Verification Form - State Of North Dakota

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VERIFICATION
STATE OF NORTH DAKOTA
)
) ss.
COUNTY OF ______________
)
_____________________being first duly sworn on oath, deposes and says that (he) (she) is the plaintiff
in the above-entitled action; that (he) (she) has read the within Complaint and knows the contents
thereof and that the same is true, except as to matters stated therein upon information and belief and
as to those matters (he) (she) states that (he) (she) believes them to be true.
________________________________
Plaintiff
STATE OF NORTH DAKOTA
)
) ss
COUNTY OF ______________
)
On __________________, _____, before me, a Notary Public, in and for the county and state,
personally appeared ___________________, known to me to be the person who is described in and who
executed the within instrument and acknowledged to me that (he) (she) executed the same.
________________________________
Notary Public
(SEAL)

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