Attestation Statements: Examples from the Real World

The Basics of an Attestation Statement

Attestation Statements are formal, conclusive statements made by individuals or companies in a variety of formal actions such as executing contracts, opening banking accounts, or testing lab results. An attestation statement signifies that the individual or entity is swearing to the authenticity of the document or information contained within.
Generally, the individual or entity is attesting that the information it contains is authentic and true in a legally binding manner. In this context, an attestation statement serves to strengthen documentation and reduce the potential for fraud.
An attestation statement is often used in the legal and professional context. For example , a company may be required to provide an attestation statement verifying the results of a safety audit, or a person may need to state that a contract was executed properly.
Having attestation statements drafted, executed, and considered during the process of transactions or audits is considered best practice in many cases. Because these statements are legally binding and serve to verify the authenticity of documentation, they are important to all parties involved and may be heavily examined in the event of a dispute.

Examples of Legal Attestation Statements

Understanding Attestation Statements: Real-World Examples
Any Court or tribunal may require a party to provide a legal attestation statement as evidence of the truth of a fact.
(a) Affidavit
An affidavit is a written sworn statement made under the best possible knowledge and belief. An affidavit may be called an affidavit when it is given in a court or before an authorized person or officer (magistrate, notary public, commissioner for oaths). A sample affidavit for a couple seeking to obtain a marriage certificate is used as an example. In short, an affidavit must consist of: the identity of the setting (the court name, title, place, date, signature block); the declarant’s identity; the declarant’s statement of truth; the assertion of facts; and the signature of the declarant. A marriage certificate sample attached to the sample affidavit is used.
(b) Statutory Declaration
A statutory declaration is a written statement of facts. The statement may or may not be sworn before a Court or tribunal. A statutory declaration affirms a fact stated within it, it does not merely state the fact. A sample statutory declaration for a birth certificate application is used as an example. In short, a statutory declaration must consist of: the setting (the court name, title, place, date, signature block); the declarant’s identity (person making the statement), qualifying declaration; the statement of truth; the facts asserted; the signature of the declarant; and the identities of the witnesses. A birth certificate sample attached to the sample statutory declaration is used.

Examples of Financial Attestation Statements

In the financial sector, attestation statements are equally ubiquitous. A commonly used example is the internal controls audit report that accompanies financial statements. These reports, such as SSAE 18 Reports and ISAE 3402 Reports, provide an independent auditor’s examination of the design, implementation, and effectiveness of an organization’s internal controls as they relate to financial reporting. Financial institutions will often seek these reports for any service organization that provides critical services to their business. A fresh Salesforce SSAE 18 Report will be required before a bank will use your software application to manage its financial data.
Attestation statements can take many different forms in the financial sector. Many financial institutions require an attestation statement attesting to compliance with the Payment Card Industry Data Security Standard (PCI DSS). This is a set of security standards designed to ensure that organizations handle credit card transactions securely.
Offset Services, for example, provides outsourced payment processing and check writing services to businesses. Offset utilizes a T-RAISER System® which allows for the electronic processing of transactions in a wide variety of formats. All these capabilities provided by Offset require significant security and privacy measures.
Similarly, there are a number of organizations that provide check writing services and the like. Due to the security risks associated with check writing, many banks or other financial institutions require the vendor to provide an attestation statement.

Examples of Healthcare Attestation Statements

Healthcare attestation statements can cover a broad range of subjects from general medical condition or health status, to medical records themselves, to the medical history of family members. For purposes of this discussion, I am going to only briefly consider two examples: medical records and vaccinations.
In these examples, there is a more specific attestation that can be attached to the records. A physician can attest to the authenticity of a medical record created by that physician in a very straightforward manner. Most current EHR software packages will allow a physician to attach a digital signature to any of the documents contained in the EHR. With the correct configuration and process, the physician can create a digital signature and be prompted to apply it to key documents in the record prior to or concurrent with releasing the record to the patient. This can serve to authenticate the document for treatment, payment or healthcare operations purposes. The actual copy of the document would be disclosed, but tampering with this document, if not done through an approved process established by your organization, would cause it to become a tampered document by an adversary which may, or may not, run afoul of the secure storage requirements for electronic Protected Health Information ("PHI"). So, we may have gone "full circle" here but it is still worth the effort. Just "attesting" to the accuracy of the record is not the same as "verifying" the identified record as being "the" record of care. Authentication , though an important concept, is not the same as verification of the integrity of the record(s) as an entity. But, that would be a topic for another blog.
Vaccination records are a very specific example of a common area of interest in terms of verifying the accuracy of this type of medical information. A vaccination card can be easily forged or altered and falsified vaccination records are a very common problem in the prevention of pediatric vaccines. In fact, many states have laws requiring physicians to provide copies of vaccination records for minor children to the public health or state agencies. When a vaccination record is verified as an accurate depiction of a child’s medical events, it can now be uploaded to a central registry or database designed specifically to prevent forged vaccination cards for minors. This is now a common practice in public health, and provides a highly specialized example of the types of attestation statements being implemented by healthcare organizations today for broader, and more specialized purposes.
These examples are not exhaustive, but serve to illustrate the nature and scope of actual healthcare attestation statements designed to address specific circumstances or conditions in the clinical, legal and operational context. Having debated the issue directly with Senators and Congressman and medical and legal experts, I can confidently say that the following is a working concept which should be the basis for the definition of attestation statements.

Examples of Professional Attestation Statement

Attestation statements are commonly used by companies and professional organizations to verify qualifications, skills, and compliance with ethical standards among members and clients. For instance, a certification board such as the Center for Clinical Social Work may request an attestation statement from the candidate’s supervisor or supervisor from his or her previous position. An example of the attestation statement required by the Center for Clinical Social Work is:
Certification Board Attestation Form
The Certification Board of the Center for Clinical Social Work requires an attestation from your previous and/or current supervisor regarding your post-Master’s social work supervision. If you are currently in supervision it is the responsibility of the supervisor to submit this form to the Center for Clinical Social Work at [email protected] or by mail to:
The Center for Clinical Social Work: Certification Board
4400 West 18th Street, Suite 108
Chicago, Illinois 60623
It is your responsibility to make sure that your supervisor has completed and returned the form before the deadline of April 15th. Submitting a form after the deadline will cause your application to be considered late.
In this example, the applicant is required to provide the Certification Board with a separate attestation statement completed by his or her current or prior supervisor. The attestation statement is not contained in with the application and must be mailed directly to the Center for Clinical Social Work. In addition, the employer or supervisor is sent the attestation statement to complete.
Another example of a professional attestation statement is the one required by the American Association of Medical Assistants. The American Association of Medical Assistants requests the following attestation statement to be completed by an employer upon hire or upon request:
Attestation of Clinical Externship Experience
(Completion of Form is Required)
It is my responsibility as supervisor of over qualified applicants who have graduated from a qualified Medical Assistant program to attest to their skills as outlined below. In some instances, the individual may have taken a different path to gain the experience needed to gain employment in a physician’s practice. I can attest to the fact that the above named individual has not and will not have access to an area where supervised medications are administered, stored, or retrieved (such as a pharmacy or pharmacy practice). Please refer to the attached description under the header Medication for further clarification.
Superior
Outstanding in all categories
Average
Above average in all categories, but may not necessarily excel in all categories
Below Average
Poor performance in one or more categories
Very Poor
Extremely poor performance in two or more categories
The Center for Clinical Social Work and American Association of Medical Assistants provide specific requirements and guidelines for their attestation statements. It is the responsibility of the applicant to request an attestation statement from employers or supervisors, and to make sure the statements are completed and returned by the deadline.

How to Write Quality Attestation Statements

Attestation statements are common legal instruments in securities offerings; they are used to verify an investor’s accredited status or to certify other qualifications for an exemption from Securities and Exchange Commission (SEC) registration. Still, most companies that raise capital through offerings of securities have only a tenuous appreciation of the purpose, requirements, and legal effect of these statements. Attorneys working with traditional private placements know that the standard forms used in these offerings are becoming increasingly unsuitable as a result of new regulations and changing markets. In today’s marketplace, a well-tailored attestation statement ensures that the issuer has adequate documentation to support its claimed exemption, meets the requirements of Rule 506, and does not alienate the investor customers it seeks to attract.
Properly drafted, an attestation statement is a simple but substantial addition to your investment offering materials . Your attestation statement should convey the following useful information to your investor customers: It is, therefore, important for a company to work with legal counsel to draft an attestation statement that is tailored to its securities offerings and adequately captures the important information about which counsel and the company itself care most.
A good attestation statement will state the purpose of the attestation, explain how the prior representations in the private placement questionnaire and/or accredited investor questionnaire relate to the attestation, and then set out the various legal requirements in question-and-answer format. Each question and answer should include a reference to the applicable law, and any explanatory material should accompany the statement as an appendix. Your attestation statement is meant to be a legal form, not a marketing tool, and should be crafted accordingly. Legal counsel should, of course, review the draft statement and its contents to ensure that the issuer adequately protects itself from liability.