Charging Affidavit

Charging Affidavit
You will need a copy of the Referral Hall Rules in order to complete this form. A copy of the Referral Hall Rules can be obtained by clicking here.

Click "next" to begin.

Accuser Name*

First NameLast NameSuffix
Email*
example@example.com

Offender Name*

First NameLast NameSuffix

Steward Name:*

First NameLast NameSuffix

Witness Information
Witness 1*

First NameLast NameSuffix
Witness 2

First NameLast NameSuffix
Witness 3

First NameLast NameSuffix
Witness 4

First NameLast NameSuffix
Witness 5

First NameLast NameSuffix
Witness 6

First NameLast NameSuffix
Witness 7

First NameLast NameSuffix
Witness 8

First NameLast NameSuffix
Witness 9

First NameLast NameSuffix

I, {accuserName}, hereby certify the information contained herein is true and correct to the best of my knowledge. Pursuant to Article 8 Section 2(a)(10) of the Referrall Hall Rules, "Falsifying documentation given to the Referral Hall Committee" is a chargable offense.
Signature*

Clear
Date Submitted

MonthDayYear
Date
Hour MinutesAM/PM Option
Type a question
replyto
example@example.com
Should be Empty: