Affidavit (Less Than $500)
This is a Missouri form that can be used for Administrative Rules within Secretary Of State.
Last updated: 1/24/2009
AFFIDAVIT PUBLIC COST STATE OF MISSOURI ) ) ss. COUNTY OF _________) I, name of person with authority, name of department, board or commission, first being duly sworn, on my oath, state that it is my opinion that the cost of proposed rule, insert rule number, is less than five hundred dollars in the aggregate to this agency, any other agency of state government or any political subdivision thereof. ____________________________________ Signature of person with authority Name of proper authority Title of proper authority Name of department, board or commission Subscribed and sworn to before me this ________day of month, year. I am commissioned as a notary public within the County of name of county, State of Missouri, and my commission expires on date. ____________________________________ American LegalNet, Inc. www.FormsWorkflow.com