Before me, ___________________________, (hereinafter (Affiant(s)) personally appeared before me, on this ___________ day of _____, personally known by me to be the person(s) whose name(s) is/are subscribed hereto, and who after being duly sworn, on his/her/their oath(s) state(s) that for the Land described in Schedule “A” of the Commitment and hereinabove, represent(s) to Stewart Title Guaranty Company (the “Company”) in this transaction that on his/her/their oath(s) state(s) the following to be true and correct:
Any blank shall be deemed to be an affirmative statement as “None”.
1. The Affiant(s) is/are the owners of the Land, and no one has ever questioned or disputed my/our ownership.
2. The Affiant’s marital status is ____________ (single/married) this status ___________ (has/has not) changed since the date of the acquisition of the Land. If there has been a change in marital status since the acquisition of the Land, please describe: (Please list or if “None”, please write the word “None”. Please note: if left blank, the answer will be deemed “None”)
3. The Affiant(s), jointly or individually, has/have not filed any petition for relief in the Bankruptcy Court and the Land is not under the control of the Bankruptcy Court or the Trustee in Bankruptcy or any receivership.
4. There are no:
(i) tax liens or any other liens, unsatisfied mortgages, foreclosures, judicial resolutions or judicial agreements affecting or against the Land, legal actions for the possession of the Land and/or affecting the Land, executions, attachments, judgments, bankruptcies, claims, lawsuits or encumbrances of any kind against said Land; or,
(ii) suits pending, or unsatisfied judgments against Affiant(s) and no suits or proceedings against anyone affecting the Land,
except as described in the Commitment dated _______ and as set forth below: (Please list or if “None”, please write the word “None”. Please note: if left blank, the answer will be deemed “None”)
5. All taxes and assessments by a taxing authority are paid through ________________. There have been no special tax assessments granted on the Land. All tax exemptions were lawful, if any.
6. All assessments and maintenance fees by the homeowners' association for the subdivision/condominium are paid current and outstanding assessments and maintenance fees are not yet due and payable.
7. At no time within  days of the date hereof has any work, service or labor been performed, or any fixture apparatus or material been furnished, in connection with, or to, the premises, except as have been fully and completely paid for. There is no claim or indebtedness to/by anyone for any labor, fixture, apparatus, materials, services, or work performed upon, or in connection with, the premises. There is no mechanics lien claim against the premises, whether of record or otherwise.
8. There are no tenants, unrecorded easements or parties in possession, except as set forth below: (Please list or if “None”, please write the word “None”. Please note: if left blank, the answer will be deemed “None”)
9. There is no agreement or contract for sale or conveyance, purchase options or rights of first refusal, or deed, conveyance by written lease, or writing whatsoever, affecting the title to the Land, except those in connection with which this affidavit is given. There are no parties in possession of the Land other than the Affiant(s).
10. There are no pending repairs or improvements to the street(s), curb(s), or gutter(s) adjacent to the Land.
11. The Affiant(s) is/are not aware of, nor have permitted, the storage or disposal of any hazardous materials or waste on the Land.
12. There are no unpaid or delinquent water or sewer service charges against said Land.
13. The Land has a single family house/condominium known as _______________________ and does not have a separate building, garage, or apartment used as a second residence.
14. Any improvements Affiant(s) added to the Land were authorized by a building permit.
15. Affiant(s) is/are not aware of and have not been told that any improvements on the Land violate any building permit, zoning laws, restrictions or covenants, including, but not limited to, any applicable condominium or homeowners' association declaration, regulation or bylaws.
16. Affiant(s) is/are not aware, and have not been told, that any fence or other improvements on the Land encroach over any building lines, easements or property lines.
17. Affiant(s) is/are not aware, and have not been told, that any fence or other improvements by our neighbors encroach over our property lines.
18. The Land has actual pedestrian and vehicular access based on a legal right of access to the Land.
19. Affiant(s) hereby acknowledge that Company, in this transaction is relying on the representations contained herein and would not issue a Title Insurance Policy unless said representations were true and correct.
Affiant(s) hereby agree(s) to indemnify and hold harmless Company from any loss, liability, costs, expenses and attorneys' fee, including attorneys' fees to enforce this agreement, because of any errors or incorrectness of this affidavit and because of any defects, liens, encumbrances or other matters currently affecting or that may affect the title to the Land before the recordation of our conveyance or mortgage and/or currently apply or affect the title to the Land, or are subsequently established against the Land, and are created by or known by the Affiant(s), or have an inception or attachment date prior to the issuance of the Title Insurance Policy.
State of ___________________
County of _________________
Sworn to and subscribed before me the undersigned authority on this the __________ day of _____________ by
______________________ and ________________________.
______________________ Notary Public in and for ____________________
My Commission expires: ___________________
Copyright 1970-2022 Stewart Title Guaranty Company. All rights reserved. The use of this form (or any derivative thereof) is restricted to Stewart Title Guaranty Company, it’s issuing agents, and affiliates in good standing as of the date of use. All other uses are prohibited.
No guidelines are available for this form at this time.