CIVIL CASE NUMBER
STATE OF SOUTH CAROLINA	)
)	IN THE MAGISTRATE’S COURT
COUNTY OF	)
)
)
PLAINTIFF(S)	)
)	AFFIDAVIT AND ITEMIZATION
VS.	)	OF ACCOUNTS
)
)
DEFENDANT(S).	)

Plaintiff, , personally appearing before me, who, being duly sworn, states that he is the plaintiff in this action, and that the itemization of accounts which follows is true and correct.

He further states that no part of the sum included in the itemization below has been paid or satisfied in any fashion, and is today due and owed to him.

ITEMIZATION OF ACCOUNTS

$
$
$
$
$
TOTAL	$0.00
(Copies of bills, papers or other proof of any of the above accounts should be attached to this document.)

Sworn to and Subscribed before me	)
this	day of	,	2 .	)
)
)
Magistrate or Notary Public for South Carolina	)	PLAINTIFF (or his attorney)
)
My Commission expires	)

SCCA/716 (Amended 05/2008)

﷡﷡﷡﷡﷡

Jeannie Grady

2002-07-25

mbaughman