Legal & declarations
Statement of an incident template
Reviewed against the Law of Evidence — Regulator: Ministry of Justice — Last reviewed: 6 November 2026
This template follows the law of Saudi Arabia, not the law of the United States or any other country. Naming the regulator identifies the law that applies; it does not mean the regulator approved this template. This is a general template and does not replace advice on your own case.
- 20 designs, Arabic and English
- Fill the blanks in your browser
- Print, or save as PDF or Word
- No account needed to start
Preview — Formal concise
Statement of an Incident
Date: Statement Date
I, Reporter Name, Reporter Role, state that on Incident Date at Incident Time at Incident Place the following took place:
Facts of the Incident
The people involved were: People Involved.
Reporter Name – Signature: Signature