37-29-213 - Form of affidavit.

§ 37-29-213. Form of affidavit.
 

    Such affidavit as is provided for in Section 37-29-211 may be in substantially the following form:
 


    STATE OF ______________

    COUNTY OF ______________

    I, ________ (name of affiant), being an applicant for the position of at (name of institution), being first duly sworn, do hereby depose and say that I am now or have been within the past 5 years a member of the following organizations and no others:

   
 
________________________
   
 
________________________
   
 
(names and addresses of organizations)
and further, that I am now paying, or within the past five years have paid, regular dues or made regular contributions to the following organizations and no others:

   
 
________________________
   
 
________________________
   
 
(names and addresses of organizations)
   

                    __________________________________________________________

   
                    (signature of Affiant)

   

                    __________________________________________________________

   
                    Affiant

    Sworn to and subscribed before me, this the ________ (date) day of (month), 2________ (year).

   

                    __________________________________________________________

   
                    (signature of Official)

   

                    __________________________________________________________

   
                    Title of Official
 

Sources: Codes, 1942, § 6282-42; Laws,  1956, ch. 265, § 2.