fmard/pdf-api
0
1<!DOCTYPE html>2<html lang="en">3<head>4 <meta charset="UTF-8">5 <meta name="viewport" content="width=device-width, initial-scale=1.0">6 <title>Affidavit</title>7 <style>8 * {9 margin: 0;10 padding: 0;11 box-sizing: border-box;12 }13 body {14 font-family: 'Georgia', 'Times New Roman', Times, serif;15 font-size: 13px;16 line-height: 1.8;17 color: #1a1a1a;18 padding: 40px;19 max-width: 210mm;20 margin: 0 auto;21 }22 h1, h2, h3 {23 font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Helvetica, Arial, sans-serif;24 color: #111;25 }26 h1 {27 font-size: 22px;28 text-align: center;29 margin-bottom: 8px;30 text-transform: uppercase;31 letter-spacing: 1px;32 }33 .subtitle {34 text-align: center;35 font-size: 12px;36 color: #555;37 margin-bottom: 30px;38 border-bottom: 2px solid #4f46e5;39 padding-bottom: 15px;40 }41 h2 {42 font-size: 14px;43 margin-top: 24px;44 margin-bottom: 10px;45 text-transform: uppercase;46 letter-spacing: 0.5px;47 }48 .section-number {49 color: #4f46e5;50 margin-right: 6px;51 }52 .bold {53 font-weight: bold;54 }55 .section {56 margin-bottom: 16px;57 text-align: justify;58 }59 .list-item {60 margin-left: 20px;61 margin-bottom: 8px;62 padding-left: 10px;63 border-left: 2px solid #e5e5e5;64 }65 .affiant-info {66 margin: 20px 0;67 padding: 15px 20px;68 background: #f9f9fb;69 border-left: 3px solid #4f46e5;70 }71 .affiant-info p {72 margin-bottom: 6px;73 }74 .oath-section {75 margin: 25px 0;76 padding: 15px 20px;77 background: #fffdf5;78 border: 1px solid #e8e0c8;79 font-style: italic;80 }81 .signature-block {82 margin-top: 50px;83 page-break-inside: avoid;84 }85 .signature-line {86 border-bottom: 1px solid #333;87 margin-top: 50px;88 margin-bottom: 5px;89 }90 .signature-label {91 font-size: 11px;92 color: #555;93 }94 .notary-block {95 margin-top: 40px;96 padding: 20px;97 border: 1px solid #ddd;98 background: #fafafa;99 }100 .notary-block p {101 margin-bottom: 4px;102 }103 .stamp-area {104 margin-top: 20px;105 width: 120px;106 height: 120px;107 border: 2px dashed #ccc;108 display: flex;109 align-items: center;110 justify-content: center;111 font-size: 10px;112 color: #999;113 text-align: center;114 }115 </style>116</head>117<body>118 <h1>Affidavit</h1>119 <div class="subtitle">Sworn Statement / Surat Pernyataan</div>120 121 <div class="section">122 <p style="text-align: center; margin-bottom: 20px;">123 <span class="bold">Jurisdiction:</span> {{ jurisdiction | default('_________________________') }}124 </p>125 </div>126 127 <div class="section">128 <p>I, the undersigned, being of legal age and sound mind, do hereby declare and state under oath as follows:</p>129 </div>130 131 <h2><span class="section-number">I.</span> Affiant Information</h2>132 <div class="affiant-info">133 <p><span class="bold">Full Name:</span> {{ affiant_name | default('_________________________') }}</p>134 <p><span class="bold">Address:</span> {{ affiant_address | default('_________________________') }}</p>135 <p><span class="bold">Identification No.:</span> {{ affiant_id | default('_________________________') }}</p>136 </div>137 138 <h2><span class="section-number">II.</span> Sworn Statements</h2>139 <div class="section">140 <p>I hereby solemnly affirm and declare that the following statements are true and correct to the best of my knowledge and belief:</p>141 {% if statements %}142 {% for statement in statements %}143 <div class="list-item">144 <p><span class="bold">{{ loop.index }}.</span> {{ statement }}</p>145 </div>146 {% endfor %}147 {% else %}148 <div class="list-item">149 <p><span class="bold">1.</span> _________________________</p>150 </div>151 <div class="list-item">152 <p><span class="bold">2.</span> _________________________</p>153 </div>154 <div class="list-item">155 <p><span class="bold">3.</span> _________________________</p>156 </div>157 {% endif %}158 </div>159 160 <h2><span class="section-number">III.</span> Purpose</h2>161 <div class="section">162 <p>This affidavit is made for the purpose of:</p>163 <p style="margin-top: 8px; margin-left: 20px;">164 {{ purpose | default('establishing the truth of the above statements for all legal intents and purposes.') }}165 </p>166 </div>167 168 <h2><span class="section-number">IV.</span> Acknowledgment</h2>169 <div class="section">170 <p>I understand that this affidavit is made under oath and that making false statements herein may subject me to171 penalties for perjury under the laws of {{ jurisdiction | default('the applicable jurisdiction') }}.</p>172 </div>173 174 <div class="oath-section">175 <p>I, <span class="bold">{{ affiant_name | default('_________________________') }}</span>, do solemnly swear176 (or affirm) that the statements made in this affidavit are true and correct to the best of my knowledge, information,177 and belief. I make this solemn declaration conscientiously believing it to be true and knowing that it has the same178 force and effect as if made under oath.</p>179 </div>180 181 <div class="section">182 <p><span class="bold">Date:</span> {{ date | default('_________________') }}</p>183 </div>184 185 <div class="signature-block">186 <div style="width: 50%;">187 <div class="signature-line"></div>188 <p class="bold">{{ affiant_name | default('_________________________') }}</p>189 <p class="signature-label">Affiant</p>190 <p class="signature-label">ID No.: {{ affiant_id | default('_________________') }}</p>191 </div>192 193 <div class="notary-block">194 <h2 style="margin-top: 0;">Notarial Acknowledgment</h2>195 <p style="margin-top: 12px;">Subscribed and sworn to before me this <span class="bold">{{ date | default('_________________') }}</span>,196 in {{ jurisdiction | default('_________________________') }}.</p>197 198 <p style="margin-top: 8px;">The affiant, <span class="bold">{{ affiant_name | default('_________________________') }}</span>,199 personally appeared before me and exhibited their identification document (ID No.: {{ affiant_id | default('_________________') }}),200 and is known to me to be the same person who executed the foregoing instrument and acknowledged that the same is their free201 and voluntary act and deed.</p>202 203 <div style="display: flex; justify-content: space-between; margin-top: 30px; align-items: flex-end;">204 <div style="width: 50%;">205 <div class="signature-line"></div>206 <p class="bold">{{ notary_name | default('_________________________') }}</p>207 <p class="signature-label">Notary Public</p>208 <p class="signature-label">Commission No.: {{ notary_commission_number | default('_________________') }}</p>209 <p class="signature-label">Commission Expires: {{ notary_expiry | default('_________________') }}</p>210 </div>211 <div class="stamp-area">212 <span>NOTARY<br>SEAL</span>213 </div>214 </div>215 </div>216 </div>217</body>218</html>