Prepared by: When recorded return to: AFFIDAVIT (By Owner on Sale or Financing) Before me, the undersigned authority, personally appeared the undersigned who has executed this Affidavit, and who made the following statements: 1. Identification. executing this Affidavit. The word "I" or "me" as hereafter used means each party 2. Purpose of Affidavit. knowledge to induce: I am making this Affidavit based upon my personal [ to purchase] [and] [ to lend money secured by a mortgage on] the real property described [as follows: ] [on attached exhibit entitled "Real Property"] (the "Real Property"); [and] [ to issue a policy insuring title to the Real Property based upon my statements] . 3. Statements Relative to the Real Property. A. The Real Property has been owned by me since and during such time (a) my possession thereof has been open and undisturbed and (b) no one has claimed any right to the Real Property adverse to my ownership. B. No one disputes the boundary line of the Real Property. C. There are no mortgages on or security agreements affecting the Real Property or any equipment or fixtures located on the Real Property [except] [if described on attached exhibit entitled "Mortgages or Security Agreements"] [for the following: BAR FORM NO. R-4.10 © Florida Lawyers Support Services, Inc. 2008 ]. D. No one other than me has the right to possession or are in possession of the Real Property, and there are no occupants, lessees, or tenants of the Real Property [except] [if identified on exhibit attached entitled "Parties in Possession"] [for the following: ]. [E. the past 90 days.] No improvements or repairs have been made to the Real Property within [E. Improvements or repairs have been made to the Real Property within the past 90 days in accordance with my oral agreements or written contracts with party or parties described [on exhibit attached entitled "Real Property"] [as follows: ]. I have paid in full all of such agreements or contracts [except for those and in the amounts described [on attached exhibit entitled "List of Agreements or Contract"] [as follows: ]. ] F. There are no unpaid bills for services of architects, engineers or surveyors in connection with the Real Property. G. or recorded. H. After I have not and I will not do anything or permit anything to be done which could affect title to the Real Property except as referenced in Paragraph 2 of this Affidavit. There are no suits, judgments or bankruptcies involving me either pending Appropriate Signature(s) Jurat - Required