the authorised person identifying the annexure as the document referred to in the affidavit.

Affidavit

The wording of the statement is:

This is the document referred to as Annexure [insert reference number] in the affidavit of [insert deponent’s name], sworn/affirmed at [insert place] on [insert date] before me [authorised person to sign and provide name and qualification].

The statement must be signed at the same time as the affidavit and by the same authorised person.

Family Court

A document that is to be used in conjunction with an affidavit and tendered in evidence in a court proceeding, must be identified in the affidavit but must not be attached to (or annexed to) the affidavit, or filed as an exhibit to the affidavit. There may be exceptions where court orders or the Rules provide otherwise (for example Family Law Rule 15.62 in relation to expert reports). The document/s referred to in the affidavit must be served with the affidavit on the other party/ies after filing and referenced in the disclosure list. The document/s must then be tendered in evidence at the court event when the relevant affidavit is relied upon or as required. See Family Law Rule 15.08. Source: Family Court of Australia.

Signing an affidavit

The person making an affidavit (the deponent) must sign the bottom of each page in the presence of an authorised person, such as a lawyer (as long as they have not participated in preparing the affidavit or in the proceedings in which the affidavit is intended to be used), or Justice of the Peace.

If you are overseas a Notary Public or Australian Diplomatic/Consulate Officer can witness the signature.

On the last page of the affidavit the following details must be set out (known as a jurat):

  • the full name of the person making the affidavit, and their signature

  • whether the affidavit is sworn or affirmed

  • the day and place the person signs the affidavit, and

  • the full name and occupation of the authorised person, and their signature.

If any alterations (such as corrections, cross-outs or additions) are made to the affidavit, the person making the affidavit and the witness must initial each alteration.

Related reading:

Sample

If you have decided to end your relationship, you should start to educate yourself. I know the overwhelming feelings of making these decisions and facing your new realities. My book, The First Steps through Separation and Divorce will guide you through the emotional and practical aspects you may need to address in the coming weeks, months and years.

Get a feel for what's covered:View the Table of Contents.

Sample Statement Affidavit Form

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Published by, Christine Weston
Founding Director and Creator of Divorce Resource
Australian Nationally Accredited Mediator and Divorce Coach

The information in this article is general in nature and a sample only and should not be considered as legal advice. You should seek the advice of a registered professional who will be able to appropriately assess your specific circumstances before offering their expert opinion.

Edited by Pat Bitton

July 24, 2019

An affidavit (also known as a general affidavit) is a written statement of facts, sworn under an oath and signed before a notary public or another authorized officer. A standard affidavit form can be used as an evidence in a court of law.

Sample Affidavit Form in the PDF Format

Here is a structure and example for an affidavit form needed for the remote witnessing:

Disclaimer: The templates here are provided for reference only and you should always talk to a professional for all legal matters.

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  1. At the top of the general affidavit form, enter the name of the state and county.

  2. In the main body of the form, you will be required to provide your personal information such as the full name and the state and county of residence.

  3. In the blank space below, insert the statement that you swear to be true. The basic affidavit form statement can contain one or more sections.

  4. After that, you should fill in the date that the statement is being made.

  5. At the end of the form, you and a notary should sign the completed form to get your affidavit form notarized. Ask your notary public the exact date on which the notary public's commission expires to put it in the bottom left corner. Alternatively, you can leave the expiration date blank for the notary to complete.

Tips on How to Write an Affidavit

  1. Determining Your Statement

    Before drafting an affidavit, you first have to specify the facts that must be included in the document. There can be just one or a few facts stated in a numbered list. Unless you have been asked to prepare an affidavit paper as an expert witness, the statement should contain an outline of what you saw or heard, rather than opinions and rumors.

  2. Choosing the Right Notary Public

    Choosing a notary public is just like choosing any other professional consultant. You need not only someone to be familiar with the basic laws and regulations in your state or territory, but you also can reasonably expect from the notary considerate cooperation and understanding your individual circumstances. For example, don’t choose the notary who is way too busy with other clients to avoid delayed and non-committal responses.

  3. Creating an Affidavit Document

    Download PDFChef with free printable form templates. Select the affidavit template. The information should include the name of the state and county, the affiant’s full name, the sworn facts stated, and the signatures of the parties involved.

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