CALIFORNIA GENERAL DECLARATION

Declarant Information
___[declarant's name]___
___[declarant's address]___
___[city, state, Zip]___
County of ___[county name]___
Telephone: ___[declarant's phone]___
Email: ___[declarant's email]___

Optional box
Case Information
___[case name]___
___[case number]___
___[court name]___

I, ___[declarant's name]___, declare and state as follows:___[declaration contents]___

CALIFORNIA GENERAL DECLARATIONPage 1 of 2

I declare under penalty of perjury under the laws of the State of California that the foregoing is
true and correct.

___[declarant's name]___

______________________________
Signature

Executed on ____________ in the state of California, County of ______________________.

(month/day/year)

CALIFORNIA GENERAL DECLARATIONPage 2 of 2

(name of county)