Fill and Sign the Affidavit of Publication Corporation Form

Affidavit of Publication Page 1 of 2 Prepared by, recording requested by and return to: Name: ___________________ Company: ___________________ Address: ______________________ City: ___________________ State: _____ Zip: __________ Phone: _______________ Fax: _______________ ----------------------Above this Line for Official Use Only--------------------- AFFIDAVIT OF PUBLICATION--CORPORATION (M.C.A.§ 71-3-533) I, _________________________________, as a representative of _________________________________ a __________________________________ corporation, do hereby certify under oath that I have published the attached Notice of Completion once each week for three (3) successive weeks in a newspaper of general circulation in the county where the land on which the work or improvement was performed is situated. This the _____ day of ______________, 20______. ______________________________ Signature______________________________ Type or Print Name______________________________ Title______________________________ Corporation Attest: Secretary Affidavit of Publication Page 2 of 2 State of Montana County of ________________ _______________ (date) Signed and sworn to (or affirmed) before me on __________________________________ by ____________________________________ (name(s) of person(s) making statement). ______________________________ Notary Public (SEAL) Title (and Rank): _______________ Printed Name: _________________ Residing at:____________________ My Commission Expires: ______________ MT § 71-3-533(5)