Del. R. Sup. Ct. Form 4

As amended through November 14, 2024
Form 4 - Employer Affidavit

IN THE SUPREME COURT OF THE STATE OF DELAWARE

RULE 55. 3

EMPLOYER AFFIDAVIT - RULE 55.3

STATE OF ___________

COUNTY OF __________

BE IT REMEMBERED, that on this ____ day of ______, A.D., 20, personally appeared before me, [FULL NAME OF U.S. ATTORNEY FOR THE DISTRICT OF DELAWARE], who being duly sworn according to law, did depose and say:

1. I am the United States Attorney for the District of Delaware.

2. I certify that [NAME OF APPLICANT], hereinafter Applicant, is employed as a lawyer by the United States Department of Justice as an Assistant United States Attorney for the District of Delaware and that the nature of the Applicant's employment conforms to the requirements of Rule 55.3.

3. I certify that Applicant works exclusively for the United States Department of Justice.

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 in the context of Rule 55.3.

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 55.3 change.

Signature of United States Attorney for the District of Delaware

_______________________

Printed name of U.S. Attorney

Sworn to and subscribed

before me this ____

Day of _________, 20

_________________

Notary Public

Del. R. Sup. Ct. Form 4

Added effective 10/23/2012.