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Click ‘Get Form’ to open the under penalty of perjury statement example in the editor.
Begin by filling in the state and county where you reside at the top of the form. This establishes your jurisdiction.
Enter your name as the account holder, followed by the financial institution's name that issued the ACH debit notification.
Provide your account number and the date of the unauthorized or improper transaction, along with the amount charged.
Complete either Section 1 or Section 2 based on whether you are disputing an unauthorized consumer entry or an improper entry. Check the appropriate boxes and fill in any required details.
Sign and date the form at the bottom, certifying that all information provided is true and correct under penalty of perjury.

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How to write a statement under penalty of perjury?

I solemnly affirm under the penalties of perjury that the contents of the foregoing paper are true to the best of my knowledge, information, and belief. Personal Knowledge. I solemnly affirm under the penalties of perjury and upon personal knowledge that the contents of the foregoing paper are true.

Does a declaration under penalty of perjury need to be docHubd?

Because such declaration does not require a notary or other official to administer oaths, individuals preparing statements for use in litigation should consider using this format.

What is a written statement under penalty of perjury?

Declaration under penalty of perjury is a statement of facts or testimony accompanied by the declaration that the person making the statement will be found guilty of perjury if the facts declared in the statement are shown to be untrue.

What does I declare under penalty of perjury that all of the information provided above is accurate?

(2) A written declaration means the following statement: Under penalties of perjury, I declare that I have read the foregoing [document] and that the facts stated in it are true, followed by the signature of the person making the declaration, except when a verification on information or belief is permitted by law, in

What is an example of a written statement under oath?

A sworn declaration (also called a sworn statement or a statement under penalty of perjury) is a document that recites facts pertinent to a legal proceeding. It is very similar to an affidavit but is not witnessed and sealed by an official such as a notary public.

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How to write a statement under penalty of perjury?

Does a declaration under penalty of perjury need to be docHubd?

What is a written statement under penalty of perjury?

What does I declare under penalty of perjury that all of the information provided above is accurate?

What is an example of a written statement under oath?

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Under penalty of perjury statement example 2026

Here's how it works

How to use or fill out under penalty of perjury statement example with our platform

Complete this form in 5 minutes or less

Got questions?

How to write a statement under penalty of perjury?

Does a declaration under penalty of perjury need to be docHubd?

What is a written statement under penalty of perjury?

What does I declare under penalty of perjury that all of the information provided above is accurate?

What is an example of a written statement under oath?

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