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Home » DISCRIMINATION AND ACCOMMODATION ISSUES IN EDUCATION » Examination Declaration - Custodian

Examination Declaration - Custodian

DECLARATION  OF CUSTODIAN FOR EXAMINEE



 
I,  __________________________________, of  ___________________________________________,  hereby declare that
_________________________________ has been in my presence and  custody from the time of  ____________  to _____________ on  _____________________.   

During that time said examinee did not have contact with anyone involved in the _________________________ examination and did not communicate with any other person about the contents of the examination.  

 I have read the foregoing and hereby declare under penalty of perjury, that the foregoing is true and correct.

Executed on _____________, at _______________________,  __:__
                                  (Date)                                        (Location)                        (Time)
 
____________________________________
                          (Signature)