Affidavit of Payment

Affidavit of Payment

Accounting – Court Registry
I, First Name Last Name, swear under oath that I am the person entitled to the funds deposited in the Registry of the Court in accordance with the Judgment/Order in the Travis County District Clerk, under Case # Case Number.
I am requesting that my funds be distributed to me in the following manner:

Chase (ACH) QuickPay with ZelleMail Paper Check-Standard USPS
Email Address
Phone # Associated with Zelle Account
Address

Street Address

Street Address Line 2

CityState

Zip Code
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number
County
Current Date

MonthDayYear
Signature

Clear
Should be Empty: