Sworn statement – Letter Template

Sworn statement - Letter Template

The sworn statement is a simple statement in writing and signed. His writing is often required when no other proof do can prove a fact or situation for you. To help you properly prepare your sworn statement, here are the rules to know and sample letters.

Form of declaration

The formalities are simple. The affidavit indeed takes the form of a letter signed by you and by which you acknowledge in good faith the existence of facts or situation that you expose in your mail. In principle, it is not necessary to write the certificate in hand, except when this formality is specifically requested you.
Warning: the facts that you represent must be accurate. A false statement can be used against you in litigation.

The advice of Eric Roig, founding director of droit-finances.net


Many agencies (CPAM, bank, Caf, employment center, taxes, administration ...) can ask for a sworn statement. In practice, this document may notably be requested at:

  • signing a PACS,
  • the fulfillment of the wedding formalities
  • the creation of a company
  • the cessation of activity of a retired employee,
  • the opening of a youth booklet
  • compensation of an employee for occupational incapacity,
  • a request for allowance for school when your child is 16 or over, etc.

The letter in which an owner certifies that a person (a family member, friend ...) is hosted at home is also a very common case of sworn statement. For a specific example of this type of mail, see as a proof of accommodation model.

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Standard form

The exact content of each letter of course depends on what you are asked to testify. But in all cases, you must not forget to mention your identity (after "I undersigned (e)") And sign your letter. Otherwise, the document would have no value.

To write your mail, you can breathe in a sworn statement kind. Here is a free model.

First Name receiver
No. Street
Code City Name Sender Name
No. Street
CP City

Subject: Declaration on honor

I, (e) Mrs / Miss / Mr (first name) born (e) (date of birth) to (place of birth) and the remaining (address) hereby confirm (display accurately the facts making the subject of the statement).
I have knowledge of criminal penalties by the author of a false certificate.
Made to serve and to assert that right.

(Place) on (date)

Sworn statement - Letter Template Download a model certificate of honor (word format).
Sworn statement - Letter TemplateDownload this article (PDF)
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