AFFIDAVIT OF FACTS
OF _________________
SPECIAL DEPOSIT
State of DATE: _________________________
County of
, Affiant(s), after first being duly cautioned and sworn, state the following to be true
according to personal knowledge:
Current Record Owner: ___________________________________________
Facts: ___________________________________________________________-__
_______________________________________________________:
_ _______________________ _
___________________________________________________________________________
(The attached documents, if any, are incorporated herein by reference and are true and accurate copies of the instruments by
which this conveyance or transfer of real estate is effected)
_______________________________________
Affiant
Before me, a Notary Public, in and for said County and State, personally appeared the above name,
________________________________, who acknowledged that he/she/they did sign the foregoing
instrument and that the same is his/her/their free act and deed.
In testimony, whereof, I have hereunto set my hand and official seal, this ___________ day of,
_______________________, 20___.
___________________________________
Notary Public:
____________________________________
____________________________________
This Instrument was prepared by: (Needs prepared by Affiant or Attorney)
___________________ (Seal)
Print Name
