AFFIDAVIT REGARDING IMPROVEMENTS TO PREMISES State of County of The undersigned owner(s) of the property known as , being first duly sworn and deposed, say the following: That, to the best of their knowledge, said Plat GIS survey accurately shows the location of the improvements on said property. That they have not made any additions to the house which would change the exterior lines of the house. That they have not erected or placed any structures on the property, such as garages, storage barns , sheds, decks and carports. That they have not had any swimming pools, spas, tennis courts or other recreational facilities constructed or placed on the property. That they have not had any notice of dispute, either formally or informally, regarding property lines or encroachments of improvements over the property lines or into easement areas during their period of ownership of the property. NOTE: If any improvements have been made to the property, indicate in pen, to the best of Affiant(s) knowledge, the location of those improvements. to This affidavit is given to induce a lender to lend money and issue a policy of title insurance which offers extended coverage regarding the matters set forth in this affidavit. ______________________________________________ ______________________________________________ Sworn to before me and subscribed in my presence this day of , 20 . ______________________________________________ Notary Public (FOR USE IN RESIDENTIAL REFINANCE TRANSACTIONS ONLY) File Number: American LegalNet, Inc. www.FormsWorkflow.com