IN THE COURT OF COMMON PLEAS OF DELAWARE COUNTY,
PENNSYLVANIA
CIVIL DIVISION
__________________________ NO. _____________________
vs.
__________________________
VERIFICATION
I verify that the statements made in this ______________________________________
are true and correct to the best of my knowledge, information, and belief. I understand
that false statements made herein are subject to the penalties of 18 PA. C.S,Subsection
4904, relating to unsworn falsification to authorities.
Date: ___________________ ___________________________