Sworn Statement for Contractor Template

This sworn statement for contractor template has 3 pages and is a MS Word file type listed under our consultant & contractors documents.

Sample of our sworn statement for contractor template:

APPLICATION FOR PAYMENT AND SWORN STATEMENT FOR CONTRACTOR AND SUBCONTRACTOR TO OWNER Development Title Date Page No. of Building Payment Application # Owner Period From Architect Change Orders # Contractor IHDA No. 1 2 3 4 5 6 7 Contractor Work/Material Contracted For Adjusted Total Contract Including Change Orders Work Completed & Materials Stored (% & $) Total Retained Including This Application Previously Paid Net Amount Now Due Col 3 - Col 4&5 Balance Become Due Col 2 - Col 5&6 Amount of Original Contract $ Work Completed (Col. 3) $ Extras to Contract $ $ Total Retained (Col. 4) $ Total Contract & Extras $ $ Net Amt Earned (Col. 3 - Col. 4) $ Credits to Contract $ $ Previously Paid (Col. 5) $ Adjusted Total Contract $ $ Net Amt Due (Col. 6) $ State of County of The undersigned being first duly sworn, on oath deposes and says, that he/she is The [TITLE] of [FIRM NAME]. Contractor for the [TYPE OF WORK] for the following project located at That, for the purpose of this work the foregoing orders have been place and the foregoing parties subcontracted with and these have furnished materials or have provided labor or both, for said project.