§ 28-15-3. Standard form. The standard form of assignment required by this chapter shall be as follows:

Know All Men and Women by These Presents;

That I, .................... in county of ........................................ for a valuable consideration, to me paid by .................... of ........................................ the receipt whereof I do hereby acknowledge, do hereby assign and transfer to said .................... all claims and demands (which I now have, and all) which within a period of ................ from the date hereof I may and shall have against my present employer and against any person whose employ I shall hereafter enter (for all sums of money due and) for all sums of money and demands which, at any time within said period, may and shall become due to me, for services as ....................

To have and to hold the same to the said ...................., his executors, administrators and assigns, to secure a debt

(1) Of ............ dollars (with interest thereon from ................................ at the rate of ........ percent per annum), for money (or goods) actually furnished by the assignee amounting to ............ dollars,

(2) Contracted prior to the execution of this assignment (or contracted simultaneously with the execution of this assignment).

In witness whereof I have set my hand this day of

Signed and delivered in presence of:

History of Section. (P.L. 1908, ch. 1551, § 6; G.L. 1909, ch. 260, § 6; G.L. 1923, ch. 304, § 6; G.L. 1938, ch. 292, § 6; G.L. 1956, § 28-15-3.)