(e) In any claim filed with a governmental entity under this act, the claim shall be signed by the claimant under oath in substantially the following format:
I, ______________, have read and understand the provisions of the false swearing statute. I hereby certify under penalty of false swearing that the foregoing claim, including all of its attachments, if any, is true and accurate.
______________ ______________
Signature of Claimant Date
______________
Printed Name of Claimant
STATE OF WYOMING |
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ss. |
COUNTY OF _____________ |
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Subscribed and sworn to before me, a Notarial Officer, this ... day of ....., ....
______________
Notarial Officer
My Commission Expires: (Seal).