Danny N. Crank, Butler County Recorder Form 66. (Sec. 68). NOTE ­ This form is to be used in cases where no specific provision is by the land title registration law made for registering a claim against or interest in registered land. Examples would be, (a) written contracts of purchase, (b) verbal contracts of purchase with such part performance as would make them valid in law, &c., &c ­ (Sec. 68). AFFIDAVIT OF ADVERSE CLAIM AGAINST REGISTERED LANDS. (Sec. 68). _________________________________________ whose residence is in the County of _______________________ and State of ___________________ and P.O. address __________________________________, being first duly sworn say(s) that _______ is/are asserting against the Registered Lands situate in the State of Ohio described in the following Registered Certificates of Title, to wit: Certificate No. Issued to. Date. Registration Book. Page. a claim adverse to the registered owner, no specific provision for the registration of which is made by the land title registration law of Ohio, the character and nature of which said adverse claim and how and under whom derived, are as follows, to wit: American LegalNet, Inc. www.FormsWorkFlow.com Danny N. Crank, Butler County Recorder And _______ do hereby designate ________________________________ in the State of Ohio as a place at which all notices relating to said claim in any proceeding or suit in reference thereto may be served upon ______ by registered mail. And being nonresident(s) of the State of Ohio, do hereby designate _____________________________ residing in the County of _____________, Ohio, and whose P.O. address is _____________________________________, Ohio, as _______ agent upon whom service of notice in all suits or other proceedings relating to said adverse claim may be made an by which service _____ will be bound the same as if personally made upon _____ in said State of Ohio. __________________________________ Adverse Claimant. Sworn to and subscribed before me a _______________________________ in and for ________________________ County, __________________ this ___ day of ___________________, 20___. ______________________________ _____________________ in and for __________________ County, Ohio. American LegalNet, Inc. www.FormsWorkFlow.com