Nebraska State Court Form AFFIDAVIT IN SUPPORT OF _______________________________________________
CC 3:28 New 06/18
________________________________ Plaintiff
vs.
________________________________ Defendant
Case No.____________________
AFFIDAVIT IN SUPPORT OF _______________________________________________
STATE OF NEBRASKA) ) ss:
COUNTY OF _____________ ) (County where signed)
I, __________________________, being duly sworn under oath, say: (your full name)
_____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ____________________________________________________________________________________________________________________________________________
Page 1 of 1Affidavit CC 3:28 New 06/18
Date Signature (your signature)
Your Full Name
Your Full Street Address/P.O. Box
City/State/ZIP Code
Phone Email Address
SUBSCRIBED AND SWORN to before me this ______ day of _____________, 20___.
________________________________ Notary Public
(name of person listed as plaintiff in original action)
(name of person listed as defendant in original action)
(case number assigned by clerk of court)
****DO NOT SIGN UNTIL YOU ARE IN THE PRESENCE OF A NOTARY***