Fill and Sign the Affidavit of Mailing Individual Form

Affidavit of Mailing Page 1 of 2 AFFIDAVIT OF MAILING — CORPORATION , LLC, etc. STATE OF ARIZONA COUNTY OF __________________ On the _____ day of _______________ , 20 _____ , the Preliminary Twenty Day Notice was mailed to __________________________________ at ___________________________________ . ___________________________________ would hereby show that _____________________________________ has failed to complete the acknowledgment or failed to complete and return the acknowledgment within thirty days from the date of mailing. Proof of mai ling is hereby made by affidavit of the person making the mailing. The time, place and manner of mailing were ____________________ ________________ . The facts showing that such service was made in accordance with Arizona Revised Statutes § 33 - 992.01 are ___________________________________ . The name and address of the person to whom a copy of the Preliminary Twenty Day Notice was mailed is ___________________________________ . The title or capacity in which he was given the notice is _____________________________________ . If mailing was made by first class mail sent with a certificate of mailing, the cer tificate of mailing is attached to this Affidavit. If the mailing was by certified or registered mail, the receipt of certification or registration is attached to the Affidavit. This the _____ day of ___________________ , 20 _____ . ______________________________ Name of Co mpany By: ____________ _____ ___ ______ ___ _____ __ Signature Title ______________________________ Type or Print Name Affidavit of Mailing Page 2 of 2 State of Arizona County of ______________________________ The foregoing instrument was acknowledged and sworn to before me this _______________(date) by _________ ________________________________________(name of officer or agent, title or officer or agent) of ____________________________________________(name of corporation acknowledging) a _________________________(state or place of incorporation) corporation, on be half of the corporation. _____________________________ NOTARY PUBLIC Print Name: _______________________ My Commission Expires: _____________________ AZ § 33.992.02