Agency, Authority, Commission, Department or Institution
Address, City and Zip Code
Print Name of Officer or Employee
(51 O.S., 36.2A)
I do solemnly swear (or affirm) that I will support the Constitution
and the laws of the United States of America and the Constitution and
the laws of the State of Oklahoma, and that I will faithfully discharge,
according to the best of my ability, the duties of my office or
ment during such time as I am
Here put name of office, or if an employee, insert An employee of________” followed
by the complete designation of the employing officer, agency, authority, commission,
department or institution.) 51 O.S., 36.2.
Affiant Sign Here
State of ____________________
County of __________________
Signed and sworn to (or affirmed) before me on this ______day of
____________ , ______by _______________________________.
Print name of the person taking the oath.
Signature of the Notary
(Seal, if any)
Title and Rank (if other than a notary)
My Commission Expires:_______________
Commission Number: _________________
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