TO BE FILED WITH THE LASALLE COUNTY RECORDER OF DEEDS AFFIDAVIT FOR PURPOSE OF ILLINOIS PLAT ACT REQUIREMENTS THIS IS A LEGAL DOCUMENT - PLEASE CONSULT YOUR ATTORNEY (Zoning & Subdivision Ordinances May Also Apply) PARCEL NUMBER:__________________________ I ___________________ Grantor, Grantor's Attorney or Grantor's Authorized Representative in a deed transferring interest in the real estate described in the accompanying deed, being duly sworn on oath, state this transfer IS EXEMPT FROM THE ILLINOIS PLAT ACT (765 ILCS 205) BECAUSE OF THE FOLLOWING: 1. NOT A DIVISION OF LAND - PARCEL BOUNDARIES REMAIN UNCHANGED (The Recorder will proceed with recording the deed. Please sign and have notarized) A DIVISION OF LAND THAT MEETS ONE OF THE FOLLOWING EXCEPTIONS (If marking this box, also select the applicable subsection A - J below and sign and have notarized.) A. The divisions or subdivision of land into parcels or tracts of 5 acres or more in size which does not involve any new streets or easements of access. B. The division of lots or blocks of less than 1 acre in any recorded subdivision which does not involve any new streets or easements of access. C. The sale or exchange of parcels of land between owners of adjoining and contiguous land. D. The conveyance of parcels of land or interest therein for use as a right of way for railroads or other public utility facilities and other pipe lines which does not involve any new streets or easements of access. E. The conveyance of land for highway or other public purposes or grants or conveyances relating to the dedication of land for public use or instruments relating to the vacation of land impressed with a public use. F. Conveyances made to correct descriptions in prior conveyances. G. The sale or exchange of parcels or tracts of land following the division into no more than 2 parts of a particular parcel or tract of land existing on July 17, 1959 and not involving any new streets or easements of access. H. The sale of a single lot of less than 5 acres from a larger tract when a survey is made by an Illinois Registered Land Surveyor; provided that this exemption shall not apply to the sale of any subsequent lots from the same larger tract of land, as determined by the dimensions and configuration of the larger tract on October 1, 1973, and provided also that this exemption does not invalidate any local requirements applicable to the subdivision of land. I. J. The preparation of a plat for wind energy devised under section 10-620 of the Property Tax Code. Division meets criteria for agricultural exemption 2. I swear to the best of my knowledge that the statements contained herein are true and correct. Grantor/Grantor's Attorney further states that this affidavit for the purpose of indicating to THE RECORDER OF DEEDS OF LASALLE COUNTY, ILLINOIS, that the conveyance by the attached instrument is within, and in compliance with, the provisions of the Illinois Plat Act. Printed Name:__________________ Signature:______________________ Date:___________ Subscribed and sworn to before me this _______ day of _____________, 20_______. ________________________________________ Notary Public Approval for State Plat Act, County Subdivision and Zoning Code Purposes: American LegalNet, Inc. www.FormsWorkFlow.com