AFFIDAVIT OF SURETY CASE NO. .............................................................................................. ........................................................................................ [ ] General District Court [ ] Juvenile & Domestic Relations District Court [ ] Circuit Court v. ......................................................................................................................... The undersigned state under oath that the following information is true: .............................................................................................................................. ...................................................................................................................................................................................................................................................................... (NAMES OF ALL OWNERS OF PROPERTY PLEDGED AS SECURITY) [ ] Real Estate – fair market value $ ............................................................................... $ ............................................................................... ............................................................................................................................................ ADDRESS OF REAL ESTATE ............................................................................................................................................ DESCRIPTION OF REAL ESTATE [ ] Personal Property Items – fair market value ............................................................................................................................................ DESCRIPTION OF PERSONAL PROPERTY ITEMS Less encumbrances to title: Loans or charge accounts – personal property $ ................................................................................. Mortgage or deeds of trust – real estate $ ................................................................................. Unpaid taxes $ ................................................................................. Unsatisfied judgments $ ................................................................................. Other surety bonds Other (assessments, mechanic’s liens, etc.) Specify $ ................................................................................. type of lien ............................................................................... $ ................................................................................. Total Encumbrances $ ................................................................................. NET EQUITY $ ........................................................................................... The undersigned further state they are the sole owners of the property, that there are no other encumbrances on the property and that no other person, group, or entity has any equity interest in the property described above. ______________________________________________ (seal) .............................................................................................................................. NAME (PRINT OR TYPE) SIGNATURE ______________________________________________ (seal) .............................................................................................................................. NAME (PRINT OR TYPE) SIGNATURE ______________________________________________ (seal) .............................................................................................................................. NAME (PRINT OR TYPE) SIGNATURE Acknowledged, sworn/affirmed and signed before me this day: .............................................................................................................................. (DATE OF ATTESTATION) _____________________________________________________________ [ ] JUDGE [ ] CLERK [ ] MAGISTRATE FOR NOTARY PUBLIC’S USE ONLY: State of ........................................................................................................... [ ] City [ ] County of .................................................................................................. Acknowledged, subscribed and sworn to before me this ...................... day of ............................................................................................ , 20 ................................................................................................ NOTARY REGISTRATION NUMBER FORM DC-332 REVISED 11/07 .................... _______________________________________________________________ NOTARY PUBLIC (My commission expires: .................................................. ) American LegalNet, Inc. www.FormsWorkflow.com