Sworn Statement regarding Proof of Loss for Automobile Claim

A sworn proof of loss is the insureds signed sworn statement as to his belief of the amount of loss. The oath carries with it the penalties of perjuryup to 5 years in prison in most states. This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.