IN THE COURT OF COMMON PLEAS OF DELAWARE COUNTY, PENNSYLVANIA CIVIL DIVISION __________________________ NO. _____________________ vs. __________________________ VERIFICATION I verify that the statements made in this ______________________________________ are true and correct to the best of my knowledge, information, and belief. I understand that false statements made herein are subject to the penalties of 18 PA. C.S,Subsection 4904, relating to unsworn falsification to authorities. Date: ___________________ ___________________________ American LegalNet, Inc. www.FormsWorkflow.com