STATE OF LOUISIANA§
PARISH OF _____________ §
BEFORE ME, the undersigned authority, personally came and appeared ______________
________________, Affiants, being by me first duly sworn upon their oath did depose and say:
That Affiants are the owners of the property described in the attachment made a part hereof, and have been owners of said property since the date of the survey relied upon herein, a copy of which is attached hereto and made a part hereof:
That since the date of the survey relied upon herein:
1. No improvements (e.g., additions to the house, swimming pools, hot tubs, decks, fences added by either the Affiants or adjoining landowner) have been made to said property;
2. No alterations of the boundaries or fences of said property have occurred; and
3. No other changes to said property have occurred which would be reflected by a current, accurate survey.
That, to the best of Affiants' knowledge, there are no encroachments, overlappings, or insets or any improvements or fences across the lot lines or easements except as shown on the survey relied upon.
That Affiants herein realize it is in reliance upon statements herein made, as well as upon the acknowledgments to said instrument, that _________________, as issuing agent for Stewart Title Guaranty Company, has agreed to insure the lien created by the mortgage place on the property.
That Affiants agree to hold harmless, defend and indemnify ____________, Stewart Title Guaranty Company and Notary in the event a loss occurs, which loss relates to an untrue or incorrect statement made herein.
SWORN TO AND SUBSCRIBED before me, Notary, this _____ day of ____________, 20____.
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