GENERAL AFFIDAVIT

 
 
State of __________________ 	)	
 				)          AFFIDAVIT
County of _________________ 	)		
 
Before the undersigned notary, an officer duly commissioned by the laws of this state, on the below date, personally appeared the undersigned affiant who, having been first duly sworn, deposes and says: 
 
___________________________________________________________________ 
 
___________________________________________________________________ 
 
___________________________________________________________________ 
 
 
	
________________  		_________________
Affiant		    		Witness
			 
Sworn and subscribed before me this ___day of ___________A.D. 20__ 
 
 
__________________________ 
Notary Public for this State
 
__________________________
My Commission Expires