AFFIDAVIT

I, [Your Name], residing at [Your Company Address], being duly sworn, hereby depose and state as follows:

1. Personal Information

Name: [Your Name]

Date of Birth: [Your Date of Birth]

Address: [Your Company Address]

2. Affidavit Statement

I, [Your Name], hereby affirm that the following statements are true to the best of my knowledge and belief:

[State your purpose]

3. Supporting Documentation

[Supporting Documentation]

4. Declaration

I hereby certify under penalty of perjury that the foregoing is true and correct. I understand that if any of the foregoing statements made by me are willfully false, I am subject to punishment.

Dated this [Day] day of [Month], [Year].

5. Signature

[Your Name]

[Date]

6. Notary Public

Subscribed and sworn to (or affirmed) before me on this [Day] day of [Month], [Year], by [Your Name], proved to me on the basis of satisfactory evidence to be the person who appeared before me.

Notary Public Signature

Seal:

[Notary Seal here]