Affidavit By An Initial Transferee By Individual
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Affidavit By An Initial Transferee By Individual Form. This is a Minnesota form and can be use in Department Of Commerce Statewide.
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Tags: Affidavit By An Initial Transferee By Individual, 100.2.3, Minnesota Statewide, Department Of Commerce
(Top 3 inches reserved for recording data)
AFFIDAVIT BY AN INITIAL TRANSFEREE
by Individual
Minn. Stat. 523.11 subd. 4 (1984)
Minnesota Uniform Conveyancing Blanks
Form 100.2.3 (2011)
State of Minnesota, County of
, being first duly sworn,
on oath says:
1. Affiant is an initial transferee named in that deed dated
, and filed for record on
(month/day/year)
, as Document Number
(or in Book
of
(month/day/year)
Page
), in the Office of the
County Recorder
Registrar of Titles of
County, Minnesota,
(check the applicable boxes)
from
, as Attorney-in-Fact for
, as Grantor and Principal,
relating to real property in
County, Minnesota, legally described as follows:
Check here if all or part of the described real property is Registered (Torrens)
2. Affiant had not received, at the time of the conveyance, a written instrument of revocation of that certain Power of Attorney dated
, and filed for record on
, as Document Number
(month/day/year)
(or in Book
(month/day/year)
of
Page
), in the Office of the
County Recorder
Registrar of Titles
(check the applicable boxes)
of
County, Minnesota.
Note: Remainder of page left blank, signature page follows.
Page 1 of 2
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Minnesota Uniform Conveyancing Blanks Form 100.2.3
Page 2 of 2
Affiant
(signature)
, by
Signed and sworn to before me on
(month/day/year)
(insert name of person making statement)
.
(Stamp)
(signature of notarial officer)
Title (and Rank):
My commission expires:
(month/day/year)
THIS INSTRUMENT WAS DRAFTED BY:
(insert name and address)
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