Sworn Statement

Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

SWORN STATEMENT

I, the undersigned, {{employee_full_name}} (Employee Number: {{employee_id_number}}), hereby declare under oath as follows:

Personal Details

Full Name: {{employee_full_name}}

Employee Number: {{employee_id_number}}

Department: {{department}}

Position: {{position}}

Date of Birth: {{date_of_birth}}

Identity Document/Passport Number: {{id_passport_number}}

Statement Details

Date of Incident/Declaration: {{date_of_incident_declaration}}

Time of Incident/Declaration: {{time_of_incident_declaration}}

Location of Incident/Declaration: {{location_of_incident_declaration}}

Nature of Incident/Declaration (brief summary): {{brief_summary_of_incident}}

Detailed Account

I hereby provide a true and accurate account of the events related to the above-mentioned incident/declaration. I understand that any false statement made herein may subject me to disciplinary action or legal proceedings.

{{detailed_account_of_events_para1}}

{{detailed_account_of_events_para2}}

{{detailed_account_of_events_para3}}

{{detailed_account_of_events_para4}}

Supporting Evidence (if any)

Are there any witnesses? (Yes/No): {{witness_present}}

If Yes, please provide details of witnesses: {{witness_details}}

Are there any documents, photographs, or other evidence to support this statement? (Yes/No): {{supporting_evidence_present}}

If Yes, please list and attach all supporting evidence: {{list_of_supporting_evidence}}

Declaration of Truth

I understand that the contents of this statement are true and correct to the best of my knowledge and belief, and that I have not withheld any information pertinent to this matter.

I am aware that I am making this statement under oath/affirmation, and I understand the legal implications thereof.

Signature Block

___________________________

Signature of Declarant (Employee)

Full Name: {{employee_full_name}}

Date: {{date_signed}}

I certify that the declarant has acknowledged that he/she knows and understands the contents of this statement, and that it was sworn to/affirmed and signed before me at {{place_of_signing}} on this {{day_of_month}} day of {{month}}, {{year}}.

___________________________

Commissioner of Oaths / Designated Company Official

Full Name: {{commissioner_name}}

Designation: {{commissioner_designation}}

Stamp/Seal (if applicable)