Defendants Financial Affidavit Page 3

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____________________________________________________________________________ .
I swear or affirm that the information and facts I have provided for the Court on this
motion are within my personal knowledge and are true and correct. I understand that if I
intentionally or knowingly give false information either in this affidavit or during the hearing on
this motion, that I may be prosecuted for the offense of aggravated perjury, a felony.
___________________________________
DEFENDANT
Sworn to and subscribed before me this ____day of _______________, A.D. 20____.
___________________________________
DEPUTY DISTRICT CLERK
3

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