I HEREBY ATTEST THAT ALL OF THE WRITING ABOVE ARE TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE, AND FULLY UNDERSTAND THAT I AM ACCOUNTABLE FOR THIS STATEMENT THROUGH O.R.C. CODE 2921.13.
Furthermore, I, the undersigned, hereby understand that this form is a legal document and all statements, accusations and recollections of any kind included within this document are true and accurate.
I have read statement which bears my signature. Any corrections that have been made bear my initials and I declare that the facts contained within this statement form are true and correct.