Free Simple Affidavit of Facts Template
Simple Affidavit of Facts
STATE OF Wisconsin
COUNTY OF Dane
I, [Your Name], residing at Madison, WI 53701, being of legal age and of sound mind, hereby declare and affirm under penalty of perjury that the following facts are true and correct to the best of my knowledge.
1. Personal Information
I, [Your Name], am a citizen of the United States, born on August 15, 2055, currently residing at Madison, WI 53701. I am providing this affidavit of my own free will, without any coercion or undue influence from any third party.
2. Statement of Facts
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On or around February 5, 2090, I entered into an agreement with Primeve, a Wisconsin-based entity, to provide consulting services regarding data analytics for their upcoming project, “Project Quantum.”
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On March 10, 2090, I paid $15,000 to Primeve for services as outlined in the contract dated February 5, 2090.
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Despite the payment and fulfillment of my obligations under the agreement, Primeve has failed to deliver the agreed-upon services or provide any justification for their non-performance.
3. Evidence and Supporting Documents
To support the facts mentioned above, I have attached the following documents as evidence:
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A copy of the signed agreement between myself and Primeve dated February 5, 2090.
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Bank statements showing the $15,000 payment made to Primeve on March 10, 2090.
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Email correspondence between myself and Primeve representatives regarding their failure to deliver the agreed-upon services.
These documents are true and accurate to the best of my knowledge and are referenced in this affidavit to substantiate my claims.
4. Oath and Verification
I, [Your Name], swear under oath that the facts presented in this affidavit are accurate, truthful, and complete. I understand that making false statements in this affidavit may result in penalties for perjury under the laws of Wisconsin.
[Your Name]
Affiant
Date Signed: September 18, 2090
5. Notarization
SWORN TO AND SUBSCRIBED before me, the undersigned Notary Public, on this 18th day of September, 2090, in the County of Dane, State of Wisconsin.
Notary Public:
Evelyn Thomas
Commission Number: 4876531
Commission Expires: July 31, 2092
