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AFFIDAVIT



	STATE OF ______(1)_______)  

			ss:  

	COUNTY OF ____(2)________)



	KNOW ALL YE MEN BY THESE PRESENTS,  



	That on this _(3)__ day of ______(4)_________, 19_(5)_, personally came and appeared 

before me ______(6)__________, of __________(7)_______________, known, and known to 

me, who after being first duly sworn, deposes and says:  



(Insert Sworn Statement) 



	FURTHER AFFIANT SAYETH NOT.  



                                        __________(8)____________



	SUBSCRIBED TO AND SWORN TO before me this ___(9) day 

of____(10)____________, 19_(11)_.  



                                        _____________(12)__________

                                                    NOTARY PUBLIC

                                   

	My Commission Expires __(13)__ 





NOTICE



	The information in this document is designed to provide an outline that you can follow 

when formulating business or personal plans.  Due to the variances of many local, city, county 

and state laws, we recommend that you seek professional legal counseling before entering into 

any contract or agreement.