Sample Affidavit Template
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1AFFIDAVIT
710 Buffalo Street
Park Tower, #213
Corpus Christi TX 78401
This is a legal document and MUST be typed.
361-884-1100
866-BOX-ING1
Your Name
866-269-4641
AFFIDAVIT OF
_______________________________________________
info@auditmasters.net
Name of Auditor
Audit Masters
Your County
COUNTY OF
_________________________________________________
Your State
STATE OF
___________________________________________________
Your Name
BEFORE ME, the undersigned authority, on this day personally appeared
_________________________________________
Name of Auditor
and after being first duly sworn according to law, deposes and states as follows:
Your Name
1. My name is
. I am over the age of eighteen (18) years, of sound mind,
________________________________________
Name of Auditor
competent to testify as to the matters contained herein, personally acquainted with the facts stated herein, and
state that they are true and correct.
2. I am currently employed by Audit Masters
9:00
9th
September
3. At approximately
P.M. on this
day of March 2013
of March 2013
___________
_________
i T
m
e
D
a
y
Joe's Bar and Grill
I entered
_______________________________________________________________________________________________________
Name of Establishment
1234 Main Street
_______________________________________________________________________________________________________________
Street Address
Your City and State
212-555-1212
_________________________________________________________________
_________________________________________
City/State/Zip
10 Digit Phone Number
Joe's Bar and Grill
During my visit I observed that
was displaying the
________________________________________
Name of establishment
Mayweather vs Ortiz
UFC 158 St. Pierre vs Diaz event and/or its undercard or preliminary bouts. I took a head count at this time and
UFC 158 St. Pierre vs Diaz ev
75
3
counted approximately
persons inside the establishment. I also noticed there were
televisions
________
________
and/or monitors for viewing by patrons indisde this establishment.
4. The television monitor(s) displayed the following: (Logos as they appear on the microphone, ringmat, ring
posts, or television screens; and the identity of any boxing activity witnessed, specifically, if applicable, names of
fighters, color of boxing trunks, round number and time remaining in round.)
At the time I was there it was the 3rd round of the match between FLOYD MAYWEATHER JR who was wearing Black and white
_______________________________________________________________________________________________________________
Trunks and VICTOR ORTIZ who was wearing Red and Blue trunks, on the ring mat I saw the logo for (name whatever casino name is
on the mat) as well as a logo for (name whatever beer name is on the Mat) I also noted that the ring posts were (name whatever color
_______________________________________________________________________________________________________________
the posts are) Hanging over the ring I could see a banner for (name one of several signs that will be hanging over the ring) On the
Bottom right hand corner of the Screen I also saw a countdown clock with the letters HBO PPV
_______________________________________________________________________________________________________________
PLEASE REMEMBER TO DATE AND SIGN THIS AFFIDAVIT IN THE PRESENCE OF THE NOTARY PUBLIC WHO SHALL NOTARIZE YOUR SIGNATURE.
By
___________________________________________________________________________
Signature of Auditor
Your Name
_____________________________________________________________________________
Printed Name of Auditor
September 9th
Dated
, 2013
_________________________________________________________________
9th
September
Sworn to and subscribed before me this
day of
, 2013
____________
____________
Your State
Notary Public In and For the State of
__________________________________________
December 31st, 2013
My Commission Expires
______________________________________________________
_____________________________________________________________________________
Signature of Notary Public
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