CL-0171-1 IN THE COUNTY COURT, CIVIL DIVISION IN AND FOR VOLUSIA COUNTY, FLORIDA Case No. Division Plaintiff(s), -vs- Defendant(s). AFFIDAVIT OF PROOF/VENUE stated: 1. Under filed herein the defendant now owes the plaintiff$ plus interest of $ plus costs of $ 2.This action has been brought in the County in which venue is proper, pursuant to Chapter 47, FloridaStatutes. I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this Affidavit and that the punishment for knowingly making a false statement includes fines and/or imprisonment. Signature of Plaintiff(s) Printed Name Address: City, State, Zip: Telephone No.: Fax No.: Sworn to and subscribed before me on , , by the affiant, , who is personally known to me or produced as identification. SIGNATURE OF NOTARY PUBLIC CLERK OF THE CIRCUIT COURT Printed Name of Notary Public: By: Deputy Clerk Commission Expires: Commission#: American LegalNet, Inc. www.FormsWorkFlow.com