Wyoming General Affidavit

STATE OF WYOMING
COUNTY OF [County Name]

Introduction:

Before me, the undersigned authority, on this day personally appeared [YOUR NAME], who being duly sworn, deposes and says:

Statement of Facts:

I, [YOUR NAME], residing at [YOUR ADDRESS], was born on [DOB].
I am employed as an [Occupation] and possess an identification number listed as [Driver’s License/State ID/Passport Number].
This statement is crafted to affirm my personal identity and professional information accurately.
It is prepared for the purpose of any legal, official, or verification requirements that necessitate the disclosure of such details.
I, [YOUR NAME], hereby make this affidavit to assert the following facts regarding the dispute/claim with [Other Party’s Name/Insurance Company Name] concerning concerning an auto accident claim on [Date]".
- Fact 1: The accident occurred on [Date] at the intersection of [Street Name] and [Street Name].
- Fact 2: The weather at the time of the accident was clear, and both vehicles were traveling at a moderate speed.
- [Continue as necessary]
These facts are provided in support of my [claim/dispute] filed with [Insurance Company/Court Name] and are true and accurate to the best of my knowledge and belief.

Purpose of Affidavit:

This affidavit is executed for the purpose of providing a sworn statement of fact regarding the aforementioned dispute/claim in small claims court proceedings.

Oath of Affiant:

I understand that this affidavit is made under the penalties of perjury. I affirm under penalty of perjury under the laws of the State of Wyoming that the foregoing statements are true and correct to the best of my knowledge, information, and belief.

Executed on this [DAY] of [MONTH], [YEAR].

Signature:

[YOUR NAME]

Subscribed and sworn to (or affirmed) before me on this[DAY] of [MONTH], [YEAR], by [YOUR NAME], known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument.

[Notary Public’s Printed Name]