Affidavit (Court Of Common Pleas Of Philadelphia County)
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Civil Division
Forms
IN THE COURT OF COMMON PLEAS OF PHILADELPHIA COUNTY
CIVIL TRIAL DIVISION
:
TERM, 20___
:
v.
:
:
:
No:
AFFIDAVIT
I, _____________________________________ , Esquire, hereby state and affirm that I have complied with the
Order issued on ____________________________________by the Honorable _____________________ as follows:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Copies of bank accounts are attached hereto.
I verify that the statements in this Affidavit are made subject to the penalties of 18 Pa. C.S. §4904 relating to
unsworn falsification to authorities.
Date: __________________________
________________________________________
, Esquire
Attorney for Petitioner
227
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