MUST BE SIGNED AND SEALED BY SURVEYOR FOR FIRM REGISTRATION
Affirmation of employment to be signed and sealed by each RPLS who is employed by firm:
I hereby certify under penalty of perjury that I _________________________________________, Registered Professional Land
Surveyor No. __________________ am employed full time by herein named Firm. I hereby acknowledge this statement by affixing
my Registered Professional Land Surveyor seal hereto.
I hereby certify under penalty of perjury that I _________________________________________, Registered Professional Land
Surveyor No. __________________ am employed full time by herein named Firm. I hereby acknowledge this statement by affixing
my Registered Professional Land Surveyor seal hereto.
I hereby certify under penalty of perjury that I _________________________________________, Registered Professional Land
Surveyor No. _________________ am employed full time by herein named Firm. I hereby acknowledge this statement by affixing
my Registered Professional Land Surveyor seal hereto.
Please attach additional information regarding branch offices, directors and surveyors as needed.
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