Free Verification of Signed Original Document - Missouri

APPENDIX E

S A M P L E

F O R M A T

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MISSOURI EASTERN DIVISION __________________________, Plaintiff(s), vs. __________________________, Defendant(s). ) ) ) ) ) ) ) ) )

Case No.

VERIFICATION OF SIGNED ORIGINAL DOCUMENT Pursuant to Local Rule 11-2.11, (Attorney for Plaintiff or Defendant) hereby attests to the existence of a paper copy of ___________________ bearing the original signature(s) of _________________. The document was filed electronically on _____________________ with a blank signature line. Counsel will retain the paper copy bearing the original signature(s) during the pendency of the litigation including all possible appeals.

Attorney for (Plaintiff or Defendant) Federal Bar Number: ___________ Address:

CERTIFICATE OF SERVICE I hereby certify that on (Date) , the foregoing was filed electronically with the Clerk of Court to be served by operation of the Court's electronic filing system upon the following: ___________________________. , the foregoing was mailed by United States Postal I hereby certify that on (Date) Service to the following non-participants in Electronic Case Filing: __________________________.

____________________________ Attorney's Signature
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