_COMMONWEALTH OF MASSACHUSETTS



Blank  Affidavit form

Instructions and form

Instructions

Use this form to state the facts the judge needs to know about what happened and when. In an affidavit you swear that everything you say is true.

1. In the blank for _________ DIVISION, put the county for the court where you are filing this affidavit.

2. In the blank for PROBATE & FAMILY COURT No._______, put the docket number for the case, if you know it.

3. The plaintiff is the person who filed the complaint that started the case.

4. The defendant is the other person in the case.

5. You are submitting this affidavit. Put your name in the blank after AFFIDAVIT OF _________.

6. On the blank lines, list the facts the judge needs to know about what happened and when.

7. Put the date you sign the affidavit at the bottom of the form.

8. Sign the affidavit where it says signature. Remember when you sign this affidavit; you are swearing that everything you put into this statement is true.

See blank affidavit form on next page…

COMMONWEALTH OF MASSACHUSETTS

TRIAL COURT

__________________________ DIVISION PROBATE & FAMILY COURT

No.__________________________

____________________________ Plaintiff

V.

__________________________ Defendant

1

AFFIDAVIT OF

__________________________________

Your name

I, __________________________(your name), swear that the following statements are true

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Signed under the pains and penalties of perjury,

_____________________________ _____________________________________________

date signature

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