HomeMy WebLinkAboutBurkhardt, John C Original
Oath of Office for Volunteer Fire Policemen
(New York State Municipal Law, Section 209-C.)
STA*E OF NEW YORK
SUFFOLK COUNW
478'
TOWN OF SOUTHOLD
1, ....3..~..~x,..t~. .... .~. ..... ...~....~...~..~..t~..~.~.,~do solemnly swear (or affirm,
(Type or Print Name)
that I will support the Constitution of the United States, and the Constitution of the State
of New Yorg__~ and t~ s~l faithfully discharge the duties of the office of Fire Policeman
of the .......... j~..e,~e~.....~..,x. ....................... Fire Department, according to the best of
my ability.
Address ...... .~....~...~......~..~'..~ ..........
Post Office ......~...~.~~ .........
S~vorr~ before ~ne, this '~(-~ day
o ..... : .....
ALLAN C. DICKER$ON
NOTARY PUBLIC, ,'~TATE OF NEW* YORK
~*~. §2-602.2275 Suffolk Ce.
Commission £xpircs ~4arc,:~ ~0, 19~lll
Original to be filed with Town (Village) Clerk.
Copy to be held by Deportment .Secretary.
Date filed ........................................