46 CFR Appendix B to Subpart A of Part 68: Appendix B to Subpart A of Part 68—Oath of Parent or Subsidiary Corporation Act of September 2, 1958 (46 U.S.C. app. 883-1)

Department of Homeland Security, U.S. Coast Guard

Oath of Parent or Subsidiary Corporation, Act of September 2, 1958 (46 U.S.C. app. 883-1)

Corporation:

Name

Address

State of incorporation

Status (Parent) 1 ________ (Subsidiary) 2 ________

Name of associated corporation

Address

State where incorporated

Affiant:

Name

Address

Company

Title or capacity

I, the affiant named above, swear that the corporation first named herein is the (parent) 1 (subsidiary) 2 of the associated corporation named, that I am the duly authorized officer or agent of the corporation first named, and that the associated corporation has previously established that it is a citizen within the meaning of the Act of September 2, 1958 (46 U.S.C. app. 883-1).

Signature

Subscribed and sworn to before me on the day and year shown

(Notary Public)