Verified Affidavit

I, ____________________________, being of sound mind and having reached the

age of majority, duly appointed as scribe to take notes and record the minutes of
the Assembly meeting of the People inhabiting the land of
_________________________ on this _______ day of ______________, 2012.
I hereby affirm the attached copy of said minutes is true, correct and complete.

______________________________________

_______________

Signature of Affiant

State of ________________________
County of ______________________

Date

)
)ss
)

Before me, the undersigned notary public, this day personally appeared
_______________________________________________, presenting acceptable identification, who
being duly sworn according to law deposes the following: This affidavit is true, correct, and complete.
Subscribed and sworn to before me this__________day of_______________,2012
__________________________________
Notary Public Signature

(seal)

my commission expires ______________________