AFFIDAVIT OF COURSE COMPLETION 
Iowa Diversity and Inclusion On-Demand CLE
Iowa Activity Number 362180 


I certify under penalty of perjury that I completed ____ hours of the Continuing Legal Education program "Iowa Diversity and Inclusion" offered by Richard Clem Continuing Legal Education. During the course of the audio program, I heard the following codes given: 

B 3 __ __
B 3 __ __
B 3 __ __
B 3 __ __
B 5 __ __
B 5 __ __
B 5 __ __
B 5 __ __


I certify under penalty of perjury and pursuant to the laws of the state of Iowa that the preceding is true and correct. 

Date: ______________ Signature: ________________________________ 

To sign this affidavit, you may type your name above next to the word "signature". If you prefer, you may print this page, sign it traditionally, and e-mail or mail me a copy. If signing traditionally, please print your name legibly as well. Upon completion, please submit this form to Richard Clem Continuing Legal Education by e-mail or U.S. Mail. Do NOT submit this form to the Iowa CLE Commission. 

Return form to: 
Richard P. Clem 
PO Box 14957 
Minneapolis, MN 55414 
clem.law@usa.net