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Circuit Court Rules

Schedule: B - Forms

Form: 6A iii Personal Injuries Affidavit of Verification

S.I. No. 526 of 2005

FORM 6A(iii)

AFFIDAVIT OF VERIFICATION


O. 5A, r. 7

AN CHUIRT CHUARDA

THE CIRCUIT COURT


Record No.

Between

A.B.

Plaintiff

AND

C.D.

Defendant

I, AB, ………………..of …………………. , the (plaintiff, defendant or state other capacity or authority) in the above-entitled proceedings, aged eighteen years and upwards MAKE OATH and say as follows:

1. I beg to refer to the contents of the (personal injuries summons, defence, reply, further information etc. - as the case may be) delivered herein on behalf of the (plaintiff/ defendant) on the …..day of ……… 20 …. *[to which this affidavit is appended] *[and upon a true copy of which marked "A" I have signed my name prior to the swearing hereof].

2. The assertions, allegations and information contained in the said (personal injuries summons etc.) which are within my own knowledge are true. I honestly believe that the assertions, allegations and information contained in the said (personal injuries summons, etc.) which are not within my own knowledge are true.

3. I am aware that it is an offence to make a statement in this affidavit that is false or misleading in any material respect and that I know to be false or misleading.

SWORN etc

*Delete if inapplicable.

**Insert where deponent is swearing in capacity of a next friend or committee.