Witness Statement (UK)

Witness Full Name *

Address *

Occupation *

Date of Birth (optional)

Relationship to the Proceedings

On Behalf Of

Statement Number

Court Name *

Claim Number *

Claimant Name(s) *

Defendant Name(s) *

Statement Date *

Background & Introduction *

Statement of Facts *

State facts within your own knowledge. Where information is from another source, identify the source and state that you believe it to be true.

Witness Initials (for exhibit numbering) (optional)

Exhibit 1 Description (optional)

Exhibit 2 Description (optional)

Exhibit 3 Description (optional)

Exhibit 4 Description (optional)

Statement of Truth Wording

Representative Name & Capacity (optional)

Include Contempt of Court Warning?

Solicitor / Legal Representative (optional)

Solicitor Reference (optional)

Note: Exhibits should be marked with the witness's initials and a number (e.g. "TEC-1"). Each exhibit must be identified in the body of the statement. Attach originals or certified copies.

Important: A witness statement must contain a statement of truth. Proceedings may be brought for contempt of court against a person who makes, or causes to be made, a false statement in a document verified by a statement of truth without an honest belief in its truth.