Affidavit of CREDITOR NAME HERE in making loan account # 123456789 by USER NAME HERE agent for CREDITOR NAME HERE
Affiant, hereinafter, John Henry Doe, under the penalty of perjury that the following statements and facts, regarding account #123456789 or other related matter, are of my own first-hand knowledge, do solemnly swear, aver, and depose; that John Henry Doe is of the age of majority and is willing to testify and witness to the matters set forth herein; that John Henry Doe has first hand personal knowledge of the facts stated herein; and all the facts stated herein are true, accurate, correct, and complete:
This declaration of facts is based on my own first-hand knowledge with supporting evidence; mark my words;
1.	On December 25, 2002 USER NAME HERE, agent for CREDITOR NAME HERE, offered John Henry Doe an agreement by CREDITOR NAME HERE in loaning CREDITOR NAME HERE’s capital.
2.	USER NAME HERE intentionally induced John Henry Doe into believing that John Henry Doe was borrowing CREDITOR NAME HERE’s capital for account #123456789.
3.	USER NAME HERE intentionally induced John Henry Doe into believing that once approved by CREDITOR NAME HERE, John Henry Doe could borrow CREDITOR NAME HERE’s capital.
4.	USER NAME HERE intentionally induced John Henry Doe into believing that goods or services were being paid out of CREDITOR NAME HERE’s own capital for making loan #123456789.
5.	USER NAME HERE intentionally induced John Henry Doe into allowing CREDITOR NAME HERE to place an alleged interest upon John Henry Doe’s property as assurance in John Henry Doe’s paying back CREDITOR NAME HERE for borrowing CREDITOR NAME HERE’s capital.
6.	USER NAME HERE intentionally induced John Henry Doe into signing an alleged agreement agreeing to compel John Henry Doe into repaying CREDITOR NAME HERE interest on top of the principle amount borrowed from CREDITOR NAME HERE’s capital. 
7.	The documents and actions by USER NAME HERE, agent for CREDITOR NAME HERE, provide evidence of CREDITOR NAME HERE’s intent that John Henry Doe believe that CREDITOR NAME HERE is making loan account #123456789 out of CREDITOR NAME HERE’s own capital and also provide evidence that #123456789 is funded by CREDITOR NAME HERE.

USER NAME HERE’s failure by not providing a certified rebuttal of any points in this Affidavit constitutes tacit agreement with and consent unto removing all entitlements or interests (liens) in John Henry Doe or any property or collateral connected with JOHN HENRY DOE or account 123456789.

Because of the duty of full disclosure imposed by law and contract [UCC 1-203], USER NAME HERE’s failure by not providing a certified rebuttal of all points in this Affidavit constitutes a waiver of any immunities or defenses regarding violations set by State or Federal law.

USER NAME HERE or CREDITOR NAME HERE also agree with and consent unto a claim of triple damages of the original dollar amount of account #123456789 unto John Henry Doe. USER NAME HERE’s failure by not providing a certified rebuttal of any points in this Affidavit constitutes tacit procuration that John Henry Doe has the power of attorney-in-fact regarding the affairs and property of USER NAME HERE and CREDITOR NAME HERE until all claims of damage by John Henry Doe are settled. Any rebuttal of this Affidavit by USER NAME HERE must be in the manner of this Affidavit, by signing in the capacity of a fully liable man or woman being responsible and liable under the penalty of perjury while offering direct testimony.  Any direct rebuttal with certified true and complete accompanying proof must be posted into the Notary address herein within ten days.  Evidence of absence of a timely, verified rebuttal of this Affidavit along with a “Certificate of Non-Response” serves as USER NAME HERE and CREDITOR NAME HERE’s agreement with any violations and consent unto judgment against USER NAME HERE in favor of John Henry Doe.

Date:  November 13, 2003 
By:_____________________________ 
John Henry Doe
Jurat

On this day came before me the Affiant a living flesh and blood man to oath and attest and affirm the signature is true, complete, and correct on the foregoing affidavit.  John Henry Doe the undersigned, who is personally known by me or upon proper oath and identification, personally came before me, the subscriber, a notary public in and for said County and State, and Duly Affirmed the truth of the foregoing Affidavit in my presence.  The Affiant also acknowledged the signing thereof to be his own voluntary act and deed.  Signing the within instrument in my presence and for the purpose therein stated.

Signed this day________________, of____________________, ______________ at 
________________________________.

My commission expires on: ________________________

By_________________________ 				seal:___________________

PROOF OF SERVICE

One, John Henry Doe, a living breathing man, does hereby swear and affirm on One’s own unlimited commercial liability, that true, correct and complete copies of the Affidavit have been served this date November 13, 2003 addressed as follows:

via Certified Mail # XXXX XXXX XXXX XXXX XXXX to:

CREDITOR NAME HERE, 
123 RIPOFF LANE
ANOTHER TOWN, TX 54321

	

By:___________________________

Jurat

On this day came before me the Affiant a living flesh and blood man to oath and attest and affirm the signature is true, complete, and correct on the foregoing affidavit.  John Henry Doe the undersigned, who is personally known by me or upon proper oath and identification, personally came before me, the subscriber, a notary public in and for said County and State, and Duly Affirmed the truth of the foregoing Affidavit in my presence.  The Affiant also acknowledged the signing thereof to be his own voluntary act and deed.  Signing the within instrument in my presence and for the purpose therein stated.

Signed this day________________, of____________________, ______________ at 

________________________________.

My commission expires on: ________________________

By_________________________