I do solemnly swear (or affirm) that I am not disqualified under the Industrial Relations Act from acting as a member of a conciliation board and that I will faithfully, truly and impartially to the best of my knowledge, skill and ability, fulfil and perform the duties which devolve upon me under the Industrial Relations Act by reason of my duties as ________________ and that I will not, except in the discharge of my duties, disclose to any person any of the evidence or the matter brought before the said board. (In the case where an oath is taken add “So help me God”)

I do solemnly swear (or affirm) that I am not disqualified under the Industrial Relations Act from acting as a member of a conciliation board and that I will faithfully, truly and impartially to the best of my knowledge, skill and ability, fulfil and perform the duties which devolve upon me under the Industrial Relations Act by reason of my duties as ________________ and that I will not, except in the discharge of my duties, disclose to any person any of the evidence or the matter brought before the said board. (In the case where an oath is taken add “So help me God”)