Facsimile Affidavit Declaration

Superior Court of Washington County of Jefferson _________________________________, Plaintiff/Petitioner vs. _________________________________, Defendant/Respondent No. ___________________________________ FACSIMILE AFFIDAVIT/DECLARATION (AF) I, _____________________________________(name), ______________________________ (title), with ___________________________________________ (firm/organization), declare and state the following: The attached is a facsimile transmission of __________________________________________________ ____________________________________________________________________ (titles of documents) submitted by_________________________________(name), ______________________________ (title), in the above-entitled matter. The attached document(s), prepared for filing on the ________ day of ____________________, 20______, and consisting of ______________ pages, including this affidavit page, has been examined and determined by me to be complete and legible. DATED: ___________________________ SIGNED: __________________________________ Address: __________________________________ __________________________________ Phone: __________________________________ American LegalNet, Inc. www.FormsWorkFlow.com