Complaint Against: | ___________________ |
Complaint made by: | ___________________ |
Address: | ___________________ |
Telephone: | ___________________ |
A brief chronological statement of the facts:
Verification
State of _________________ | ) |
) ss | |
County of ________________ | ) |
______________________ of lawful age, being first duly sworn, states: I have read the foregoing statement, am familiar with the contents thereof and the statements therein contained are true and correct, to the best of my knowledge and belief.
____________________________________ |
(Signature) |
Subscribed and sworn to before me this ____ day _______________ of _____.
____________________________________ |
(Notary Public) |
My Commission expires: |
____________________ |
Okla. Stat. tit. 20 , 376:10-1 app A