Gr 17 Affidavit

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IN THE SUPERIOR COURT OF THE STATE OF WASHINGTON
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IN AND FOR THE COUNTY OF PEND OREILLE
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In re:
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No.
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GR17 AFFIDAVIT RE
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FAXED MATERIALS
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,
I,
with
(name)
(title)
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declare and state the following:
(firm/organization),
The attached is a facsimile transmission of
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submitted by
(titles of documents)
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in the above-entitled
(name),
title),
matter.
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The attached document(s), prepared for filing on the
day of
, 20
and consisting
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of
pages, including this affidavit page, has been examined and determined by me to be
complete and legible.
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Dated:
Signed:
Address:
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Phone:
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SUBSCRIBED AND SWORN to before me this
day of
,20
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Notary Public, State of Washington
(SEAL)
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Commission expires
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GR17 AFFIDAVIT

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