[Petitioner] v. [Respondent]

[Court name]

Case No. [Case number]

DECLARATION OF [YOUR FULL NAME]

I, [Your full name], declare as follows:

1. I am the Self-Represented Party in this matter. I make this declaration based on my own personal knowledge, and if called to testify I could and would testify competently to the facts stated here.

1. [Describe what happened — one clear fact per paragraph, in the order it occurred. Include dates.]

1. [Continue with the next fact. Attach and reference any exhibits by number, e.g. "See Exhibit 1."]

1. [Add or remove numbered paragraphs as needed. Keep each paragraph to a single point.]

1. [State clearly what you are asking the court to do, if this declaration supports a specific request.]

I declare under penalty of perjury under the laws of [state] that the foregoing is true and correct.

Dated: [Date]

_______________________________

[Your full name]

Self-Represented Party, self-represented

[Address]

[Phone] · [Email]