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<document>AFFIDAVIT OF TITLEState of New York, County ofss.:Title No. *If owner is a corporation, fill in office held by deponent and name of corporationbeing duly sworn, says:I reside at No. I am the * owner in fee simple of premises andthe grantee described in a certain deed of said premises recorded in the Register'sOffice ofCounty in (Liber) (Record Liber)(Reel)of Conveyances,pagemyitsmyitsSaid premises have been inpossession since; thatpossession thereof has beenpeaceable and undisturbed, and the title thereto has never been disputed, questioned, or rejected, nor insurance thereof refused, as far as I know. I know of no facts by reason of which said possession or title might be called in question, or by reason of which any claim to any part of said premises or any interest therein adverse toCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .meitmight be set up. There are no Federal tax claims or liens assessed or filed against:::::::Index No.meitmeit. There are no judgments againstunpaid or unsatisfied or record entered in any court of thisstate, or of the United States, and said premises are, as far as I know, free from all leases, mortgages, taxes, assessments, water charges, sewer rents and other liens and encumbrances, exceptCalendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)Said premises are now occupied bymeitNo proceedings in bankruptcy have ever been instituted by or againstin any court or before anyhave I has itofficer of any state, or of the United States, norat any time made an assignment for the benefit ofcreditors, nor an assignment, now in effect, of the rents of said premises or any part thereof.*I am a citizen of the United States, and am more than 18 years old. I am by occupation. I am married towho is over the age of 18 years and is competent to convey or mortgage real estate. I was married to her on the. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .day of,. I have never been marriedto any other person now living. I have not been known by any other name during the past ten years.*This paragraph to be omitted if owner is a corporation* That the charter of said corporation is in full force and effect and no proceeding is pending for its dissolution or annulment. That all license and franchise taxes due and payable by said corporation have been paid in full.THE PEOPLE OF THE STATE OF NEW YORK TOThere are no actions pending affecting said premises. That no repairs, alterations or improvements have been made to said premises which have not been completed more than four months prior to the date hereof; nor have any obligations been incurred which have become or will become liens on the above premises.*This paragraph to be omitted if owner is not a corporation.GREETINGS:There are no facts known to me relating to the title to said premises which have not been set forth in this affidavit.WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomThis affidavit is made to induce to accept aof onsaid premises, and to induce The TitleYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.Guarantee Company and Pioneer National Title Insurance Company hereinafter called The Company to issue its policy of title insurance covering said premises knowing that they will rely on the statements herein made., one of the Justices of theSworn to before me thisCourt in Witness, Honorableday of, 20 County,day of,20(Attorney must sign above and type name below)Attorney(s) forOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com</document>