GENERAL AFFIDAVIT State of __________________ County of _________________ Before the undersigned, an officer duly commissioned by the laws of ____________, on this_____day of _____________, 19____, personally appeared ______________________________ who having been first duly sworn depose and say: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ _________ Witness:________________ _______________________________
Sworn and subscribed before me this ___day of ___________ A.D. 19__ __________________________ __________________________