כמה שווה התביעה שלך? כדי להשתמש במצגת האינטראקטיבית שלנו, בחר בדף הבא, העבר את הסמן באמצעות העכבר על חלקי הגוף השונים, והקלק לקבלת דוגמאות לפיצוי לפי פגיעות ספציפיות.

Affidavit and Undertaking



I, the undersigned, Dvora XXXX Passport No. 10150737 after being warned that I must state the truth or be liable to penalties under law, hereby declare as follows:

1.    This Affidavit is submitted in support of  the Application for entrance the u.s. of my 3 daughters, Ravit XXXX, Passport  No. 10556409 , Mor XXXX Passport  No. 10556406 and Shir XXXX Passport No. 10556408.

2.    I hereby declare that I am aware and agree the above travel the U.S and I also support them financially during their stay in the U.s.

I affirm that I have the financial ability to do so.

3.    I affirm that all the information provided in the Application and the attached documents is true and accurate.



        ______________________________________                              
         Date                                           Signature


I the undersigned, Oren Bashari, Adv., Israel Bar Association

License No. 29404, hereby confirm that Ms. Dvora XXXX holder of Passport No. 10150737 appeared before me on Thursday, December 27, 2007 and after being cautioned that any failure to declare the truth will be punishable by law, signed the above Affidavit.


Signature and Stamp