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1. Declaration Header: States document type and jurisdiction, including statutory declaration format
2. Claimant Information: Full details of the person/entity making the claim including name, address, contact details, and relationship to insured property
3. Policy Details: Insurance policy number, type, coverage details, insurer information, and policy period
4. Loss Description: Detailed account of the loss event, date, time, location, circumstances, and cause of loss
5. Loss Amount: Itemized breakdown of claimed losses, including values and basis of calculation
6. Verification Statement: Sworn statement confirming truth of information provided, with statutory declaration wording and warning about perjury
1. Additional Insurers: Details of other insurance policies covering the loss, including policy numbers and insurers
2. Third Party Claims: Information about related third-party claims or potential claims arising from the same incident
3. Salvage Details: Information about salvaged property, including condition and current location
1. Schedule A - Supporting Documentation: List and copies of attached evidence supporting the claim (receipts, invoices, reports)
2. Schedule B - Itemized Loss Calculation: Detailed breakdown of loss amounts with calculations, including depreciation if applicable
3. Schedule C - Photographs: Visual evidence of damage or loss, with dates and descriptions of each photograph
Find the exact document you need
Sworn Proof Of Loss Form
An England & Wales legal document detailing and verifying insurance claims for significant losses or damages.
Sworn Affidavit Of Claim
A legal document in England & Wales providing sworn evidence for civil litigation or court applications.
Statement Of Small Claim And Notice Of Trial
An England & Wales legal document initiating small claims proceedings with required details and evidence.
Statement Of Claim And Notice Form
An England & Wales legal document initiating civil litigation by outlining claims and remedies sought.
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