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Sworn Statement of Account

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SWORN STATEMENT OF ACCOUNT FROM OTHER PARTY TO CONTRACT TO
LIENOR - INDIVIDUAL

TO:

DATE:

In accordance with Section 713.16(1), Florida Statutes, and in response to your demand
for a statement of account in your letter dated 20 the
undersigned submits the following Statement of Account:

Nature of labor or services performed, if any:

Nature of labor or services to be performed, if any:

Materials furnished:

Materials to be furnished, if known:

Amount paid to date: $

Amount due: $

Amount to become due, if known: $

Amount of our contract: $

Names of Parties to the contract:

The undersigned certifies that this Statement of Account has been served at the address
specified above, on 20, in accordance with Section 713.18,
Florida Statutes.

Name of Other Party to Contract

By (signature)

Type or Print Name

STATE OF

COUNTY OF

Sworn to (or affirmed) and subscribed before me this day of

20 by who is
personally known to me or produced , and who
did take an oath.

NOTARY PUBLIC

Printed Name of Notary

Commission Expires

Enter text

What a Sworn Statement of Account Is and When It’s Used

Sworn Statement of Account is a written, sworn affidavit that itemizes charges, credits, and the outstanding balance for an account. It is typically used by creditors, attorneys, or agents to present an authoritative record of amounts owed and the basis for each charge. The document affirms under penalty of perjury that the listed entries are true and accurate as of the statement date. Courts, collection agencies, and transactional counterparties commonly accept a properly executed sworn statement of account as evidentiary support for claims of indebtedness.

Why a Sworn Statement of Account Matters for Disputes and Collections

A Sworn Statement of Account documents amounts due on the record, streamlines dispute resolution, and creates a sworn evidentiary record for collection or litigation. When properly executed it supports admissibility and accuracy of account balances without repeated oral testimony.

Why a Sworn Statement of Account Matters for Disputes and Collections

Who Prepares and Relies on a Sworn Statement of Account

Creditors, attorneys, collection agencies, and billing departments commonly prepare Sworn Statements of Account to document owed balances for litigation or collection proceedings.

  • Small businesses and lenders use it to formalize unpaid invoice histories before collection.
  • Law firms attach it to pleadings or settlement packages as sworn evidence of damages.
  • Courts and adjudicators accept sworn statements as documentary proof when notarized and properly dated.

Core Components That Make a Sworn Statement Reliable

Core components ensure a sworn statement is complete, verifiable, and ready for evidentiary use in litigation, collections, or administrative reviews.

Account Ledger

Detailed ledger listing each invoice, payment, adjustment, date, and reference number. Include per-item amounts, payment applications, and running balance to show how the outstanding total was calculated and to facilitate verification.

Statement Date

Clear effective date using MM/DD/YYYY format that anchors the account balance. The date determines which transactions are included and affects statutory limitation periods for collection or dispute resolution.

Parties Identified

Full legal names, business entity types, and mailing addresses for creditor and debtor. Include taxpayer identification or account numbers where relevant to avoid misidentification and improper service.

Attestation

A sworn attestation statement declaring the truthfulness of the account under penalty of perjury. Specify statutory citation when required and identify the person making the oath and their authority.

Signature & Notary

Signature blocks for the declarant and, if required, notary acknowledgement with venue, notary stamp, and commission expiration date. Remote Online Notarization may be acceptable where authorized.

Supporting Exhibits

Attach invoices, account statements, contracts, or payment receipts as numbered exhibits. Cross-reference exhibit labels to ledger line items for clear traceability during review or in court.

Required Information to Include on the Form

Full Legal Name: Enter exact legal name from ID.
Mailing Address: Street, city, state, ZIP code.
Account Number: Creditor or debtor account identifier.
Statement Date: MM/DD/YYYY effective date format.
Itemized Transactions: Invoice numbers, dates, and amounts.
Signature & Notary: Signed, dated, and notarized if required.

Step-by-Step: Prepare and Execute a Sworn Statement of Account

Follow these steps to prepare, verify, and execute a Sworn Statement of Account that holds up in administrative or judicial proceedings.

  • 01
    Gather Records: Collect invoices, receipts, and payment records in chronological order.
  • 02
    Prepare Ledger: Itemize charges, credits, and running balances clearly.
  • 03
    Draft Attestation: Include sworn statement language and declarant details.
  • 04
    Notarize/Sign: Sign before notary or obtain required witness attestations.

Where to File, Send, or Submit a Sworn Statement

After execution, route the sworn statement to intended recipients: court clerk, opposing counsel, collection agency, or internal records for enforcement and filing.

  • Court Filing: File with clerk when attached to pleadings or motions.
  • Opposing Counsel: Serve as part of discovery or settlement documentation.
  • Collection Agencies: Provide to agencies to support collection demands and reporting.
  • Internal Records: Keep certified copies in corporate billing and legal files.

Common Mistakes That Undermine a Sworn Statement

  • Failing to include invoice reference numbers or item dates, which makes it difficult to trace charges and invites challenges to the accuracy of the claimed balance.
  • Using informal or ambiguous attestation language that omits perjury clause or signer authority, undermining admissibility and weakening evidentiary weight in court.
  • Submitting unsigned, notarization-missing, or improperly dated statements leads to rejection by courts or refusal by collection agents.
  • Failing to retain originals and only providing photocopies without proper certification can hinder authenticity claims and complicate dispute resolution.

Key Risks and Penalties for Incorrect or Misleading Statements

Perjury Exposure: Criminal penalties if knowingly false.
Evidentiary Exclusion: Court may deem document inadmissible.
Collection Delay: Errors prolong disputes and enforcement.
Fee Assessments: Additional interest and collection fees accrue.
Credibility Loss: Weakened witness reliability in litigation.
Administrative Fines: Regulatory fines in certain industries.

Typical Professionals Who Prepare or Rely on This Document

Creditor AR Manager

Responsible for compiling invoice histories and initiating sworn statements to document outstanding balances. Uses the statement to support internal collection decisions, justify reporting to credit agencies, and provide authoritative documentation for legal teams or third-party collection services.

Collections Counsel

Prepares sworn statements to attach to complaints or settlement packages, verifies supporting evidence, and ensures attestation language meets court requirements. Coordinates notarization, identifies appropriate jurisdiction for filing, and anticipates defenses to preserve admissibility and enforceability.

How to Configure an Online Workflow for a Sworn Statement

Configure eSignature workflow fields, authentication, and attachments before sending a sworn statement for signature to ensure legal and operational compliance.

Field Configuration
Signature Type Simple or digital signature, per risk profile
Authentication Email link, SMS code, or KBA for high risk
Conditional Logic Show itemized exhibits when balance exceeds threshold
Notary Settings Enable RON or include notarization block for jurisdiction

Platform Features to Support Signing and Submission

Use a platform that supports PDF, Word, and secure audit trails, plus integrations with storage and case management systems.

  • File Formats: PDF, DOCX, and HTML supported.
  • Integrations: Salesforce, Microsoft 365, NetSuite, Box supported.
  • Authentication: Email, SMS, or advanced signer authentication.

eSignature Pricing and Capabilities Compared

Price and capability comparison across common eSignature providers for preparing and distributing sworn statements and related exhibits.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial Yes, 7-day trial Varies Varies Varies Varies
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Updating or Correcting a Sworn Statement: Process Overview

Use a clear amendment workflow to revise a sworn statement, maintaining attestation continuity and evidentiary integrity.

01

Identify Amendment:

Document specific inaccuracies and the reason for correction.
02

Prepare Amendment:

Draft an addendum or corrected ledger with attending dates.
03

Obtain Signatures:

All original signatories re-sign or acknowledge amendment.
04

Notarize/Attest:

Notarize the amendment per jurisdictional requirements.
05

File Updated Copy:

Submit corrected version to court or custodian.
06

Retain Originals:

Keep both original and amended documents securely.

Practical Tips to Improve Accuracy and Acceptance

Practical measures reduce errors, improve admissibility, and speed resolution when using sworn statements in financial or legal workflows.

Use consistent numbering and cross-references
Number ledger lines and exhibits consistently; cross-reference exhibit labels in both the ledger and the attestation. Clear internal numbering prevents misalignment between statements and supporting documents and expedites verification by opposing parties or the court.
Include a perjury clause and signatory authority statement
Specify the perjury penalty and state the declarant's role or title. Clear attestation language reduces challenges to credibility and provides courts with necessary context about the declarant's knowledge and authority to make account assertions.
Attach primary source documents and index exhibits
Provide digital and physical exhibits, each labeled and referenced to ledger lines. Include originals or certified copies when possible and retain chain-of-custody documentation to counter authenticity challenges during discovery or trial.
Verify calculations with independent reconciliation
Reconcile ledger totals to bank statements or accounting system reports and document the reconciliation procedure. Independent verification helps address creditor or debtor disputes and provides a defensible audit trail for auditors and judges.

Illustrative Examples of Sworn Statements in Practice

Real-world examples show how a well-prepared Sworn Statement of Account clarifies balances, supports motions, and shortens resolution timelines in collection and litigation.

Martin Properties

A property manager used a sworn statement to consolidate unpaid rent ledgers and serve formal demands ahead of eviction proceedings.

  • Compiled itemized charges and notarized the attestation.
  • "I can process and execute all of these documents online with 100% compliance and built-in security. Whether on mobile or working offline, I can get forms back to their necessary parties efficiently." — Tim Martin, Founder, Martin Properties

Fertility Centers of Illinois

A healthcare provider reconciled patient balance statements before appeal and audit to verify billing accuracy.

  • Provided verified transaction list and notarized attestation.
  • "The airSlate SignNow team has been exceptional, responsive, the API has been great, and we're extremely happy that we chose airSlate SignNow as a company." — John Butler, Founder, Fertility Centers of Illinois

Key Milestones from Preparation to Enforcement

Typical milestone sequence outlines preparation, verification, execution, filing, and enforcement stages for a Sworn Statement of Account.

01

Preparation

Collect records and prepare itemized ledger.

02

Verification

Reconcile totals and attach supporting exhibits.

03

Execution & Notarization

Sign, swear, and obtain notary acknowledgment.

04

Filing & Service

File with court or serve adversary per rules.

Frequently Asked Questions About Sworn Statements of Account

[INTRO] Answers to common questions about preparing, signing, notarizing, and submitting a Sworn Statement of Account.


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