Del. R. Sup. Ct. Form 4
IN THE SUPREME COURT OF THE STATE OF DELAWARE
RULE 55.1 EMPLOYER AFFIDAVIT
STATE OF ____________:
COUNTY OF: ___________:
BE IT REMEMBERED, that on this ______ day of ________, A.D., 20, personally appeared before me, [FULL NAME OF CORPORATE OFFICER], who being duly sworn according to law, did depose and say:
1. I am the [TITLE OF CORPORATE OFFICER] of the [FULL NAME OF COMPANY], a corporation organized and existing under the laws of the State of [JURISDICTION], having its principal place of business in Delaware at [DELAWARE ADDRESS OF COMPANY].
2. I certify that [NAME OF APPLICANT], hereinafter Applicant, is employed as a lawyer by [NAME OF COMPANY] and that the nature of the Applicant's employment conforms to the requirements of Rule 55.1.
3. I certify that Applicant works exclusively for [NAME OF COMPANY] or one or more of its subsidiaries or affiliates whose business is other than the practice of law or the provision of legal services.
4. I certify that Applicant will remain an active member in good standing of the [BAR/LAW SOCIETY] of the [STATE/COMMONWEALTH/JURISDICTION] of [NAME] during the entire course of his/her employment.
5. I certify that I, or my successors, will notify the Supreme Court immediately if Applicant's employment is terminated, or if any conditions required by Rule 55.1 change.
signature of officer
_______________
Printed name of officer
Sworn to and subscribed
before me this day
of ______________, 20
___________________
Notary Public
Del. R. Sup. Ct. Form 4