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Pca
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_SETUP.1
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810016.BLD
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Text File
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1997-07-22
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729b
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39 lines
#100
@001 Enter the name of the declarant:
~Enter the name of the person making this declaration.
@002 Enter the state where declaration is given:
~Enter the state where the declaration is being made.
@003 Enter the county where declaration is given:
~Enter the county, parish, judicial district or borough where the
~declaration is being made.
#end control section
#100
DECLARATION UNDER PENALTY OF PERJURY
STATE OF @002)
COUNTY OF @003)
@001, herewith declares under the penalties of perjury:
That they are competent under the law to give this declaration
and unless stated have personal knowledge of the facts
stated herein:
____________________________________
@001