1. Regulations
  2. title 5
  3. chapter II
  4. part 1201
  5. subpart H
  6. appendix AppendixIV

Appendix IV - Appendix IV to Part 1201—Sample Declaration Under 28 U.S.C.1746

Declaration

I, ___________, do hereby declare:

I declare under penalty of perjury under the laws of the United States of America that the foregoing is true and correct.

Executed on Date Signature

AUTHORITY: 5 U.S.C. 1204, 1305, and 7701, and 38 U.S.C. 4331, unless otherwise noted.

SOURCE: 54 FR 53504, Dec. 29, 1989, unless otherwise noted.