Fill and Sign the Mississippi Affidavit Document Form

LOAN NO. ___________________ STATE OF MISSISSIPPI COUNTY OF ___________________ AFFIDAVIT AS TO SOLVENCY OF _______________________________ I, ___________________ , President of ___________________ , a Mississippi corporation, being duly sworn, depose and say of my own personal knowledge, that: 1. I am presently the President of ___________________ , a Mississippi corporation, and I am making this Affidavit to induce ___________________ to enter into a Modification of Note and Deed of Trust, an unexecuted copy of which is attached hereto as Exhibit "A," and to induce ___________________ to issue an Endorsement of Policy No. ___________________ insuring a valid first lien of the Deed of Trust described therein, as modified, and to induce said ___________________ to insure a Deed of Trust in favor of ___________________ , as a second lien, on the land described in Exhibit "B" attached hereto. 2. The fair market value of the assets of ___________________ , does, on this date, exceed its liabilities and it is presently meeting all of its debts as they mature with the exception of the Note described in Exhibit "A," which is in default. 3. That the execution and delivery by ___________________ , of the documents described in Exhibit "A" and anticipated to be executed pursuant to said Modification will not cause or render said corporation insolvent as defined in 11 U.S.C. 101(31). IN WITNESS WHEREOF, I have hereunto set my hand this the ____ day of _________ , _______ . By: __________________________________ _______________________________ President and Individually SWORN to and subscribed before me, this the ____ day of _________ , _______ . __________________________________ NOTARY PUBLIC My Commission Expires: _____________________