Statement Letter Template

By | January 10, 2011

Date –/–/—-

(Name of recipient)

(Title of recipient)

(Company name)

(Company address)

Dear (recipient),

This is to notify you that this is my statement of (mention the type of statement).In this letter I am certifying that (mention the statements that you are certifying as true).

My name is (mention your name) and I hail from (your address). My documents regarding the (the reason for the need of documents) are provided with the letter. By this letter I certify that all the documents provided are correct and original with no discrepancies whatsoever. I also certify that in case of any ambiguity I may be contacted immediately the address and contact number enclosed.

I also certify that in case of any misconduct or illegality criminal proceedings may be issued against me. I shall not hold the (The place of your work/ university) responsible for any misconduct of mine under any situation.


(Name of sender)