DISTRICT COURT OF MARYLAND FOR City/County Located at Court Address Case No. Plaintiff Defendant vs. Address City, State, Zip Address City, State, Zip PROPERTY DAMAGE AFFIDAVIT (Md. Rule 3-509) I HEREBY CERTIFY: 1. I am a with the following training and/or experience: State sufficient facts to show qualification 2. Attached is an itemized repair bill itemized estimate of the cost of repairing the damaged of 3. The repairs or estimate were made by me under my supervision. 4. In my opinion the itemized repair bill or estimate is fair and reasonable. 5. In my opinion the fair market value of the property on immediately before the damage was $ was $ and immediately after the damage and before repairs . and after repairs is or will be $ I solemnly affirm under the penalties of perjury and upon personal knowledge that the contents of the foregoing paper are true. Date Signature of Affiant Printed Name Address City, State, Zip Telephone Number Fax E-mail DC-CV-020 (Rev. 10/2014) American LegalNet, Inc. www.FormsWorkFlow.com