Hospitals, clinics, and businesses use this sworn affidavit when producing records for an insurance claim or lawsuit, to confirm the copies are true, complete, and kept in the regular course of business. Hospitals, clinics, and businesses use this sworn affidavit when producing records for an insurance claim or lawsuit, to confirm the copies are true, complete, and kept in the regular course of business.
Serving Nevada. Appointments must be handled by Nevada-commissioned notaries.
Hospitals, clinics, and businesses use this sworn affidavit when producing records for an insurance claim or lawsuit, to confirm the copies are true, complete, and kept in the regular course of business.
What you'll need
Review the original packet and any receiving-agency instructions.
Bring the required document details and acceptable identification.
How to complete it
Fill in the request (Page 1) Identify the records, dates, and number of pages produced, or check that no records were found.
Swear before a notary Sign under oath before the notary with a current, government-issued photo ID.
A release ends an injury claim in exchange for a settlement payment. Many insurers require the claimant’s signature to be notarized before they issue the check.
Insurers often require a sworn, notarized proof of loss before paying a property or theft claim. This form states the loss, its cause, and the amount claimed.
These forms are a free convenience, not legal advice. First Choice Mobile Notary & Apostille is not a law firm. Consult an attorney licensed in the relevant state for legal questions.