Example of a Recommended Format for a Written Statement
By Robert A. Corry
Director, Fire Investigation Specialist
Statement of Howard Smith, 5 Maple Place, Anytown, TX DOB 4/7/62; SSN
583456468, Tel# (787) 555-2323 (H)/ (787) 555-7995 (W). Next of kin: Jane
Smith (wife), 5 Maple Place, Anytown, TX Tel# (787) 555-2323 (H). Employed:
Handyman Lumber, 57 Main Street, Anytown, TX - Boss: Kevin Kelman Tel#
787-555-0129. Statement taken by Jones/Regan.
HS: I live with my wife Jane at 5 Maple Place. I left my house this morning
for my usual morning jog at 5:30AM according to my kitchen clock. I went
from Maple to Dunbar for about a mile then turned onto Windy Street right
around 6AM according to my wristwatch. When I ran past 173 Windy Street
I saw flickering light behind the picture window in the front of the house.
I also saw that black smoke was coming out the front door. I realized that
there was a fire. I went to the next house and knocked on the front door
& asked the woman to call 911. She said, "the Quincys might be
inside the house since their car was in the driveway."
I ran to the Quincys' back door behind the building and tried to open
it. The door was definitely locked. I hit it with my shoulder and broke
the jam so the door flew open. I tried to crawl in on my hands and knees
yelling for the Quincys to answer. I could hear only crackling. The smoke
was heavy and I couldn't see more than a few feet and had difficulty breathing.
I backed out the same door I entered & saw the neighbor I had spoken
with on the front lawn. She helped me get away from the house. I could barely
breath & may have briefly passed out. We waited on the front lawn for
the fire and police to arrive. HS
/s/ Howard Smith
4/18/99 10:15 AM
Reprinted with permission from the author.