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Fill and Sign the Affidavit of Publication Individual Montana Form

Fill and Sign the Affidavit of Publication Individual Montana Form

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Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only---------------------Name: ___________________ Company: ___________________ Address: ______________________ City: ___________________ State: _____ Zip: __________ Phone: _______________ Fax: _______________ AFFIDAVIT OF PUBLICATION--INDIVIDUAL (M.C.A.§ 71-3-533) I, __________________________________ , 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 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) Affidavit of Publication Page 1 of 1

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