"Affidavit" - Missouri

Affidavit is a legal document that was released by the Missouri Department of Health and Senior Services - a government authority operating within Missouri.

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AFFIDAVIT
Before me, the undersigned authority, personally appeared,
,
who being by me duly sworn, deposed as follows:
I,
, am of sound mind, capable of making this affidavit,
and personally acquainted with the facts herein state:
I am employed with the
Ambulance Service, as the
Administrator. Included in my responsibilities as the Administrator is oversight of the
ambulances and the equipment stocked in each one.
Attached hereto is a copy of the equipment listing for
Ambulance Service. I do affirm that
out of
ambulance(s) carries the exact listing
attached.
, Ambulance Administrator
In witness whereof, I have hereunto subscribed my name and affixed my official
seal, this _
of
, 20____.
NOTARY PUBLIC
My Commission Expires:
AFFIDAVIT
Before me, the undersigned authority, personally appeared,
,
who being by me duly sworn, deposed as follows:
I,
, am of sound mind, capable of making this affidavit,
and personally acquainted with the facts herein state:
I am employed with the
Ambulance Service, as the
Administrator. Included in my responsibilities as the Administrator is oversight of the
ambulances and the equipment stocked in each one.
Attached hereto is a copy of the equipment listing for
Ambulance Service. I do affirm that
out of
ambulance(s) carries the exact listing
attached.
, Ambulance Administrator
In witness whereof, I have hereunto subscribed my name and affixed my official
seal, this _
of
, 20____.
NOTARY PUBLIC
My Commission Expires: