Oath of Applicant
STATE OF ____________________ COUNTY OF __________________
Print Name
) ) ss. )
Capacity of affiant, i.e. president, owner, general manager
I, ______________________________, do hereby swear or affirm as __________________________________ of ________________________________________, That I have personally verified the information contained in the
Name of Collection Agency
attached Initial Collection Agency Application and Nebraska Collection Agency Board Personal/Corporate Financial Statement and the information contained therein is true and correct to the best of my knowledge. _________________________________ Signature SUBSCRIBED AND SWORN to before me this _____ day of ____________, 20____. ________________________________ Notary Public