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    91-B:4 Affidavit. –

Proof of publication by broadcast of the notice shall be made by affidavit of the owner, manager, assistant manager or program director of the station, in substantially the following form:

AFFIDAVIT OF BROADCAST

State of New Hampshire

County of
__________

I
__________, being duly sworn, depose and say that I am the owner, manager, assistant manager or program director of station
__________, a radio (television) station broadcasting from
__________, and state that the notice (or summary or description of the notice) described as
__________ was broadcast on the following days:

(here set forth dates and times when the notice was broadcast.)

Subscribed and sworn before me
________________
, 20
___.

Month, Day

Notary Public/Justice of the Peace

My commission expires:

Source. 1983, 117:1, eff. July 24, 1983.