Nebraska State Court Form AFFIDAVIT IN SUPPORT OF _______________________ ________________________ CC 3:28 New 06/18 ________________________________ Plaintiff vs. ________________________________ Defendant Case No.____________________ AFFIDAVIT IN SUPPORT OF _______________________ ________________________ STATE OF NEBRASKA) ) ss: COUNTY OF _____________ ) (County where signed) I, __________________________, being duly sworn under oath, say: (your full name) _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Page 1 of 1 Affidavit CC 3:28 New 06/18 Date Signature (your signature) Your Full Name Your Full Street Address/P.O. Box City/State/ZIP Code Phone Email Address SUBSCRIBED AND SWORN to before me this ______ day of _____________, 20___. ________________________________ Notary Public (name of person listed as plaintiff in original action) (name of person listed as defendant in original action) (case number assigned by clerk of court) ****DO NOT SIGN UNTIL YOU ARE IN THE PRESENCE OF A NOTARY***