Affidavit of Direct Payment
Affidavit of Direct Payment
State of [STATE],
County of [COUNTY]
I, [YOUR NAME], residing at [YOUR ADDRESS], being duly sworn, depose and state as follows:
Statement of Facts
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I am the undersigned, and I have personal knowledge of the matters stated herein.
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On [DATE], I made a direct payment of $[AMOUNT] to [PAYEE], in relation to [PURPOSE OF PAYMENT].
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The payment was made via [METHOD OF PAYMENT], and the transaction was conducted in accordance with the terms agreed upon between myself and [PAYEE].
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I did not utilize the services of any intermediaries or third parties in making this payment. It was a direct transaction between myself and [PAYEE].
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Attached hereto and marked as Exhibit A is a copy of the receipt or any supporting documentation evidencing the payment made.
Sworn Oath
I declare under penalty of perjury under the laws of the State of [STATE] that the foregoing is true and correct.
Executed on this [DAY] day of [MONTH], [YEAR].
Signature
[Your Name]
Sworn to and subscribed before me on this [DAY] day of [MONTH], [YEAR].
[Notary Public's Name]
Notary Public
My Commission Expires: [Date]
