I, _______________________________________ (Name),

____________________ (TDCJ-ID#),

being presently incarcerated in the

______________________ Unit

of the Texas Department of Criminal Justice

in _______________ County, Texas,

verify and declare under penalty of perjury that

the foregoing statements are true and correct.

Executed on this

the _________ day of ____________, 20_____.

____________________________________________ (Signature)

____________________________________________, ____________
(Print Name) and (TDCJ-CID#)

GENERAL AFFIDAVIT

Before a Notary

STATE OF___________________

COUNTY OF__________________

Before the undersigned,

an officer duly commissioned

by the laws of the State of ________________,

on this ___ day of _____________, 20___,

personally appeared the Declarant

___________________________________

who having been first duly sworn or having

duly affirmed to tell the under depose and says:

That Declarant is competent to give this affidavit and

unless stated has personal knowledge of the fact(s)

stated and indicated on these/this ____________ page(s).

_____________________________________________ ____________
(Signature of Declarant) and (Date)

Sworn and subscribed before me

this _______ day of _____________, 20 ___ .

My commission expires: ____/____/______.

________________________
Notary Public