Written statement made by defendant; form.
A statement in writing shall be made, signed by the defendant and verified by his or her oath, to the following effect:
It shall authorize the entry of judgment for a specified sum.
If it be money due, or to become due, it shall state concisely the facts out of which it arose, and shall show that the sum confessed therefor is justly due, or to become due.
If it be for the purpose of securing the plaintiff against a contingent liability, it shall state concisely the facts constituting the liability, and shall show that the sum confessed therefor does not exceed the same.