Statement Of Use Sale Non-Existence Of Property Or Discontinuation Of Business Page 2

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Part III - Attestation
I, (printed name of person making affidavit)
, being first placed under
oath by the undersigned official authorized to administer oaths under the laws of this State, do solemnly swear or affirm that
the information herein and attached is true and correct.
,
Sworn and subscribed to before me this
day of
.
(seal)
Signature of property owner/affiant
Title (Printed)
NOTARY PUBLIC, State of Texas
My Commission Expires
The making of a false statement in a governmental record is punishable as provided by Section 37.10 of the Texas
Penal Code.

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