Free Microsoft Word - Affidavit & Item. of Accounts-- HARD COPY.dot - South Carolina

CIVIL CASE NUMBER STATE OF SOUTH CAROLINA ) ) COUNTY OF _______________________ ) ) _____________________________________ ) PLAINTIFF(S) ) ) VS. ) ) _____________________________________ ) DEFENDANT(S) ) IN THE MAGISTRATE'S COURT

AFFIDAVIT AND ITEMIZATION OF ACCOUNTS

Plaintiff, ________________________________________, personally appearing before me, who, being duly sworn, states that he is the plaintiff in this action, and that the itemization of accounts which follows is true and correct. He further states that no part of the sum included in the itemization below has been paid or satisfied in any fashion, and is today due and owed to him.
ITEMIZATION OF ACCOUNTS

________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ TOTAL

$___________ $___________ $___________ $___________ $___________ $___________

(Copies of bills, papers or other proof of any of the above accounts should be attached to this document.)

Sworn to and Subscribed before me this day of

, 2

Magistrate or Notary Public for South Carolina My Commission expires

) . ) ) ) ) ) )

PLAINTIFF (or his attorney)

SCCA/716 (Amended 05/2008)