37-101-189 - Form of affidavit. - Mississippi Statutes

§ 37-101-189. Form of affidavit.
 

Such affidavit as is provided for in Section 37-101-187 may be in substantially the following form: 
     
 
"STATE OF ____________

    COUNTY OF ____________

    I, ____________ (name of affiant), being an applicant for the position of at (name of institution), being first duly sworn, do hereby depose and say that I am now or have been within the past 5 years a member of the following organizations and no others:

   
 
________________________
   
 
________________________
   
 
(names and addresses of organizations)
    and further, that I am now paying, or within the past five years have paid, regular dues or made regular contributions to the following organizations and no others:

   
 
________________________
   
 
________________________
   
 
(names and addresses of organizations)
                                                             ________________

                                                       (Signature of Affiant)

                                                            ________________"

                                                                      Affiant

    "Sworn to and subscribed before me, this the ____________ (date) day of (month), 2____ (year).

                                                             ________________

                                                      (Signature of Official)

                                                           ________________ "

                                                            Title of Official
 

Sources: Codes, 1942, § 6282-42; Laws,  1956, ch. 265, § 2.