A sample declaration under 28 U.S.C. 1746 is a short written statement in which you set out facts in numbered paragraphs, sign and date the document yourself, and close with a specific sentence placing the statement under penalty of perjury. Done correctly, it carries the same legal weight as a notarized affidavit in federal proceedings, and no notary is involved.
Sample Template
The body will change with your facts, but the structure and the closing sentence should track this pattern for a declaration signed inside the United States:
DECLARATION OF [YOUR FULL NAME]
I, [Your Full Name], declare as follows:
1. I am over the age of 18 and competent to make this declaration. I have personal knowledge of the facts stated below.
2. [State your first fact clearly and in your own words. Keep each numbered paragraph to a single topic or event.]
3. [State your next fact.]
4. [Continue as needed.]
I declare under penalty of perjury that the foregoing is true and correct. Executed on [Month Day, Year].
____________________________
[Your Printed Name]
This format tracks the sample declaration the federal government publishes for proceedings before the Merit Systems Protection Board, which uses the same 28 U.S.C. 1746 framework.1eCFR. Appendix IV to Part 1201 – Sample Declaration Under 28 U.S.C. 1746 If you are signing from outside the United States, the closing sentence has to change. That is covered below.
The Closing Sentence Is What Gives It Legal Force
Everything above the closing sentence is just your factual narrative. The closing sentence is the part that turns the paper into a sworn statement under federal law, and 28 U.S.C. 1746 gives you two versions of it.2Office of the Law Revision Counsel. 28 USC 1746 – Unsworn Declarations Under Penalty of Perjury
Signed Inside the United States
If you sign anywhere in the United States, its territories, possessions, or commonwealths, use:
“I declare (or certify, verify, or state) under penalty of perjury that the foregoing is true and correct. Executed on (date).”2Office of the Law Revision Counsel. 28 USC 1746 – Unsworn Declarations Under Penalty of Perjury
Signed Outside the United States
If you sign from abroad, the sentence must explicitly tie the statement to U.S. law:
“I declare (or certify, verify, or state) under penalty of perjury under the laws of the United States of America that the foregoing is true and correct. Executed on (date).”2Office of the Law Revision Counsel. 28 USC 1746 – Unsworn Declarations Under Penalty of Perjury
The only difference is the phrase “under the laws of the United States of America.” Use the domestic version while signing overseas and a court can reject the document.
The statute says the closing must follow “substantially” this form, so small word choices, such as “certify” instead of “declare,” generally will not invalidate it.2Office of the Law Revision Counsel. 28 USC 1746 – Unsworn Declarations Under Penalty of Perjury That is not a license to freelance. Stay as close to the statutory language as you can, and never drop the date or the penalty-of-perjury phrase.
What Else Has to Be on the Page
Three additional elements have to be present for the declaration to hold up:
- A signature. You must personally sign. In federal court electronic filing systems, “/s/” followed by your typed name generally satisfies this. For paper filings, sign by hand.
- The date of execution. The date fixes when you affirmed the contents as true. Leaving it off gives a court an easy reason to strike the declaration.
- Written form. Oral statements do not qualify, even if you say the penalty-of-perjury words out loud.
The statute does not require you to list the city and state where you signed, but it is standard practice. It confirms which version of the closing sentence you needed to use and removes an argument the other side might otherwise raise.
Stick to Personal Knowledge
What you put in the numbered paragraphs should come from your own firsthand knowledge. Repeating what someone told you, summarizing another person’s report, or describing what you assume happened weakens the declaration and can hurt your credibility.
There is a narrow exception for statements made “on information and belief.” That phrase signals to the court that a particular statement rests on secondhand information. Typical phrasing: “I am informed and believe that the defendant received the payment on June 1.” Courts accept this in limited circumstances, but a declaration built mostly on information and belief is much weaker than one grounded in what you personally saw, heard, or did. Where you know something firsthand, say so directly.
When 1746 Does Not Apply
Section 1746 covers any situation where federal law, rule, regulation, or order calls for a sworn written statement, which sweeps in most federal court filings and most federal agency submissions. It does not cover everything, though. The statute carves out three exceptions where an unsworn declaration cannot substitute for a sworn statement:2Office of the Law Revision Counsel. 28 USC 1746 – Unsworn Declarations Under Penalty of Perjury
- Depositions. Sworn testimony taken in discovery still has to be given under oath, typically administered by the court reporter at the start of testimony.
- Oaths of office. A written declaration cannot stand in for the oath a government official takes on entering office.
- Oaths before a specified official other than a notary. If a statute requires you to swear before a particular official, such as a judge, that requirement stands.
One more boundary worth flagging: 28 U.S.C. 1746 is a federal statute and governs only matters under federal law. State courts follow their own rules. Some states have adopted comparable provisions and some have not, and the required wording varies where they exist, so check the local rule before using a 1746-style declaration in a state case.2Office of the Law Revision Counsel. 28 USC 1746 – Unsworn Declarations Under Penalty of Perjury
What a False Declaration Costs
The penalty-of-perjury language is not decorative. Lying in a 1746 declaration carries the same criminal exposure as lying under oath.
Under 18 U.S.C. 1621, perjury is punishable by up to five years in federal prison, a fine, or both. The false statement must be material, meaning it had the potential to affect the outcome of the proceeding.3Office of the Law Revision Counsel. 18 USC 1621 – Perjury Generally
Closer to the point, 18 U.S.C. 1623 covers false declarations before a federal court or grand jury and explicitly reaches declarations made “under penalty of perjury as permitted under section 1746 of title 28.” The maximum penalty is again five years and a fine. Under 1623, the government can also prove perjury by showing you made two irreconcilably contradictory declarations, without having to specify which one was false.4Office of the Law Revision Counsel. 18 USC 1623 – False Declarations Before Grand Jury or Court
On the civil side, Federal Rule of Civil Procedure 11 lets a court sanction a party who submits filings with false factual statements. Sanctions can include monetary penalties paid to the court and an order to cover the opposing party’s attorney’s fees caused by the violation.5Legal Information Institute. Rule 11 – Signing Pleadings, Motions, and Other Papers; Representations to the Court; Sanctions Those civil consequences can land even when prosecutors decline to bring a criminal case.