Question
Affidavit from police station - stating that you are requesting a refund
Answers
GPT-4o mini
**Affidavit for Requesting a Refund**
**[Police Station Name]**
**[Police Station Address]**
**[City, State, ZIP Code]**
**[Date]**
**To Whom It May Concern:**
I, [Your Full Name], of [Your Address], [City, State, ZIP Code], do hereby affirm and declare the following:
1. I am a resident of [City, State] and am of legal age to make this affidavit.
2. On [Date of Incident], I experienced an event that led to the necessity of seeking a refund for [describe the product/service for which you are requesting a refund, including any relevant details, e.g., purchase date, transaction ID, service provided].
3. The circumstances surrounding the request for a refund are as follows:
- [Briefly describe the issue that warrants the refund request, e.g., non-delivery of goods, service not provided as promised, etc.]
4. After making attempts to resolve this issue directly with [Company/Service Provider Name], I was unable to reach a satisfactory resolution.
5. It is my intention to formally request a refund due to the aforementioned circumstances, and I have contacted [Company/Service Provider Name] on [dates of communication, if applicable] regarding this matter.
This affidavit is made to support my request for a refund and to provide verification of the circumstances leading to my pursuit of this matter.
I understand that this affidavit may be used for legal purposes, and I declare under penalty of perjury that the foregoing is true and correct.
**Signature:**
____________________________________
**[Your Full Name]**
**[Your Identification Number, if applicable]**
**Notary Public:**
Subscribed and sworn to before me this [Day] of [Month, Year].
____________________________________
**Notary Public Signature**
**[Notary's Printed Name]**
**My Commission Expires:** [Date]
**[Seal/Stamp of Notary]**
---
Please customize the template with your personal information and details about the refund request, as required.
**[Police Station Name]**
**[Police Station Address]**
**[City, State, ZIP Code]**
**[Date]**
**To Whom It May Concern:**
I, [Your Full Name], of [Your Address], [City, State, ZIP Code], do hereby affirm and declare the following:
1. I am a resident of [City, State] and am of legal age to make this affidavit.
2. On [Date of Incident], I experienced an event that led to the necessity of seeking a refund for [describe the product/service for which you are requesting a refund, including any relevant details, e.g., purchase date, transaction ID, service provided].
3. The circumstances surrounding the request for a refund are as follows:
- [Briefly describe the issue that warrants the refund request, e.g., non-delivery of goods, service not provided as promised, etc.]
4. After making attempts to resolve this issue directly with [Company/Service Provider Name], I was unable to reach a satisfactory resolution.
5. It is my intention to formally request a refund due to the aforementioned circumstances, and I have contacted [Company/Service Provider Name] on [dates of communication, if applicable] regarding this matter.
This affidavit is made to support my request for a refund and to provide verification of the circumstances leading to my pursuit of this matter.
I understand that this affidavit may be used for legal purposes, and I declare under penalty of perjury that the foregoing is true and correct.
**Signature:**
____________________________________
**[Your Full Name]**
**[Your Identification Number, if applicable]**
**Notary Public:**
Subscribed and sworn to before me this [Day] of [Month, Year].
____________________________________
**Notary Public Signature**
**[Notary's Printed Name]**
**My Commission Expires:** [Date]
**[Seal/Stamp of Notary]**
---
Please customize the template with your personal information and details about the refund request, as required.