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PA Affidavit Form

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OWNER'S (SELLER'S) AFFIDAVIT

NOTE: Complete all provisions which apply.

STATE OF PENNSYLVANIA,
COUNTY OF , SS:

(In this Affidavit the pronoun "We" means "I" when there is only one Purchaser.)

We, (owners), being sworn according to law, say under oath that:

1. We are 21 years old or older. We are the sole owners of the real estate and improvements ("Property") located at:

We received a deed to the Property dated . We are now the Sellers of the Property.

Marital Status:

2. We have been and are now (being the time and date that we are signing this Affidavit) married to each other. If not married, so state here:

Liens:

3. In this Affidavit, a lien is a legal claim of another against property for (a) the payment of a debt or (b) the performance of an obligation. Examples of liens are (a) a judgment of a court for the payment of money owed, (b) a mortgage on real estate given as security for a loan, (c) an obligation owning to a contractor, subcontractor or other mechanic who has furnished labor or material for the improvement of real estate and for which money is owed, and (d) taxes and assessments assessed against real estate. There are no liens against the Property as a result of (a) debts that we owe or (b) obligations we have undertaken, except:

(a) Real estates taxes and assessments for this year.

(b) Other

No Mechanic's Liens; Rights to Liens:

4. During the last 60 days prior to the date we have signed this Affidavit, we have made no repairs, additions, or improvements, nor ordered or contracted for any labor or materials to be performed or furnished to the Property, which have not been paid in full. We do not owe any money for improvements, labor or materials performed on or furnished to the Property within 60 days immediately preceding the date of this Affidavit. Nor have we received any notice from anyone claiming to have not been paid in full, and there are no outstanding or disputed claims for any such work or item. No such work is now in progress.

Fixtures:

5. We have fully paid for all fixtures, appliances, or other personal property attached to or otherwise used with the improvements on the Property.

No Pending Governmental Improvements:

6. There has been no work done, and we have not received any notice that any work is to be done, by the City, Village, County, Township, State of Alabama or any sewer district or other governmental authority, or at its direction, in connection with the installation of sewer, water, curbs, sidewalks, streets or alleys, or repairs or improvements thereto.

No Nuisance or Condemnation:

7. We have not received any notice from any governmental authority for the removal or abatement of any nuisance or any notice of condemnation or other exercise of the power of eminent domain, or for the violation of any Zoning Regulations concerning the Property.

No Hidden Structural Defects:

8. There are no hidden structural defects in the Property.

Boundary Lines, etc.:

9. All of the utilities and improvements concerning the Property are located within the boundary lines of the subject real estate or within lands dedicated to public use or within recorded easements for the same. There have been no violations of any restrictions affecting the Property. There are no disputes with any adjoining property owners as to the location of property lines or the encroachment of any improvements.

No Lawsuits:

10. The are no pending lawsuits against us in any court. We have not received notice of any lawsuits pending against us.

No Bankruptcy or Receivership:

11. We are not a debtor in any proceeding under the bankruptcy laws of the United States, and no bankruptcy or insolvency proceedings have been started by or against us. No receiver or trustee has ever been appointed to take possession of the Property. Our sale of the Property is not made for the purpose of hindering, delaying or defrauding any of our creditors.

Easements:

12. In this Affidavit, an easement is a right given to another for a specific and limited use of real estate. An example of an easement is a right given to a utility company to maintain poles on the property. We have not given anyone any unrecorded easements affecting the Property. Nor have we given anyone any other unrecorded rights or interests in the Property, such as land contracts, mortgages, deeds, options, leases or licenses to use any part of the Property.

Liens Affecting Similar Names:

13. Our attention has been called to the liens listed below. The liens listed below are for debts or obligations of others with names similar to or the same as ours. We are not the same person as named in the following liens:

Reliance By & Obligations To Mortgagee & Title Insurance Company:

14. We know that ("Mortgagee" is making a loan to , the "Mortgagor(s)" of the Property, and that without said loan we, the Sellers, would not now be closing the sale of the Property and would not now be receiving the sale proceeds (either directly by payment to us, or indirectly by payment to one or more of our lenders).

We know that in deciding whether or not to make the loan to our Purchasers the Mortgagee is relying on the truth of the statements made by us in this Affidavit. We also know that (the "Title Insurance Company") is insuring the title to the Property for the Mortgagee because the Mortgagee requires that the title be insurable and that it be insured before it makes the loan to the Purchasers of our Property, and before it accepts the Property as security for its loan. We know that the Purchasers may also be insuring their title to the Property.

We know that in deciding whether or not to insure the title for the Mortgagee, and for the Purchasers, the Title Insurance Company is relying on the truth of the statements made by us in the Affidavit. It is with knowledge of the reliance by the Mortgagee and by the Title Insurance Company, and it is in consideration of and as an inducement to the making of the loan and of the insuring of the title so that we can benefit by the sale of the Property, that we acknowledge and agree that we are and will continue to also be directly liable to the Mortgagee and to the Title Insurance Company for any loss or damage either or both may suffer should any of the statements made by us in this Affidavit be not true.

Penalty of Perjury:

15. We know that we shall be bounded by this Affidavit under the penalties of perjury.

Owner Signature

Print Name:

Owner Signature

Print Name:

SWORN TO and subscribed in my presence this day of , 20.

NOTARY PUBLIC

My Commission Expires:

Enter text✕

What the PA Affidavit Form Is and When it’s Used

The PA Affidavit Form is a sworn written statement used to present facts or evidence in a legally recognized format in Pennsylvania (PA). It is completed by an affiant who signs under oath or affirmation before a notary public or other authorized official. Affidavits support court filings, property matters, administrative claims, and many business or personal transactions where a verified statement of facts is required. Proper execution—accurate facts, matching identity, notarization where required, and correct dating—ensures the affidavit is admissible and minimizes later challenge or rejection.

Why a Properly Prepared PA Affidavit Matters

A correctly completed affidavit gives a clear, sworn record of facts that courts and agencies can rely on for decisions. It reduces delays, avoids disputes over credibility, and is often required when filing petitions, land records, or administrative claims.

Why a Properly Prepared PA Affidavit Matters

Who Commonly Prepares and Signs This Affidavit

In many cases the affiant (person swearing the facts) signs and a notary or other official completes the jurat; requirements vary by use and recipient.

  • Private individuals providing sworn statements in civil matters or property transactions.
  • Attorneys submitting client facts, verifications, or supporting court evidence.
  • Businesses certifying corporate facts, ownership, or transaction history to third parties.

Step-by-Step: Completing a PA Affidavit Form

Follow these steps to complete execution, notarization, and distribution without common processing errors.

  • 01
    Prepare the draft: Gather supporting facts and documents.
  • 02
    Complete fields: Enter name, address, and numbered factual statements.
  • 03
    Execute with notary: Sign in the presence of a notary or authorized officer.
  • 04
    Distribute copies: Submit certified copies to the court or recipient as required.

Essential Parts of a Professional PA Affidavit Form

A complete affidavit includes discrete sections that together create a sworn, verifiable record. Each part plays a role in admissibility and downstream processing.

Caption

Identifies the case or transaction (court name, docket, or matter). A clear caption links the affidavit to the correct file and prevents misfiling or rejection.

Affiant Identification

Full legal name, address, and relationship to the matter. This establishes standing and a chain of custody for statements made under oath.

Statement of Facts

Numbered, factual sentences describing events or observations. Keep statements factual, time-stamped, and directly relevant to the issue at hand to preserve admissibility.

Exhibits/Attachments

Label and reference supporting documents inside the affidavit. Exhibits should be paginated and cross-referenced to facts to strengthen evidentiary value.

Jurat/Notary Block

Space for the notary to verify identity and administer the oath; includes signature, seal, and date. A completed jurat is often required for court or agency acceptance.

Certification Language

Concluding statement declaring truth under penalty of perjury. Precise wording may be required depending on jurisdiction or filing purpose.

Security and Compliance Considerations

Encryption: TLS 1.2/1.3 in transit
Data at rest: AES-256 encrypted storage
Certifications: SOC 2 Type II available
Regulatory: ESIGN and UETA compliant
Healthcare: HIPAA support (BAA needed)
FDA records: 21 CFR Part 11 capable

Common Mistakes to Avoid When Preparing the Form

  • Failing to sign in front of a notary or signing before arrival compromises the jurat and may make the affidavit inadmissible.
  • Using vague or opinion language instead of first-person factual statements reduces evidentiary weight and invites credibility challenges.
  • Mismatched names or incorrect dates create identity disputes that can delay filings and trigger re-execution requirements.
  • Omitting exhibits or failing to label attachments causes confusion and may prevent proper linkage between facts and supporting documents.

Consequences of Incorrect or Fraudulent Affidavits

Perjury: Criminal perjury charge
Evidence Rejection: Court may exclude affidavit
Civil Liability: Potential damages or sanctions
Administrative Delay: Filing rejected or returned
Notary Sanctions: Notary penalties for improper jurats
Costs: Attorney and re-filing fees

Where to File or Send the Completed Affidavit

Different recipients require different submission methods; confirm destination-specific rules before finalizing execution and distribution.

  • County Recorder / Clerk: File originals or certified copies as required
  • Court Clerk: Attach to pleadings or docket entries
  • Agencies: Submit with administrative claims or forms
  • Private Parties: Provide certified copies for transactions

How to Customize and Complete the Form Online

Set up an online workflow to collect sworn statements, verify identity, and preserve a notarized record when permitted.

Field Configuration
Upload Document Use PDF or DOCX for editable fields
Place Jurat Add a notary signature field and seal placeholder
Authentication Enable SMS or ID verification for signer confidence
Retention Store signed copy and audit trail securely

Digital Signing and eSubmission: Platform Considerations

Confirm the platform offers audit trails, secure storage, and any compliance addenda needed for HIPAA or 21 CFR Part 11 workflows.

  • Integrations: Salesforce, NetSuite, Microsoft 365
  • Formats: PDF, Word DOCX supported
  • Notary Support: Remote notarization where permitted

Key Dates and Timing Considerations

Track execution dates, filing deadlines, and retention start dates carefully to preserve legal effect and meet statutory timelines.

Execution Date:

Date affiant signs under oath

Notarization Date:

Date of jurat or notary certification

Filing Deadline:

Depends on recipient or court schedule

Retention Start:

Starts on creation or filing date

Corrections Window:

Address errors promptly to avoid re-execution

Practical Examples of Affidavit Use and Outcomes

Two concise examples illustrate real-world uses of affidavits and how digital tools supported execution and filing.

Martin Properties — Tim Martin

Tim used digital affidavits to verify listing histories and owner statements quickly.

  • He completed and notarized remotely where permitted.
  • The process reduced closing delays and produced an auditable record that streamlined title review and reduced follow-up questions from the buyer and lender.

Fertility Centers of Illinois — John Butler

The clinic standardized patient authorization affidavits for administrative use.

  • Staff used templates and secure eSignature workflows.
  • Standardization improved turnaround, ensured consistent jurat completion, and preserved a secure electronic trail for compliance and audits.

eSignature Vendor Comparison: Pricing and Core Capabilities

Basic pricing and capability differences across common eSignature providers to help compare platform-level costs and compliance features.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial, no credit card Varies by vendor Varies by vendor Varies by vendor Varies by vendor
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies Varies Varies

Frequently Asked Questions About the PA Affidavit Form

Answers to common questions about execution, notarization, e-signing, corrections, and storage for PA affidavits.


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