1. (a) Pleadings or other documents containing an averment of fact not appearing of record in the underlying action or containing a denial of fact shall be personally verified by the appellant or party thereto. Verification means a signed, written statement of fact supported by oath or affirmation or made subject to the penalties of 18 Pa.C.S. § 4904 (relating to unsworn falsification to authorities). If verification is required, notarization is not necessary.

2. (b) The verification form should comply substantially with the following:

   I,

   , hereby state that the facts above set forth are true and correct (or are true and correct to the best of my knowledge, information and belief). I understand that the statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 (relating to unsworn falsification to authorities).

   Date:

3. (Signature)

4. (c) When an affidavit is used, the form should comply substantially with the following:

   I,

   , being duly sworn do hereby affirm according to law, depose and say that the facts above set forth are true and correct to the best of my knowledge, information and belief.

   (Signature of affiant)

   Sworn and subscribed before me this

   day of , 20 .

   (Notary Public)

5. (d) An individual who executes a pleading or other document knowing that it contains a false statement and who causes it to be filed with the Bureau Director or Commission shall be subject to prosecution of a misdemeanor of the second degree in violation of 18 Pa.C.S. § 4904(a).
6. (e) Subsections (a)—(d) supersede 1 Pa. Code § 33.12 (relating to verification).

VERIFICATION

AFFIDAVIT