|
SWORN/AFFIRMED TO at [city], in the region of
[region], Province of
[province], this [day]
day of [month], 20____, before me:
________________________________
Commissioner of Oaths/Barrister of
the [level] Court of [province]
|
)
)
)
)
)
) _____________________________
) [Affiant Name]
) [Affiant title]
)
|
