pdf iconPrint
UCLA Procedure 120.1 : Attachment A

Declaration of Authenticity

Plaintiff Case No.


Declaration Certifying the Authenticity of Business Records Evidence Code §1561


I, _____________________________________, declare:
        (Custodian’s Name) 

I am an employee of the University of California, Los Angeles and am a duly authorized and qualified witness to certify the authenticity of the attached business records for the University.

The copies of the business records of the University which are enclosed within the attached sealed envelope are true copies of all records maintained by this office as described in the subpoena.

These records were prepared by personnel of the University in the ordinary course of business at or near the time of the acts, conditions or events described in the records.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on ________________________________, at Los Angeles, California. 
                                           (Today’s Date) 


_________________________________ (Signature)






cc:  UCLA Records Management