AFFIDAVIT State of County of , , ss: The undersigned Owner(s), whether one or more than one, being first duly sworn jointly and severally, if more than one deposes and makes the following statements for the express purpose of inducing Lender to refinance the following described property (“the Premises”), and any title insurance company to issue policies of insurance: Also known as: 1. All taxes, assessments or other charges now a lien against the Premises are shown on the Treasurer’s duplicate, and no improvements (site or area) have been installed by public authority, the costs of which may be assessed against the Premises. Owner has not been notified within the period of two years immediately preceding the date hereof of contemplated improvements (site or area) to the Premises by public authority, the costs of which are to be assessed against the Premises in the future nor has Owner any notice of condemnation or other exercise of the power of eminent domain. Owner represents that all bills for water and sewer charges issued prior to the date hereof for water and sewer services to the Premises have been fully paid. 2. No unpaid-for improvements have been made, or materials, machinery or fuel delivered to or labor performed on the Premises within ninety days immediately preceding the date hereof which might form the basis of a mechanic’s lien against the Premises, except ___________________________________________________________________________________ __________________________________________________________________________, (NONE, if nothing inserted), nor has Owner received a copy of an affidavit of mechanic’s lien which may be filed against the Premises. 3. Owner has no knowledge of an encumbrance(s) on title to the Premises other than those set forth in the evidence of title provided to Lender, nor does Owner have any knowledge of off-record or undisclosed legal or equitable interests in the Premises owned or claimed by an other person or entity, except the rights of tenants, if any, which have been fully disclosed to Lender and to any title insurance company issuing title insurance in reliance thereon. 4. To Owner’s best knowledge, the Premises has been previously surveyed at time of purchase and/or earlier refinance transaction(s), and it is Owner’s belief that any and all improvements on the Premises are located within the boundary lines of the Premises and all utility service lines serving the Premises are located either within the boundary lines of the Premises or within lands dedicated to public use or within recorded easements for the same. Further, Owner is not aware of any encroachment(s) by said improvements into any existing easement or building setback areas. 5. With respect to improvements located on the Premises, Owner has no knowledge of hidden structural defects or noncomplied with orders or notices of civil authority concerning health, building or fire code violations, and to the extent that Owner has made any structural or non-structural alteration or modifications to the improvements located on the Premises. Owner has to Owner’s knowledge obtained all necessary building permits and variance for the same. 6. Owner is not now under any legal disability which would impede or void any of Owners’ contractual obligations nor is Owner a debtor in any proceeding under the bankruptcy laws of the United States. All former spouses of Owner , if any, are deceased and/or all prior marriages, if any have been legally terminated. If Owner is a partnership or corporation, its officials consummating this transaction are properly authorized to do so, and the partnership or corporation and the undersigned, shall be bound by this affidavit. 7. That there are no court proceedings or disputes with any parties concerning the boundary lines of said premises; that there are no encroachments upon said premises from adjacent properties nor encroachments of any improvement located on subject real estate upon adjoining land, except: ______________________________________________________________ 8. That there are no unsatisfied or unreleased judgments or liens of record nor decrees of divorce, incompetency or bankruptcy nor court proceedings of any kind which would affect the title to said real estate, except: ___________________ ____________________________________________________________________________________________________ ________________________________________ ________________________________________ Sworn to before me and subscribed in my presence this day of , 20 . ___________________________________________ Notary Public WARNING: In transactions involving property in excess of $300,000.00 or property that is not to be used as a residence by Buyer, a separate affidavit should be executed in accordance with Internal Revenue Code 1445 and the Regulations promulgated thereunder (FIRPTA). File Number: American LegalNet, Inc. www.FormsWorkflow.com