Affidavit of Your Name

I, Your Name , Affiant, being of lawful age, qualified and competent to testify to, and having firsthand
knowledge of the following facts, do hereby swear that the following facts are true, correct and not
misleading:

Begin writing here only after carefully reading all the following points, and before deleting any of them: Do
not be defensive, do not quote law just tell your story, just the facts.

Do not exaggerate, or you could be prosecuted for perjury. Write only the pertinent facts. Give accurate
times and dates if known, or use “on or about”. Make your Affidavit as simple and brief as possible, limiting
the length to a maximum of three (3) pages preferably less. Concentrate only on what the charge or charges
were, and the simple facts that rebut those charges. Focus on how the involved officials violated due process
rights as guaranteed by the Constitution keep it simple

All your text should be in Times New Roman, font size 12, with nothing bolded underlined or numbered.
After filling in all the editable areas above, please save it to your computer, and then email this MS Word file
to Intake@NationalLibertyAlliance.org for review. Please keep your affidavit on point and just tell the facts
by “SIMPLY” telling your story. After you receive the document back by email recheck for accuracy, print it
out and have it notarized. Note that the document must be signed in front of the notary.

NLA requests a $100 donation to help off-set serving costs. If you cannot afford $100 please donate
whatever you can afford, we will not refuse anyone. Please mail your donation when mailing your affidavit
to: National Liberty Alliance; 3979 Albany Post Road, Suite 107; Hyde Park, New York, 12538.

_________________________________________

NOTARY

In _______________ State, _________________ County, on this ____ day of _____________, 20____,

before me, ____________________________________, the undersigned Notary Public, personally appeared
___________________________, to me known to be the living (wo)man described herein, who executed the
forgoing instrument, and has sworn before me that he/she executed the same as his/her free-will act and deed.

________________________________________
(Notary seal) Notary

My commission expires: ____________________

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