Fill and Sign the Alabama Affidavit Form for Expert

IN THE CIRCUIT COURT OF ____________ COUNTY, ALABAMA ___________________________, * * Plaintiff, * * VS. * CIVIL ACTION NO.: * ___________________________, * CV -________________ * Defendant. * AFFIDAVIT OF EXPERT NAME STATE OF ALABAMA: COUNTY OF ___________: Before me, the undersigned Notary Public, personally appeared EXPERT’S NAME , who after being first duly sworn, did depose and say: My name is _____________, and I have personal knowledge of the matters contained in this Affidavit. I am a licensed professional counselor and a practicing Psychometrist. Psychometry is the profession/field of interpreting numbers associated with educati onal testing; specifically, to determine one’s cognitive and academic abilities. Cognitive means a person’s innate intelligence ability, and academic means a person’s acquired knowledge. I received a M.Ed. Degree in Special Education from the University of ____________ in ________, and a B.S. Degree in Early Childhood Education from the University of _________________ in ________. I am currently President of _______________. In that capacity, I perform diagnostic testing, and provide services as a profe ssional counselor of children and adults who have learning disabilities and/or Attention Deficit Hyperactivity Disorder. I am qualified to perform 2 tests on individuals to determine their reading and comprehension abilities, through my education, degrees, passing the test required by the Board of Examiners in Counseling for the State of Alabama, and my experience. (A copy of my curriculum vitae is attached to this Affidavit as Exhibit 1). The tests I use are accepted and routinely used in the education, p sychology, counseling, and psychometry professions to determine an individual’s reading ability level and reading comprehension ability level. I performed the ________________________ (test(s) on [individual’s name] on [date,] at [location of testing] in _______________________, Alabama to test his/her reading ability and reading comprehension ability. The ________________________ test measures [describe test/tests] . Mr./Mrs. _______________ tested at the ________ level for reading ability and the _______ level for reading comprehension on the _______________________________ Test; at the __________ level for (reading/comprehension) on the __ _____________________ Test; and at the ____________ level for (reading/comprehension) on the _______________________. With scores at these levels, Mr./Mrs. _______________ would be considered (functionally illiterate/illiterate). FURTHER, AFFIANT SAYETH N OT. _________________________________________ Expert’s Name 3 STATE OF ALABAMA: COUNTY OF ______________: I, the undersigned Notary Public, in and for said State and County, hereby certify that _____________________, whose name is signed to the foregoing Affidavit, and who is known to me, acknowledged before me on this day that, being informed of the contents of said Affidavit, she executed same voluntarily on the day the same bears date. Given under my hand and seal this ____ day of _________________, 20___. _________________________________________ Notary Public My Commission Expires:___________________ __