Filed on behalf of the claimant Witness Statement of [insert initial and surname of witness] Number of witness statement: [insert number of witness statement in relation to the witness] Exhibit details: [insert initials and number of each exhibit referred to] Date on which statement was made: [insert date] [Date of translation: [insert date]] IN THE COUNTY COURT AT [location] Claim No. [insert number] Parties [name] Claimant (a protected party by [name] [his OR her] [family relationship] litigation friend) and [name] Defendant WITNESS STATEMENT OF [insert name] I, [insert full name] of [if the witness is making the statement in their professional, business or other occupational capacity, insert the address at which they work, the position they hold and the name of their firm or employer], Legal Representative for the Claimant wish to rely on the following evidence in support of this application. 1 The facts and matters set out in this witness statement are within my own knowledge unless otherwise stated, and I believe them to be true. 2 [I drafted this witness statement myself and these are my own words. OR This witness