Pennsylvania Code
Title 4 - ADMINISTRATION
Part XVI - LEGISLATIVELY ORDERED MATERIAL
Subpart A - DEPARTMENT OF STATE
Chapter 801 - LEGISLATIVELY ORDERED MATERIAL RELATING TO PROPOSED CONSTITUTIONAL AMENDMENTS
Appendix C - Form Affidavit for Newspaper for Missed Publication

AFFIDAVIT

I,

(name), hereby swear or affirm that:

1. I am employed by the Muncy Luminary (Luminary) as

(title). As part of my duties, I am responsible and oversee the placement of advertisements, including the advertisements of proposed constitutional amendments submitted by Red House Communications (Red House) and its subcontractor, Mid-Atlantic Newspaper Services, Inc. (MANSI), on behalf of the Pennsylvania Department of State (Department).

2. Red House and/or MANSI provided the final advertising materials (ad copy) for Joint Resolution 2018-1 (relating to the rights of victims of crime) to the Luminary on (date).

3. Red House and/or MANSI informed Luminary personnel of the importance of publishing proposed constitutional amendments according to the schedule required in the state constitution, and stated that for the 2018 advertisements, the advertisements had to be published on or before August 6, 2018.

4. The advertisement was scheduled to run in the Luminary's edition of August 1, 2018. The ad copy was provided to the Luminary with ample time to prepare for publicationon that date, but because of

(insert reasons here), it did not run in that edition.

5. The advertisement is currently set to be published in the next edition of the Luminary. Because the Luminary is a weekly publication, the next possible date for publication is August 8, 2018.

I further swear or affirm that this statement is true and correct to the best of my knowledge, information, and belief.

Date

(NAME)

(JOB TITLE)

Muncy Luminary

Commonwealth of Pennsylvania

County of

Signed and sworn to (or affirmed) before me on

(date) by

(name of Red House employee).

Signature of notarial officer

(stamp)

Title of office

My commission expires