23. (a) Were you ever discharged on account of delinquency or
misconduct from any position in which you were employed? Answer
“Yes” or “No.”
(b) If so, state when, from what position, and by whom were you
discharged.
24. Are each and all of the answers to the foregoing questions in
your own handwriting? Answer “Yes” or “No.”
I hereby certify that the answers to the foregoing questions are
true in every particular.
(Signature of Applicant) ............
(P. O. address) ..............
(The following oath must be taken before a Notary Public, or other
officer authorized to administer oaths for general purposes, and
the officer’s signature must be authenticated by official seal. If
the oath be taken before a Justice of the Peace or other officer
who has no official seal, his character must be certified by the
Clerk of Court, Secretary of State, or other proper officer, under
official seal.)
The Notary is requested to see that all the foregoing questions are
answered in full before executing the jurat.
Sworn to and subscribed before me by the above-mentioned applicant,
to me personally known, this ...... day of ................ 190..,
at ........... county of ............................ and State (or
Territory or District) ........................
(Signature of officer) ...................
(Official impressed seal.) (Official title) .........
The official seal must not be omitted.
Every applicant for examination must furnish the vouchers of two
citizens of the United States, each of whom must be at least
twenty-one years of age, and must have known the applicant for six
months or more. Vouchers will not be accepted from the father,
mother, sister, brother, husband, wife or child of the applicant,
and not more than one voucher will be accepted from relatives of
more remote degree.
No recommendations other than those provided for hereon will be
accepted by the Commission.
Vouchers.
The following is a sample of the two vouchers; all answers made by
vouchers must be in their own handwriting.
1. What is your own age? Age of voucher, not applicant, is wanted.
If you so prefer, the statement that you are over 21 years of age
is sufficient.
2. What is your occupation?
3. What is your business address in full?
4. What is your actual bona fide (legal) residence? City and State?
5. How long have you been such resident thereof?
6. How long have you been acquainted with the applicant?
7. Is the applicant addicted to the use of intoxicating beverages,
tobacco, morphine, or opium? If so, to which?
8. Has the applicant ever been addicted to the use of intoxicating
beverages, tobacco, morphine, or opium? If so, to which?
9. Is the applicant a person of good moral character, and of good
repute?
10. Are you related to the applicant? If so, what is the
relationship?
11. Are you aware of any circumstances tending to disqualify the
applicant for the public service?
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