SURVEYOR'S AFFIDAVIT CONFIRMING ERROR ON A RECORDED PLAT

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                 SURVEYOR’S AFFIDAVIT CONFIRMING ERROR ON A RECORDED PLAT


STATE OF ______________________ )
                                ) SS.
COUNTY OF ____________________ )



RE:    “_____________________________________________________________” Plat, (Plat Book ________,
       Page(s) ________________ Broward County Records)


BEFORE ME, the undersigned authority, duly authorized to administer oaths and take acknowledgements,
personally appeared before me ________________________________________________________________,
“affiant,” who being first duly sworn on oath deposes and says:

1.     That his/her name is ____________________________________________ and he/she is a Professional
       Surveyor and Mapper registered in the State of Florida and holds Registration No. __________.

2.     That he/she

           [ ] is the Surveyor and Mapper responsible for and who signed the certification on the face of the
                above referenced plat.

           [ ] is employed by the legal entity responsible for the survey and the preparation of the above-
                referenced plat

3.     That the plat contains erroneous information as follows:

           ________________________________________________________________________________

           ________________________________________________________________________________

           ________________________________________________________________________________


4.     That in his/her professional opinion the information contained in this affidavit should be substituted for the
       erroneous data shown on the plat or added to the data on the plat.
5.       That a resurvey of the subject property

                 [ ] was required and was conducted           [   ] was not required (select one)

         within the last 10 days pursuant to Florida Statutes Chapter 177.141 in order to verify that there is no
         evidence on the ground that would conflict with the corrections as stated in this affidavit.


                                                                   FURTHER AFFIANT SAYETH NAUGHT


                                                                   ______________________________________
                                                                   Print Name:



ACKNOWLEDGMENT - INDIVIDUAL

STATE OF ______________________ )
                                ) SS.
COUNTY OF ____________________ )


The foregoing instrument was acknowledged before me this _____ day of ___________________, 20__, by
______________________________________________________________________________ who is
[ ] personally known to me, or
[ ] produced identification. Type of identification produced_____________________.


                                                                   NOTARY PUBLIC:
(Seal)
                                                                   ______________________________________

                                                                   Print name: _____________________________

                                                                   My commission expires:___________________