(Top 3 inches reserved for recording data) AFFIDAVIT AS TO FEDERAL TAX LIEN(S) Minnesota Uniform Conveyancing Blanks Form 60.3.6 (2006) State of Minnesota, County of , being duly sworn on oath, says that: (insert name of affiant) 1. I am the attorney foreclosing the mortgage described in the printed Notice of Mortgage Foreclosure Sale to which this Affidavit is attached, or which is described in paragraph 4. 2. Notice of the foreclosure sale was given to the Internal Revenue Service, Office of the District Director, United States Treasury Department, pursuant to 7425(c)(1) of the Internal Revenue Code of 1986, on by Certified Mail, as (month/day/year) evidenced by the attached copy of said notice. 3. This Affidavit is made for the purpose of showing compliance with Internal Revenue Code of 1986, 7425(c)(1) and the discharge or divestment of the tax liens referred to in said Notice pursuant to Internal Revenue Code of 1986, 7425(b)(2)(C). (NOTE: If this affidavit is not attached to and filed with the Sheriff's Certificate of Sale, complete paragraph 4.) 4. The Sheriff's Certificate of Sale to which this affidavit relates was filed for record on as (month/day/year) Document Number Office of the County Recorder (or in Book Registrar of Titles of of , Page County, Minnesota. ), in the (check the applicable boxes) Note: Remainder of page left blank, signature page follows. Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com Page 2 of 2 Minnesota Uniform Conveyancing Blanks Form 60.3.6 Affiant (signature) Signed and sworn to before me on , by (month/day/year) (insert name of person making statement) . (Seal, if any) (signature of notarial officer) Title (and Rank): My commission expires: (month/day/year) THIS INSTRUMENT WAS DRAFTED BY: (insert name and address) American LegalNet, Inc. www.FormsWorkflow.com