STATE OF OKLAHOMA)
COUNTY OF)
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The undersigned (architect, contractor, supplier, or engineer)
of lawful age, being first duly sworn on oath, says that this invoice
or claim is true and correct. Affiant further states that the (work,
services or materials) as shown by this invoice or claim have been
(completed or supplied) in accordance with the plans, specification,
orders, or requests furnished the Affiant. Affiant further states
that (s)he has made no payment directly or indirectly to any elected
official, officer or employee of the State of Oklahoma, any county
or local subdivision of the state, of money or any other thing of
value to obtain payment.
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(Architect, Contractor, Supplier or Engineer)
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Subscribed and sworn to before me this _____ day of __________,
20_____.
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(Notary Public for Clerk or Judge)
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