Nevada Administrative Code
Chapter 50 - Witnesses
Section 50.035 - Form of declaration regarding preparation of solution or gas used in calibrating breath-testing device

A declaration which is referred to in subsection 2 of NRS 50.315 must be in substantially the following form:

I, ..........................................., hereby declare:

That I am a ............... (occupation) employed by ................ (employer);

That on ......................... (date) I prepared a ............... (chemical solution or gas) consisting of ................ (description and composition of solution or gas) as necessary for accurately calibrating the ................ (name of device).

I declare under penalty of perjury that the foregoing is true and correct.

Executed on ......................................... .............................................................................

(Date) (Declarant's Signature)

.............................................................................

(Declarant's Title)

Added to NAC by Com. on Testing for Intoxication by R112-97, eff. 5-26-98

NRS 50.315