Nev. Rev. Stat. § 127C.310
2. The affidavit described in subsection 1 may be substantially in the following form:
State of Nevada }
}ss.
County of................................... }
(Date)................................................................
Then and there personally appeared the within-named ................ and ................, who, being duly sworn, depose and say: That they witnessed the execution of the within relinquishment by ................ (name of person or persons relinquishing); that they subscribed the relinquishment and declared the same to be a voluntary relinquishment in their presence; that at the time the relinquishment was executed it contained the name of the agency to which relinquishment was made; that they thereafter subscribed the same as witnesses in the presence of ................ (name of person or persons relinquishing) and in the presence of each other and at the request of ................ (name of person or persons relinquishing) that at the time of the execution of the relinquishment ................ (name of person or persons relinquishing) acknowledged to them that they were, and they appeared to them to be, in full possession of their faculties and not under the influence of any drug or sedative that could impact their reasoning or judgment or subject to any duress, fear, menace, compulsion or undue influence whatever; and that they make this affidavit at their request.
Subscribed and sworn to before me
this ...... day of the month of ...... of the year ......
..................................................................
Notary Public
(Added to NRS by 2025, 1527)