Last updated: 5/11/2007
Employer Wage Affidavit {9}
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Description
FORM # 9 FORM # 9 STATE OF NORTH CAROLINA 20A JUDICIAL DISTRICT ___________________COUNTY IN THE GENERAL COURT OF JUSTICE DISTRICT COURT DIVISION CASE NUMBER: _______________________ ________________________________ , PLAINTIFF, -V________________________________, DEFENDANT. ) ) ) ) ) ) ) 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: ________________________ American LegalNet, Inc. www.FormsWorkflow.com