FORMAL COMPLAINT
and
AFFIDAVIT
Concerning:________________________
(Name of Examiner Complained against)
To the Secretary and the Board:
I hereby formally complain about the above-named polygraph examiner.
I realize that this complaint may result in formal Board action against this examiner. I agree to cooperate in any resulting investigation and to appear, if requested, to testify in person under oath concerning this matter.
The factual details and specifications of the complaint are contained in the attached affidavit and are incorporated herein by reference.
________________________________
Signature of Complainant
STATE OF ________________) CONCERNING POLYGRAPH
)
COUNTY OF _______________) EXAMINER:_____________________
AFFIDAVIT OF COMPLAINT
Before me, the undersigned Notary Public, appeared
______________________________________________________________
who, after being duly sworn, deposes and says as follows:
_______________________________
Affiant
Sworn to and subscribed before me this _____ day of _______, 199 __.
______________________________
Notary Public
My Commission expires _________
Author: Polygraph Examiners Board
Ala. Admin. Code r. 740-X-6-.01
Statutory Authority:Code of Ala. 1975, §§ 34-25-5(a), 41-22-4.