Fill and Sign the Mn Affidavit Form

FORM No. 117-M – Uniform Conveyancing Blanks AFFIDAVIT REGARDING CORPORATION State of Minnesota, ) ) ss. Affidavit Regarding Corporation County of ______________________ ) ___________________________________________________________________________________________ being duly sworn, on oath say(s) that: 1. (They are)(____he is) the ________________________________and the ____________________________ respectively, of _____________________________________________________________________________, a _______________ corporation, the corporation 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 corporation’s principal place of business is at _______________________________________________ ______________________________________________________________________________________ and said corporation’s previous principal place(s) of business during the past ten years (has) (have) been at: 3. There have been no: a. Bankruptcy or dissolution proceedings involving said corporation during the time said corporation has had any interest in the premises described in the above document (“Premises”); b. Unsatisfied judgments of record against said corporation nor any actions pending in any courts, which affect the Premises; c. Tax liens against said corporation; except as herein stated: 4. Any bankruptcy or dissolution proceedings of record against corporations with the same or similar names, during the time period in which the above named corporation has had any interest in the Premises, are not against the above named corporation. 5. Any judgments, or tax liens of record against corporations with the same or similar names are not against the above named corporation. 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: 9. There are no encroachments or boundary line questions affecting the Premises of which Affiant(s) (has )(have) knowledge. - 1 - FORM No. 117-M – Uniform Conveyancing Blanks 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 -