GENERAL
AFFIDAVIT
STATE OF
____________________
COUNTY OF
_________________
Before the
undersigned, an officer duly commissioned by the laws of
__________________, on this ___day of _____________, 20____,
personally appeared ______________________________ who having been
first duly sworn depose and acknowledges:
[Insert Statement]
Witness: ______________________________________ __________________
Name Date
DATED this ______
day of _______________, 20__
________________________
Signature of
Affiant
SWORN to subscribed
before me, this _____ day ____ __________, 20__
__________________________________
