STATE OF INDIANA
)
) SS:
COUNTY OF DELAWARE
)
Plaintiff
vs.
Defendant
IN THE DELAWARE CIRCUIT COURT NO.
CAUSE NO. 18
AFFIDAVIT OF NON-MILITARY SERVICE,
COMPETENCY, AND PROOF OF CLAIM
COMPETENCY, AND PROOF OF CLAIM
, being first duly sworn upon his/her oath, deposes and says:
1.
That the defendant(s) in the above-entitled cause of action is/are not member(s) of the Armed Forces of the United States of America; is/are at least eighteen (18) years of age and not otherwise incompetent.
2.
That (defendant) was/were and is/are justly and truly indebted to the plaintiff in the sum of $ and the consideration for the debt is as follows [check the one that applies]:
note;
promise;
goods;
contract;
lease;
loan;
other: .
3.
That said sum is now due and wholly unpaid; that there are no set-offs or counter-claims to the claim; that the plaintiff has not received or accepted and does not now hold any collateral or other security for the debt whatsoever.