Recommendation for Appointment	Recommendation for Resignation
SECTION 1 – Recommendation Information
Name:
Mailing Address:
City:	State:	Zip:
County or Area:
Remarks (Qualifications or Reason for Resignation):
I recommend the above appointment / resignation.
Regional Forester/Dir. of Fire & Emergency Resp. Name (Print)	Regional Forester/Dir. of Fire & Emergency Resp. Signature	Date
Dir. of Fire & Emergency Resp./State Forester Name (Print)	Dir. of Fire & Emergency Resp./State Forester Signature	Date
SECTION 2 – Oath
I,	do solemnly swear (or affirm) that I will
support the Constitution of the United States and the Constitution of the Commonwealth of Virginia, and that I will
faithfully and impartially discharge all the duties incumbent upon me as a Virginia Commissioned Special Forest
Warden according to the best of my ability, so help me God.
Commissioned Special Forest Warden Signature	Date
SECTION 3 – Oath Verification
This is to certify that
on this	day of	,	, took and subscribed the
Oath required by the Laws of the Commonwealth of Virginia to qualify him/her to discharge the duties of a
Commissioned Special Forest Warden
Name of Court	Clerk of Court Signature	Date