Employer Wage Affidavit
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Employer Wage Affidavit Form. This is a North Carolina form and can be use in Stanly, Union (District 20B) Local County.
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Tags: Employer Wage Affidavit, 9, North Carolina Local County, Stanly, Union (District 20B)
FORM # 9
FORM # 9
STATE OF NORTH CAROLINA
20A JUDICIAL DISTRICT
___________________COUNTY
________________________________ ,
PLAINTIFF,
-V________________________________,
DEFENDANT.
IN THE GENERAL COURT OF JUSTICE
DISTRICT COURT DIVISION
CASE NUMBER: _______________________
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EMPLOYER WAGE AFFIDAVIT
I, _____________________________________ , an officer of _______________________________
__________________________________________________________________________
[name of the company], being duly sworn, submit to the Court, as follows:
1. That _____________________________________________ [name of Plaintiff or Defendant] in
the above entitled action is an employee of said company;
2. That the records attached hereto of ___________________________________________’s
[Plaintiff/Defendant] earnings, deductions, company benefits and length of employment is true
and correct to the best of affiant’s information and belief.
This the ______ day of ________________________ , _________.
____________________________________________________
Affiant [officer of the company]
____________________________________________________
Title
Subscribed and sworn before me
this the _______day of _________________ , _________.
_________________________________
Notary Public
My commission expires: ________________________
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