North Carolina Affidavit of Custodian of Medical Records

State:
Multi-State
Control #:
US-PI-0007
Format:
Word; 
Rich Text
Instant download

Description

This affidavit is to be used by the custodian of medical records to certify that records obtained by the attorney regarding the client's treatment are true and correct copies.

How to fill out Affidavit Of Custodian Of Medical Records?

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FAQ

I, _________________________, having been first duly sworn, provide this Affidavit in support of ____________________ [enter Applicant's Name] and state the following: I am unrelated to the Applicant by blood or marriage, and not currently living in the same household with Applicant.

Affidavit of Authenticity. This affidavit verifies the authenticity of the citizenship documents accompanying it. It is only required for students submitting proof of U.S. citizenship or eligible non-? citizen status via fax or scan/email.

Once the affidavit is witnessed and attested to by a notary public or other official, it holds the force of law and binds the individual to the truthfulness of the information that they have provided.

A business records affidavit is an affidavit signed by the custodian of records where they verify the authenticity and accuracy of the records. The affidavit is signed in front of a notary public.

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North Carolina Affidavit of Custodian of Medical Records