Fill and Sign the Affidavit Seller Form

FORM No. 116-M – Uniform Conveyancing Blanks AFFIDAVIT REGARDING SELLER(S)--(INDIVIDUAL) State of Minnesota, ) ) ss. Affidavit Regarding Seller(s) County of ______________________ ) ___________________________________________________________________________________________ being duly sworn, on oath say(s) that: 1. (They are)(____he is)(_____he knows) _______________________________________________________ __________________________________________________________________________________________ the person(s) named as _______________________________________________________________________ in the document dated ______________________, 20_____, and filed for record _________________, 20 _____, as Document No. ______________, (or in Book _________ of __________ Page ___________) in the Office of the (County Recorder) (Registrar of Titles) of ___________________ County, Minnesota. 2. Said person(s) (is) (are) of legal age and under no legal disability with place of business (es) (respectively) at ____________________________________________________________________________________________ ____________________________________________________________________________________________ _________________________________ and for the last ten years (has) (have) resided at: 3. There have been no: a. Bankruptcy, divorce or dissolution proceedings involving said person(s) during the time said person(s) (have) (has) had any interest in the premises described in the above document (“Premises”); b. Unsatisfied judgments of record against said person(s) nor any actions pending in any courts, which affect the Premises; c. Tax liens against said person(s); except as herein stated: 4. Any bankruptcy, divorce or dissolution proceedings of record against parties with the same or similar names, during the time period in which the above named person(s) (has)(have) had any interest in the Premises, are not against the above named person(s). 5. Any judgments, or tax liens of record against parties with the same or similar names are not against the above named person(s). 6. There has been no labor or materials furnished to the Premises for which payment has not been made. 7. There are no unrecorded contracts, leases, easements, or other agreements or interest relating to the Premises except as state herein: 8. There are no persons in possession of any portion of the Premises other than pursuant to a recorded document except as state herein: - 1 - FORM No. 116-M – Uniform Conveyancing Blanks 9. There are no encroachments or boundary line questions affecting the Premises of which Affiant(s) (has)(have) knowledge. Affiant(s) know(s) the matters herein stated are true and make(s) this Affidavit for the purpose of inducing the passing of title to the Premises. ____________________________________ ____________________________________ __________________________________________ NOTARIAL STAMP OR SEAL (OR OTHER TITLE OR RANK): THIS INSTRUMENT WAS DRAFTED BY (NAME AND ADDRESS): - 2 -