Affidavit Form Of County Of Broward, Florida

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COUNTY ADMINISTRATOR, BROWARD COUNTY, FLORIDA
STATE OF FLORIDA
In Re: Tax Deed File No.________________
COUNTY OF BROWARD
Folio No._____________________________
DESCRIPTION OF PROPERTY: _______________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
THE UNDERSIGNED Affiant, being first duly sworn deposes and says; That her/his correct & legal
name
is _______________________________________________________& is a resident of__________________ county, residing
permanently at _________________________________________________________________________________________;
is one & the same person as ____________________________________________________________________, whose name
appears in said file as being the owner of said described real estate; who was the owner of record of said land on the date of sale
of said land, under Tax Deed Sale held pursuant to Chapter 197, Acts of 1973; and that such ownership of record was continuous
and unbroken from the date acquired title to said property, up to and including the date of aforesaid sale; and that at the date of
said sale and at the present time has the equitable and legal interest, claim and demand in and to the proceeds of said sale, after
payment of the amount necessary to pay to the certificate holder, & any and all cost, interest & expenses, now retained by the
County Administrator, in the sum of $______________________; & that it hereby makes formal demand for & request said
amount to be paid to & mail to
______________________________________________________________________________________________________
______________________________________________________________________________________________________
AND THAT, in consideration of the premises and the payment of the said money as herein
provided for, _____________ hereby ratifies and confirms the official acts and deeds of the said County
Administrator, in the aforesaid Tax Sale proceedings.
THIS AFFIANT further states that the matter, things and statements herein set forth and made,
are true, and are set forth and made with full knowledge of the force and effect thereof, as regards the civil and criminal
responsibilities arising there from; and that said statements were made after full explanation in the premises having been made to
affiant by the said County Administrator.
_____________________________________________
_____________________________________________
_____________________________________________
______________________________________________
WITNESSES
(Joined by Husband)
(And if executed by a married woman the
The husband should also subscribe)
______________________________________________________________________________________________________
is one of the subscribing witnesses to the foregoing instrument; that is personally acquainted with the person who executed the
above affidavit; that ____________________________________________________has intimately known such person for a
continuous period of _______ months / years; and that it is within personal knowledge that such party is the identical person
therein represented to be.
SWORN TO AND SUBSCRIBED BEFORE ME ON THIS______________DAY OF
____________________________ 20_________
SEAL
_______________________________________________
NOTARY

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