PA STGC Corporate Owner’s or Mortgagor’s Affidavit and Indemnity

This form applies to:
  • Pennsylvania
Forms by State
Organization Forms

PA STGC Corporate Owner’s or Mortgagor’s Affidavit and Indemnity

Form Document
V 1


Title No.  _________

PREMISES: ____________________________________________________________________________________




AND NOW, This                   day of                                                                       20   , before the undersigned officer, personally appeared  _________________________________________________________________________(“Deponent”) who holds the office of _____________________________________________________________, of the corporation known as ________________________________________(“Corporation”), and who as such officer, being duly sworn according to law, does depose and say that the Corporation is owner of the above captioned premises (“Premises”) by virtue of the following instrument:



                That no alterations, additions or repairs, have been made to said Premises within the past six months immediately preceding the date of this settlement

                That no notices have been served by any government authority for the removal or abating of nuisances, or for the repairing of walls, driveways, curbs or footway paving, or for the relaying, repaving or repairing of the curb, footway paving, streets, alleys and driveways, on which said Premises abut.  That no sidewalks have been laid, nor has any curbing, street paving, sewer, water pipe or any other municipal work been done or ordered to be done for which municipal claims could be filed against the said Premises.

                That the entire improvements, including fences, hedges and monuments, are erected within or on the title lines of the Premises and no part thereof encroaches upon lands of adjoining owners and there are no encroachments upon said Premises by the owners of adjoining lands.

                That there has been no violation of any restrictions affecting the Premises and there are no disputes with any adjoining property owners as to the location of property lines or the encroachment of any improvements.

                That there are no unrecorded leases or agreements affecting the Premises in question, other than an Agreement of Sale between the parties to this transaction.

                That the present transaction is not made for the purpose of hindering, delaying or defrauding any creditors of said Corporation and does not come within the provisions of the Bankruptcy of Insolvency Acts (or any amendments thereof).

                That all taxes, water and sewer rents or other municipal charges assessed against the said Premises have been paid.

                That no fixtures, material or equipment have been placed on the Premises during the Corporation’s ownership which have not been paid for in full.

                Deponent (s) do further aver(s) that they have not received any notice of any interim tax assessments nor bills for same.

                That there are no unpaid corporate taxes due the Commonwealth of Pennsylvania by the Corporation, except those for the current taxing period which the Corporation will pay when due.

                That the officers of the Corporation who are authorized to execute the papers are of full legal age and in every respect competent to convey or encumber the title to the Premises in question.

                That the Corporation is duly incorporated by the State of ___________________________ and is currently in good standing and that conveyance of the within Premises is in accordance with the existing By-Laws of said Corporation and has been authorized by proper corporate action.

                That the corporation has not conducted any business under any name other than the name set forth above.

                That none of the improvements nor any part thereof erected on the Premises was ever a mobile home or trailer which was registered with the Bureau of Motor Vehicles of the Commonwealth of Pennsylvania, or any other state or subdivision of the United States.

                That no part of this property is under a contract easement to obtain a favorable assessment of farmland and forestland with any county or municipality or any agency authorized by law to receive such easement.


                That there are no easements, mortgages, notes, judgments, liens, pending suits, or bankruptcies adversely affecting the owner and the said premises other than those shown on the Title commitment under the above-referenced number except the following:

                                                _________________________________________                              _________________________

                                                _________________________________________                              _________________________

                                                (If none, write NONE on blank line)

                That all labor and materials used in the construction of improvements on the above-described property have been paid for and there are now no unpaid labor or material claims against the improvements or the property upon which same are situated, and I hereby declare that all sums of money due for the construction of improvements have been fully paid and satisfied, except the following: _____________________________________________________


(If NONE, write “NONE” on blank line)

                That there are no leases, contracts to sell the land, or parties in possession other than Deponent except as follows:


(If NONE, write “NONE”  on blank line)

                To be filled in if a sale – “The Seller is not a non-resident alien, foreign corporation, foreign trust, foreign estate or other foreign entity (as defined in the Internal Revenue Code and Income Tax Regulations).  Seller’s U.S. employer identification number (or Social Security Number) is:___________________________________________.

Seller’s address (office address, if Seller is an entity; home address if Seller is an individual) is:



                This affidavit may be disclosed to the Internal Revenue Service and is furnished to Buyer to inform Buyer that withholding of tax is not required under Section 1445 of the Internal Revenue Code.

NOW, THEREFORE, it is agreed that in consideration of the Company’s issuance of its policy effective as of the date closing occurs without making exception therein of matters which may arise between the date of its commitment to issue its policy of title insurance and the date the documents creating the interest being insured have been filed for record, and which matters may constitute an encumbrance on or affect said title, the undersigned agrees to promptly defend, remove, bond or otherwise dispose of any encumbrance, lien, or objectionable matter of title which may arise or be filed, as the case may be, against the captioned premises during the period of time between the date of its commitment to issue its policy of title insurance and the date of recording of all closing instruments, and to hold harmless and indemnify the Company against all expenses, costs and attorney fees, which may arise out of the failure to so remove, bond or otherwise dispose of any said liens, encumbrances or objectionable matters.

Further, the undersigned shall be liable for all expenses, costs and attorney fees which may be incurred in the enforcement of this agreement.

The Corporation realizes that the Purchaser and Lender and Stewart Title Guaranty Company are relying on the representations contained herein in purchasing same or lending money thereon and issuing title policies and would not purchase same or lend money or issue a title policy thereon unless said representations are made.  The undersigned has authority to sign on behalf of the corporation.


Name of Corporation


Name and Title

SWORN AND SUBSCRIBED BEFORE ME This  _________ day of _______________________ 20____.


Notary Public

My Commission expires: __________________________



*NOTE:  This form is to be filled in and signed by Seller in case of sale.  If no sale, it is to be filled in and signed by the Owner-Borrower.  If Seller is a non-resident alien, foreign corporation, etc., call your manager or underwriting personnel.

No guidelines are available for this form at this time.