With the Armed Forces | ) | |||
of the United States | ) ss | |||
at ______ | ) | |||
(Body of instrument) | ||||
Subscribed and sworn to (affirmed) by ______, to me known to be a member of the Armed Forces of the United States, on active duty therewith, before me, a commissioned officer of the Armed Forces of the United States, on active duty therewith, this ______ day of ______, A.D. 20______. | ||||
(Signature) | (Serial Number) | |||
______________________________________________________ | ||||
(Grade) | (Branch of service: Army, Navy, etc.) | |||
______________________________________________________ | ||||
(Permanent mailing address) | ||||
______________________________________________________ |
§ 492.070, RSMo
RSMo 1939 § 1948, A.L. 1951 p. 533, A.L. 1991 S.B. 358
Effective 6/12/1991