ESTOPPEL AFFIDAVIT OF MORTGAGOR
STATE OF ___________________
COUNTY OF ___________________
BEFORE ME, the undersigned authority, duly authorized in the State and County aforesaid to take
acknowledgments, this day personally appeared ____________________________________________, who,
being by me first duly sworn, on oath, deposes and says:
1. The facts and matters contained and recited herein are based upon the personal knowledge
of the Affiant.
2. Affiant is a resident of the State of ____________________, County of
___________________________, and currently resides at the following address:
3. On the ________ day of ______________________, ______, Affiant executed a Mortgage Deed
in favor of _____________, which said Mortgage is of record in Official Records Book
__________, Page _______ through ________ of the Public Records of the County of
______________________, State of _________________________.
4. The above described Mortgage secures a Promissory Note of even date therewith in the
original principal amount of $_________________________________, with interest thereon at
the rate of ______________% per annum and payable in installments of principal and interest
of $_______________ per month, beginning on the _____________________ day of
___________________, ______ and payable on the __________ day of each and every month
thereafter until paid in full.
5. The principal balance remaining to be paid under the Mortgage and Promissory Note
described herein is, as of the ______ day of ____________, ____, $_________________ and that
all payments due through and including the payment due on the __________ day of
_________________, _____, have been made by the Affiant to the Mortgagee and the loan
evidenced by said documents is, in all respects, current and the Affiant is not in default in
any manner with respect thereto.
6. Affiant has continuously, since the date of said Mortgage and Promissory Note, fully insured
the property in a sum not less than the property's full insurable value, in a company or
companies acceptable to the Mortgagee and that said policy or policies of insurance have
been held by and made payable to the said Mortgagee, per the terms of the Mortgage Deed.
7. Upon any assignment of the said Mortgage and receipt by Aff