West Virginia Code Chapter 62. Criminal Procedure § 62-9-17. Indictment for perjury

An indictment for perjury shall be sufficient if it be in form, tenor or effect as follows (after following the form in section one):

That on the ․․․․․․․․․․ day of ․․․․․․․․․․, nineteen ․․․․․․․․․․, in the said county of ․․․․․․․․․․, before the ․․․․․․․․․․ court of said county of ․․․․․․․․․․, on an issue within the jurisdiction of the said court duly joined, and trial thereof before a jury of the county, between the State of West Virginia, plaintiff, and D ․․․․․․․․․․, the defendant, for a felony, A ․․․․․․․․․․ was in due form of law sworn by said court (or clerk or whoever administered the oath to the witness), having competent authority to administer to him the oath to speak the truth, the whole truth and nothing but the truth, touching the matters then and there in controversy between the State of West Virginia and the said D ․․․․․․․․․․. Whereupon, and upon said trial for a felony, it became then and there a material question to said issue upon said trial, whether (here say what the material question was in detail), and to this material matter the said A ․․․․․․․․․․ then and there willfully, falsely, corruptly and feloniously did testify and say, in substance and effect, that (here set out the testimony of A ․․․․․․․․․․ on said material issue as nearly exact as the same can be done); whereas, the said A ․․․․․․․․․․, in truth and in fact, well knew that the said statement and testimony (here state clearly the proper denial of the truth, stating the allegation to suit the particular case), against the peace and dignity of the State.