Form LTC-82 "Sworn Statement of Employment for Purposes of Texas Government Code 411.179(C)" - Texas

What Is Form LTC-82?

This is a legal form that was released by the Texas Department of Public Safety - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2017;
  • The latest edition provided by the Texas Department of Public Safety;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form LTC-82 by clicking the link below or browse more documents and templates provided by the Texas Department of Public Safety.

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Download Form LTC-82 "Sworn Statement of Employment for Purposes of Texas Government Code 411.179(C)" - Texas

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SWORN STATEMENT OF EMPLOYMENT
FOR PURPOSES OF
TEXAS GOVERNMENT CODE §411.179(C)
STATE OF
§
§
(STATE WHERE NOTARIZED)
§
COUNTY OF
§
(COUNTY WHERE NOTARIZED)
BEFORE ME, the undersigned authority, personally appeared
, who made
this Affidavit and, on oath, stated the following:
(PRINTED NAME OF APPLICANT)
I
hereby swear and affirm that the following information is true and correct:
(PRINTED NAME OF APPLICANT)
I am an active judge or attorney, not retired, and am currently employed as a:
(
) Attorney General
(
) District Attorney
(
) Assistant Attorney General
(
) Assistant District Attorney
(
) United States Attorney
(
) Prosecuting Attorney
(
) Assistant United States Attorney
(
) Assistant Prosecuting Attorney
(
) County Attorney
(
) Criminal District Attorney
(
) Assistant County Attorney
(
) Assistant Criminal District Attorney
(
) Judge
(
) Justice
Applicant’s Signature
SUBSCRIBED and SWORN TO before me, this
day of
, 20
.
(DAY)
(MONTH)
(YEAR)
NOTARY PUBLIC Signature
[seal]
Printed Name of NOTARY PUBLIC (if not on seal)
LTC-82 (Rev. 9/17)
SWORN STATEMENT OF EMPLOYMENT
FOR PURPOSES OF
TEXAS GOVERNMENT CODE §411.179(C)
STATE OF
§
§
(STATE WHERE NOTARIZED)
§
COUNTY OF
§
(COUNTY WHERE NOTARIZED)
BEFORE ME, the undersigned authority, personally appeared
, who made
this Affidavit and, on oath, stated the following:
(PRINTED NAME OF APPLICANT)
I
hereby swear and affirm that the following information is true and correct:
(PRINTED NAME OF APPLICANT)
I am an active judge or attorney, not retired, and am currently employed as a:
(
) Attorney General
(
) District Attorney
(
) Assistant Attorney General
(
) Assistant District Attorney
(
) United States Attorney
(
) Prosecuting Attorney
(
) Assistant United States Attorney
(
) Assistant Prosecuting Attorney
(
) County Attorney
(
) Criminal District Attorney
(
) Assistant County Attorney
(
) Assistant Criminal District Attorney
(
) Judge
(
) Justice
Applicant’s Signature
SUBSCRIBED and SWORN TO before me, this
day of
, 20
.
(DAY)
(MONTH)
(YEAR)
NOTARY PUBLIC Signature
[seal]
Printed Name of NOTARY PUBLIC (if not on seal)
LTC-82 (Rev. 9/17)