State of New York )
) ss.: County of )
......... (name of witness) being duly sworn, says: I reside at .......... in the .......... of .......... (fill in residence) in the state of New York; I know each of the persons whose names are subscribed to the above sheet having ............. (fill in number) signatures; and each of them subscribed the same in my presence.
...........................
(Signature of witness.)
Sworn to before me this .... day of ............ , 19.... ............................ (Official title of officer)
N.Y. Gen. Mun. Law § 703