By submitting this form, I can read and write the English Language. I have read this statement which I have voluntarily made and I attest that it is true and correct to the best of my knowledge. I am willing to submit to a polygraph examination to prove that this Statement is true and correct.

I have been informed that under the Penal Code of the State of Texas, Section 37.02: A person commits the offense of perjury if, with intent to deceive and with knowledge of the statement's meanings; he makes a false statement under oath or swears to the truth of a false statement previously made; and the statement is required or authorized by law to be made under oath.

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