Introduction

I, [YOUR NAME], residing at [YOUR ADDRESS], hereby declare and affirm the following statements under penalty of perjury under the laws of the State of Utah:

Statement of Facts

As a requirement supporting claims and requests in administrative proceedings or regulatory matters, I affirm that all statements made herein are as follows:

1. I am aware of the administrative proceedings currently underway at [AGENCY NAME], and I am submitting this affidavit in support of the applicant's request for approval of the permit, as I have firsthand knowledge of the benefits and impact of the project.

2. I certify that all information provided in this affidavit is true, accurate, and complete to the best of my knowledge and belief.

3. I understand the legal implications of providing false information in this affidavit and acknowledge that any misrepresentation may result in legal consequences.

4. I authorize [AGENCY NAME] to verify the information provided in this affidavit through any necessary means, including contacting relevant third parties or accessing official records.

5. I am willing to testify under oath to the truthfulness of the statements contained in this affidavit if required to do so.

Sworn Oath

I understand that this affidavit may be used as evidence in administrative proceedings or regulatory matters related to the claim or request being supported.

I affirm that I have not been coerced, threatened, or unduly influenced to provide the statements contained in this affidavit.

Signatures

[YOUR NAME]

Sworn to and subscribed before me on this [DATE] by [YOUR NAME], who is personally known to me or who provided [IDENTIFICATION DOCUMENT] as identification.

[NOTARY PUBLIC'S NAME]

Notary Public

[NOTARY PUBLIC'S EXPIRY DATE]

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