SWORN AFFIDAVIT - Houston

Issue Record # _____ Incident #_____ Houston Police Department: Date Printed:03/22/11 Internal Affairs Division: Intake Page ___ of ____ Pages Initials: _____ Date:_____ SWORN AFFIDAVIT STATE OF TEXAS DATE: _____ COUNTY OF HARRIS TIME: _____ Before me, the undersigned authority, appeared _____ (Print Affiant's Name) who after being duly SWORN on his/her oathdeposes and says: My full name is: _____. I am ____ years of age, and my date of birth is: _____. I currently reside at: _____, in (city): _____, (state) _____, Zip Code: _____.

Issue Record # _____ I ncident #_____

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  Affidavits, Houston, Sworn, Sworn affidavit

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