12.18
The affiant states that the following documents are attached to this affidavit:
DOCKET NO.
PLAINTIFF DEFENDANT
COUNTY/COURT DIVISION
Trial Court of Massachusetts
AFFIDAVIT PROVIDING
DOCUMENTATION OF DEBT
Mass. R. Civ. P. 8.1(d)
1. DOCUMENTS ESTABLISHING THE EXISTENCE, AMOUNT, AND TERMS AND CONDITIONS
APPLICABLE TO THE DEBT THAT IS THE SUBJECT OF THIS ACTION, INCLUDING:
A. A document provided to the defendant before the date of charge-off demonstrating the defendant
incurred the debt and the amount owed.
B. Documents establishing the terms and conditions applicable to the debt.
C. The written document, if any, signed by the defendant evidencing the defendant's agreement to
the terms and conditions described in the documents referenced in B above, or, if a signed copy of
such document is not within the possession, custody, or control of the plaintiff, documents
evidencing the defendant's acceptance of such terms and conditions (which may include the most
recent monthly statement reflecting a purchase, payment, or balance transfer authorized by the
defendant before the date of charge-off).
Other document(s) establishing the existence, amount, and terms and conditions of the debt, if any:
2. DOCUMENTS REGARDING OWNERSHIP OF DEBT:
Each bill of sale, assignment, or other document evidencing the transfer of ownership of the debt,
beginning with the original creditor. (Such documentation must include a specific reference to the
defendant or the defendant's account number.)
AFFIANT
SIGNED UNDER THE PENALTIES OF PERJURY
X
THIS FORM IS REQUIRED IN ALL CASES SUBJECT TO MASS. R. CIV. P. 8.1
Not Applicable - plaintiff is the original creditor.
DATE
The name, position, and employer of the affiant:
