1. This form provided free of charge from
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AFFIDAVIT FOR CONFESSION OF JUDGMENT
STATE OF
COURT : COUNTY OF
_________________________________________________
Plaintiff
AFFIDAVIT FOR
vs. CONFESSION OF JUDGMENT
Defendant
_________________________________________________
STATE OF )
COUNTY OF ) ss.:
, being duly sworn, depose and say:
1. That we are the Defendants in this action and reside at
in the City of , County of and
State of .
2. That we hereby confess judgment in this court in favor of the Plaintiff,
, in the sum of
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2. This form provided free of charge from
LegalSurvival.com
74 Main St., PO Box 31, Akron, NY 14001, Phone: (716) 542-5444, rfriedman@legalsurvival.com
($ ) Dollars, together with interest from the _______ day of , ________,
plus costs and disbursements and do hereby authorize the Plaintiff or assigns to enter judgment
for said amount.
3. That this confession of judgment is for a debt justly due or to become due to the
Plaintiff arising out of the following facts: Lease agreement dated and
payment agreement dated .
Sworn to before me this
_______ day of ________________, ________.
_______________________________________
NOTARY PUBLIC
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