New Mexico Administrative Code
Title 11 - LABOR AND WORKERS' COMPENSATION
Chapter 5 - OCCUPATIONAL HEALTH AND SAFETY
Part 5 - OCCUPATIONAL HEALTH AND SAFETY REVIEW COMMISSION PROCEDURES
Section 11.5.5.1009 - SAMPLE AFFIDAVIT OF POSTING

Universal Citation: 11 NM Admin Code 11.5.5.1009

Current through Register Vol. 35, No. 18, September 24, 2024

A. Format:

STATE OF NEW MEXICO

BEFORE THE OCCUPATIONAL HEALTH AND SAFETY REVIEW COMMISSION

[NAME OF COMPLAINANT OR PETITIONER],

[complainant/petitioner],

v. No. [insert case no.]

[NAME(S) OF RESPONDENT(S)],

respondent[s].

AFFIDAVIT OF POSTING

STATE OF [NAME OF STATE IN WHICH AFFIDAVIT SIGNED])

) ss.

COUNTY OF [NAME OF COUNTY IN WHICH AFFIDAVIT SIGNED])

[Name of person signing affidavit], being duly sworn, states:

1. I am the [title] of the [respondent/petitioner], [name of party], and I am authorized to make this affidavit.

2. I posted copies of the notice to affected employees ([specific type of notice]), [with an attached copy of the (title of attached document),] in accordance with 11 NMAC 5.5.203.A [now Subsection A of 11.5.5.203 NMAC], on [date of posting].

[Signature] ____________________________________

[TYPED OR PRINTED NAME]

[Address of signer (use as many lines as necessary)]

[Signer's telephone number]

SUBSCRIBED AND SWORN TO before me by [name of person signing affidavit] on [date].

[Signature of notary] ____________________________

Notary public

My commission expires:

[Expiration date]___________________

B. Usage note: If applicable, include certificate of service (Section 1001) [now 11.5.5.1001 NMAC], on or immediately following the signature page.

Disclaimer: These regulations may not be the most recent version. New Mexico may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.