4The following facts are within my own personal knowledge except as otherwise stated.

 4 The following facts are within my own personal knowledge except as otherwise stated.

 5 The defendant was on [state date of statutory demand or other relevant date] indebted to the plaintiff in the sum of $ [amount] for [state precisely the consideration, for example, goods sold and delivered etc] which sum was then due and payable.

 6 The demand, a copy of which is attached to the originating process, was signed by or on behalf of the plaintiff.  I served the demand [or the demand and the accompanying affidavit] as referred to in the originating process [or XY has been instructed to make an affidavit of service of the demand [or the demand and the accompanying affidavit]].

 7 The matters stated in the originating process concerning the demand and failure of the defendant to comply with it are true and correct.