DEKALB COUNTY SUPERIOR COURT STATE OF GEORGIA , Civil Action Plaintiff, vs. Case Number , Defendant. AFFIDAVIT , being first duly sworn, swears or affirms the following under oath or penalty of perjury: 1. I am over the age of eighteen years and competent to testify to the facts in this affidavit. I make the statements in this affidavit based upon my personal knowledge. (Witness/Affiant sign here in front of Notary Public) Name: Subscribed and sworn before me on , 20 Address: . Daytime Phone: ( ) Notary Public pro se Affidavit - General.wpd Affidavit - General — rev. July 18, 2005 Provided by the DeKalb County Superior Court and the Atlanta Legal Aid Society American LegalNet, Inc. www.USCourtForms.com