Sample Affidavit Form - PDF - PDF by few71840

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									Sample Affidavit Form
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Department of Inspectional Services
9500 West Belmont Avenue
Second Floor
Franklin Park IL 60131


Dear Sir or Madam,

I, (NAME OF PURCHASER), am purchasing the property located at (ADDRESS
OF PROPERTY BEING SOLD). I will assume responsibility for all violations listed
on the pre sale inspection report. I will rectify the violations within thirty (30) days
of closing.

    (Signature of Purchaser)                           (Printed Name of Purchaser)

State of Illinois          )
                           ) ss
County of Cook             )

I,                          , a Notary Public in and for said County and State;
personally appeared                               known to me to be the same
person who executed the foregoing instrument, and (s)he acknowledged that (s)he
executed and delivered said instrument as (his) (her) a free and voluntary act and
deed for the uses and purposes therein set forth.

Given under my hand and notarial.

Seal this                  day of                      , 20         .

       (Notary Public)

My Commission expires:

VILLAGE OF FRANKLIN PARK                 PAGE 1 OF 1                          FORM DIS5001

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