Applicants Name Applicants Address Applicants Phone Number IN THE UNITED STATES DISTRICT COURT DISTRICT OF UTAH - CENTRAL DIVISION ______________________________________________________________________________ : In re: : Application of : AFFIDAVIT Applicants Name : : __________________________________________________________________________ Pursuant to Rule 83-1.1(b)(2)(C) of the Civil Rules of Practice for the U.S. District Court forthe District of Utah, and as required by court order, Applicant Applicants name submits the followingaffidavit: Upon being duly sworn upon oath, Applicant affirms that the following statement is true: On date oath administered, I appeared before United States District or Circuit Judge Judges name of the United States District or Circuit Court for the Name of District or Circuit, in chambers or other location at the name and location of courthouse, and was administered the attorney oath for the U.S. District Court for the District of Utah pursuant to Rule 83-1.1(b)(2)(D) of the courts local civil rules of practice. FURTHER AFFIANCE SAYETH NAUGHT __________________________ ApplicantSUBSCRIBED AND SWORN to before me this ____ day of Month, Year. ________________________________ Notary Public, State of State >>>> 2________________________________ ________________________________ ________________________________ IN THE UNITED STATES DISTRICT COURT DISTRICT OF UTAH - CENTRAL DIVISION ________________________________________________________________________ ______ : In re: : Application of : AFFIDAVIT _____________________________ : : ________________________________________________________________________ __ Pursuant to Rule 83-1.1(b)(2)(C) of the Civil Rules of Practice fo r the U.S. District Court forthe District of Utah, and as required by court order, Applicant______________________ submits the followingaffidavit: Upon being duly sworn upon oath, ________________________ affirms that the following statement is true: On _________________________, I appeared before United States ________________________ ________________________________________ of the United States ______________ Court for the ______________________, in _______________________ at the __________________________ _________________________________________, and was administered the attorney oath for the U.S. District Court for the District of Utah pursuant to Rule 83-1.1(b) (2)(D) of the courts local civil rules of practice. FURTHER AFFIANCE SAYETH NAUGHT __________________________ _________________________SUBSCRIBED AND SWORN to before me this ____ day of ____________, 20____. ________________________________ Notary Public, State of ________________