Affidavit In Support Of Default

Affidavit In Support Of Default

I, [Your Name], of [Your Company Address], do hereby solemnly affirm and declare as follows:

  1. I am the creditor in the matter of the contract/agreement dated January 15, 2050, between myself, hereinafter referred to as the Creditor, and [Debtor's Name], hereinafter referred to as the Debtor.

  2. The Debtor has failed to fulfill their financial obligations as outlined in the aforementioned contract/agreement. Specifically, the Debtor has failed to make payments as agreed upon in the contract/agreement.

  3. Despite repeated attempts by the Creditor to contact the Debtor and request payment, the Debtor has failed to respond or rectify the default. The default remains unresolved as of the date of this affidavit.

  4. As a result of the Debtor's default, the amount outstanding as of [Date of Affidavit] is $5,000, inclusive of any accrued interest and fees.

I affirm under penalty of perjury that the foregoing statements are true and correct to the best of my knowledge, information, and belief.

Signed this [Date of Affidavit] at [Place of Affidavit].

[Your Name]

[Date]


On this [Date of Notarization], before me, a Notary Public, personally appeared [Your Name], known to me (or proved to me based on satisfactory evidence) to be the person whose name is subscribed to the within the instrument and acknowledged to me that they executed the same in their authorized capacity and that by their signature on the instrument, the person, or the entity upon behalf of which the person acted, executed the instrument.

Witness my hand and official seal.

[NOTARY PUBLIC NAME]

My commission expires: [NOTARY EXPIRATION DATE]

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