Federal Maritime Commission, Washington, DC.
Informal Docket No. ______
Respondent's Affidavit
I authorize the Small Claims Officer to determine the above-numbered claim in accordance with subpart S (46 CFR 502) of the Commission's informal procedure for adjudication of small claims subject to discretionary Commission Review.
(Date)
(Signed)
(Capacity)
Verification
State of ______________________, County of ____________________, ss: ____________, being first duly sworn on oath deposes and says that he or she is __________________, (Title or Position) and is the person who signed the foregoing and agrees without qualification to its truth.
Subscribed and sworn to before me, a notary public in and for the State of ________________, County of ________________, this ____________ day of ____________________, 19____.
(Seal)
(Notary Public)
My Commission expires.
Certificate of Service [See § 502.320]
[49 FR 44369, Nov. 6, 1984, as amended at 79 FR 46715, Aug. 11, 2014]
authority: 5 U.S.C. 504,
551,
552,
553,
556,
559,
561,
571; 591-596;
18 U.S.C. 207;
28 U.S.C. 2112(a);
31 U.S.C. 9701; 46 U.S.C., 40103-40104, 40304, 40306, 40501-40503, 40701-40706, 41101-41109, 41301-41309, 44101-44106, 46105;
5 CFR part 2635
source: 49 FR 44369, Nov. 6, 1984, unless otherwise noted.