SS13 | Bombyx | Witness Statement (Red Header)

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        -NANOTRASEN-
         <br>SECURITY DEPARTMENT</code>
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<u><b>FORM 601 - WITNESS STATEMENT<br></u></b>
Fill out all details below with a pen.

_By signing this form, you hereby swear that your statement is the truth and nothing but. Knowingly entering false or misleading information will be punished with the full force of Nanotrasen Space Law._
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<td><center><b><code>Receiving Officer Name</td>
<td><center><b><code>Witness Name</td>
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<td><center>[____________________]</td>
<td><center>[____________________]</td>
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<td><center><b><code>Shift Time</td>
<td><center><b><code>Witness Job Title</td>
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<td><center>[__]:[__]:[__]</td>
<td><center>[____________________]</td>
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<center><b>STATEMENT</b></center>
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