CIVIL TRIAL DIVISION
| : | CIVIL TRIAL DIVISION | |
| : | ||
| v. | : | TERM, 19 |
| : | ||
| : | NO: |
I,
, Esquire, hereby state and affirm that I have complied with the
Order issued on ___________________ by the Honorable ________________ as follows:
Copies of bank accounts are attached hereto.
I verify that the statements in this Affidavit are made subject to the penalties of 18 Pa. C.S. 4904 relating to unsworn falsification to authorities.
| DATE: ___________________ | _________________________ Attorney for Petitioner |