We are collecting declarations from California utility customers who've been impacted by Smart Meters. These declarations will be included in CPUC proceedings, and/or future civil lawsuits. This is a legal document that you believe is true to the best of your knowledge and you will testify to.
- Copy and paste the declaration template (below) into a Word document or download a Word template by clicking here.
- Follow the prompts in the template. Click here for an example.
- Email completed form to [email protected].
- You will receive a confirmation by email, with a final copy converted into PDF/A format.
- Print out and sign two copies of the PDF/A format.
- Mail one signed copy to: EMF Safety Network, PO Box 1016, Sebastopol CA 95473 and keep one signed copy in a safe place for your own records.
Please circulate this call for declarations to others who have been impacted by Smart Meters.
Thank you for your help!
DECLARATION TEMPLATE:
Declaration of <insert full name>
I, <insert full name>, have personal knowledge of all facts set forth in this declaration and am competent to testify thereto if called upon to testify in a court of law. I hereby declare:
1. My name is <insert full name>, and I reside at <insert address, city state and zip>
2. I am a utility customer of <insert name of gas and or electric company>
3. <Continue using a numbered list - write out point by point your situation and complaint against the utility, the Smart Meters, or any aspect of the program, or deployment that impacted you. This is a legally binding document. You must be truthful to the best of your knowledge. End your declaration with the following wording:>
I declare under penalty of perjury under the laws of the State of <insert state> that the facts set forth above are true and correct to the best of my knowledge. This declaration was executed this <insert date> day of <insert month>, <insert year> at <insert city>, <insert state>.
/s/ <insert full name here>