CALIFORNIA GENERAL DECLARATION

Declarant Information Optional box

Case Information
___[declarant's name]___
___[declarant's address]___ ___[case name]___
___[city, state, Zip]___
County of ___[county name]___ ___[case number]___
Telephone: ___[declarant's phone]___
Email: ___[declarant's email]___ ___[court name]___

I, ___[declarant's name]___, declare and state as follows:___[declaration contents]___

CALIFORNIA GENERAL DECLARATIONPage 1 of 2

I declare under penalty of perjury under the laws of the State of California that the foregoing is
true and correct.

___[declarant's name]___ ______________________________

Signature

Executed on ____________ in the state of California, County of ______________________.

(month/day/year) (name of county)

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