"I, ______________________ (municipal official title) of _________________ , do swear, to the best of my knowledge and belief, that the foregoing list of delinquent business and occupation taxes to be published on _______________ , is complete and accurate, and, as of _________________ (date of certification), that I have not received payment from any of the entities listed for the delinquent amounts included in the list."
W. Va. Code § 8-13-25