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AFFIDAVITOFJOHNDOE

Name:JohnDoe
Occupation:Mechanic/OwnerofJohnDoeAutoRepair
I,JohnDoe,swearoraffirm:
1.ThatIamtheOwnerofJohnDoeAutoRepair,locatedinMadisonCounty,Indiana.
2.ThatonNovember21,2011,JimJones(Mr.Jones)broughthis2010ChevyCruztomyauto
repairshopforanestimate.
3.ThatMr.Jonesexplainedtomeatthattimethathehadbeeninanaccidentandsaidthatthe
othervehicleownercausedit,andthatherinsurancecompanywouldbepayingfortherepair.
4.ThatIhaveestimatedthecostofrepairtoMr.JonesCruztobe$1,561.00,andthatsaid
estimateisattachedasexhibitA.
Furtheraffiantsaithnot.
ISWEARORAFFIRMTHATTHEABOVEANDFOREGOINGREPRESENTATIONSARE
TRUEANDCORRECTTOTHEBESTOFMYINFORMATION,KNOWLEDGE,ANDBELIEF.

________________

_____________________________________

Date

JohnDoe

STATEOFINDIANA
COUNTYOFMADISON
I,theundersignedNotaryPublic,doherebyaffirmthatJohnDoepersonallyappearedbeforeme
onthe___dayofDecember2011,andsignedtheaboveAffidavitashisfreeandvoluntaryact
anddeed.

_____________________________________
NotaryPublic

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