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Affidavit of Debt Owed

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AFFIDAVIT OF DEBT OWED

I, ______, of ______, in the Province of Ontario, MAKE OATH AND SAY that:

  1. I am the creditor, and ______ owes me the original sum of ______.

  2. The debt arose as follows: ______.

  3. It became due on , and the amount still outstanding is ______.

  4. That amount remains unpaid, and I am not aware of any valid defence or set-off against it.

  5. I make this affidavit for the following purpose: .

SWORN / AFFIRMED before me at the ______________________ of ______________________, in the Province of Ontario, this ______ day of ______________, 20______.

_______________________________ _______________________________

A Commissioner for taking Affidavits Signature of Deponent