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Oath of [ ice for Volunteer Fire Pol men
(New York State Municipal Law, Section 209-CL)
STATE OF NEW YORK
SUFFOLK COUNTY ~
TOWN OF SOUTHOLD
535'
I, . ............... ..~.~..e..v...e...n.....~.~g..n...~.:]2. ............................ , do solemnly swear (or affirm)
(Tyge or Print Nsane)
that I will support the Constitution of the United States, and the Constitution of the State
of New York, and that I will faithfully discharge the duties of the office of Fire Policeman
of the .................... ~.l;.l~.j..~.~t.¢J~ .................. Fire Department, according to the best of
my ability.
Sworn to before me, this ..~...0.....?~... day
of ..... ~~ .............. , 19.~....
Notary ...,./~/~.~z. .................
PETER,r~M. COLEMA
NOTARY PUBLIC, State of New York
No. 52-5758570
Qualified in Suffolk County
Commission Expiros March $0,
Signature ...~~:~,.. ~,...~'.~ ..............
Address . .~.O4~.. JJ. I..G.. .... .,~...~fff:.,: ~..~4.c.~.../~'..,. ~..,.
Post Office ..............................................................
Original to be filed with Town (Village) Clerk.
Copy to be herd by Department Secretary.
Date filed ........................................