Fill and Sign the West Virginia Affidavit Certifying Completion of Mandated Education Form

SCA-CG 906A / 6-00 STATE OF ___________________________________________, COUNTY OF ___________________ ______________________, to wit: I, ________________________________, the recommended conservator and/or guardian in the foregoing matter, hereby certify that I have completed the mandatory educational training required by West Virginia Code: § 44A-1-10(b), and that such education consisted of [ check applicable form of the materials studied ]: __________ Written materials __________ Recorded information, whether audio, visual or both __________ A combination of both written materials and recorded information I further certify that the foregoing educational training was completed by me on [ insert the date you completed the mandatory education ] ____________________________________________ . Given under my hand this ________ day of _______________________, 20____. _________________________________________________________ SIGNATURE The foregoing affidavit was taken, subscribed and sworn or affirmed before me by the said ____________________________________, in the foregoing action, in my said county and state on this, the _____ day of _____________________, 20 _____. Given under my hand and NOTARIAL SEAL. [ AFFIX NOTARIAL SEAL ] _________________________________________________________ NOTARY PUBLIC My Commission Expires:___________________________________. IN THE CIRCUIT COURT OF ___________ ____ COUNTY, WEST VIRGINIA For Clerk’s Use Only IN RE: _____________________________________ _________, AN ALLEGED PROTECTED PERSON DATE FILED: _____________________________________ CASE NUMBER ___________ - G - __________ AFFIDAVIT CERTIFYING COMPLETI ON OF MANDATED EDUCATION [West Virginia Code: § 44A-1-10(b).]