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 1 Affidavit 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***

Nebraska State Court Form AFFIDAVIT IN SUPPORT OF · Nebraska State Court Form AFFIDAVIT IN SUPPORT OF CC 3:28 New 06/18 ___ Plaintiff. vs. _ Defendant (Case No.___

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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***