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Sworn statement in proof of loss 2026

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This document is a sworn statement in proof of loss for a dwelling insurance policy in Texas. It outlines the necessary information required to file a claim, including details about the time and cause of loss, interests in the damaged property, other insurance coverage, valuation of the damaged property, changes in title or occupancy, and additional living expenses. The form must be signed and notarized.

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Click ‘Get Form’ to open the sworn statement in proof of loss in our editor.
Begin by filling out the 'Time And Cause Of Loss' section. Enter the date and time of loss, and provide a detailed explanation of the cause of loss.
In the 'Interest' section, list the names and interests of all insured parties in the damaged property, such as owners or leaseholders. Include any other parties with an interest, like mortgagees or assignees.
For 'Other Insurance', indicate any additional insurance that may cover this loss by providing company names and policy numbers.
Complete the 'Valuation Of The Damaged Property At The Time Of Loss' section by describing each property type (dwelling, personal property) along with its actual cash value, replacement cost value, and amount claimed.
Document any changes in title or occupancy during the policy term in the designated section.
Finally, if applicable, include details about additional living expenses or fair rental value losses. Attach supporting receipts or records.
Sign and date the form where indicated. Ensure it is notarized as required.

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How to fill out proof of loss statement?

Some of the most common pieces of information that need to be submitted on this form include the cause and date of the damage, the policy number under which this is allegedly covered, any people who have a financial interest in the claim like a mortgage holder, estimates to repair damage as a result of property

What are some examples of a sworn statement?

I currently reside at [ ]. [ A detailed account of the incident ]. I declare that, to the best of my knowledge and belief, the information herein is true and complete. I understand this statement is made for use as evidence in court and is subject to penalty for perjury.

What is a completed sworn statement in proof of loss?

In general, this is a sworn statement that is usually also signed by a notary about the losses that you suffered in a specific incident. This is your formal request for the amount that you are claiming after a covered and insured event.

How to properly fill out a sworn statement?

Heres how to do it: Title and Caption. Start with a clear titletypically just Affidavit. Affiant Information. This section introduces the person making the affidavityou. Statement of Truth. Body of the Affidavit. Recipient and Oath. Signature and Notarization. Review and docHub.

How do you fill out a sworn statement in proof of loss?

How to Fill out a Sworn Statement in Proof of Loss Obtain a copy of the Sworn Statement in Proof of Loss from the insurance company. Fill out the required information, including the policy number, insurance agents name, insurance agency, and the issue and expiration dates for the policy.

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What is a sworn statement in proof of loss document?

Although the document called a sworn statement in proof of loss sounds intimidating, it is nothing more than a second document that describes the details of your personal injury incident, as well as contains the physical evidence that demonstrates you sustained financial losses.

What is a proof of loss statement?

Proof of loss is a legal document that explains whats been damaged or stolen and how much money youre claiming. Your insurer may have you fill one out, depending on the loss. Homeowners, condo and renters insurance can typically help cover personal property.