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Filed on behalf of the [claimant OR defendant]

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 the statement was made: [insert date]

[Date of translation: [insert date]]

Claim No. [insert claim number].

[IN THE HIGH COURT OF JUSTICE

[BUSINESS AND PROPERTY COURTS [OF ENGLAND AND WALES OR IN [insert location] OR

[Specify division]

[Specify specialist court]

[Insert location] DISTRICT REGISTRY

THE COUNTY COURT AT [insert location]

[BUSINESS AND PROPERTY COURTS LIST

between:

1. [insert name]        Claimant

1. and

1. [insert name]        Defendant

_______________________________________

[NUMBER