AFFIDAVIT-BLANK.doc

The document is a Living Wage Affidavit where an individual, identified as the Affiant, attests to being over eighteen years old and in a position within a specific employer. The Affiant acknowledges that the employer is subject to the living wage ordinance of the Town of Manchester. They confirm that all eligible employees of the employer, working in the State of Connecticut, are receiving both living wage and health benefits as required by the ordinance. The Affiant's statement is signed and affirmed before a Commissioner of the Superior Court or a Notary Public in the State of Connecticut.