Affidavit
_________________
County of _________________
The undersigned, _________________, being duly sworn, hereby deposes and says:
1. I am over the age of 18 and am a resident of _________________. I have personal
knowledge of the facts herein, and, if called as a witness, could testify completely thereto.
2. I suffer no legal disabilities and have personal knowledge of the facts set forth below.
3. _________________
I declare that, to the best of my knowledge and belief, the information herein is true, correct, and
complete.
Executed this ______ day of ___________________, 20______.
__________________________________
_________________
                              NOTARY ACKNOWLEDGMENT
_________________, County of _________________, ss:
_________________________________
Notary Public
_________________________________
Title (and Rank)
My commission expires _____________
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