Get OH OHMR 2823 1972-2022
WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH: (PRINT NAME) EXHIBIT INITIALS OF PERSON MAKING STATEMENT PAGE ____ OF ____ PAGES ADDITIONAL PAGES MUST CONTAIN THE HEADING 'STATEMENT OF _________________ TAKEN AT _______________________ DATED __________________________ CONTINUED.' THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT AND BE INITIALED AS "PAGE _____ OF ______ PAGES.' WHEN ADDITIONAL PAGES ARE UTILIZED, THE BACK OF PAGE 1 WILL BE LINED OUT.
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