GENERAL AFFIDAVIT
State of __________________
County of _________________
Before the undersigned, an officer duly commissioned by
the laws of ____________, on this_____day of _____________,
19____, personally appeared ______________________________
who having been first duly sworn depose and say:
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
Witness:________________ _______________________________
Sworn and subscribed before me this ___day of ___________
A.D. 20__
__________________________
__________________________