1. Regulations
  2. title 46
  3. chapter IV
  4. part 502
  5. subpart S
  6. appendix-i 1

- Exhibit No. 2 to Subpart S [§ 502.304(e)] of Part 502—Respondent's Consent Form for Informal Adjudication

Federal Maritime Commission, Washington, DC. Informal Docket No. ______ Respondent's Affidavit

I authorize the Small Claims Officer to determine the above-numbered claim in accordance with subpart S (46 CFR 502) of the Commission's informal procedure for adjudication of small claims subject to discretionary Commission Review.

(Date) (Signed) (Capacity) Verification

State of ______________________, County of ____________________, ss: ____________, being first duly sworn on oath deposes and says that he or she is __________________, (Title or Position) and is the person who signed the foregoing and agrees without qualification to its truth.

Subscribed and sworn to before me, a notary public in and for the State of ________________, County of ________________, this ____________ day of ____________________, 19____.

(Seal) (Notary Public) My Commission expires. Certificate of Service [See § 502.320] [49 FR 44369, Nov. 6, 1984, as amended at 79 FR 46715, Aug. 11, 2014]

AUTHORITY: 5 U.S.C. 504, 551, 552, 553, 556(c), 559, 561-569, 571-584; 591-596; 18 U.S.C. 207; 28 U.S.C. 2112(a); 31 U.S.C. 9701; 46 U.S.C., 40103-40104, 40304, 40306, 40501-40503, 40701-40706, 41101-41109, 41301-41309, 44101-44106, 46105; 5 CFR part 2635.

SOURCE: 49 FR 44369, Nov. 6, 1984, unless otherwise noted.