Affidavit Form printable pdf download

Affidavit Form

FORM AFFIDAVIT

STATE OF TEXAS

COUNTY OF ______________

I, ________________________________, have personal knowledge and hereby offer

the following facts:

Due to extreme fire hazards in _____________________ County on or about the

_____ day of _____________, 2011, a disposal of ___________

(number)

animal carcasses was performed on my property, being in the _____of Section

______, Block _______, ____________ Survey, ___________County, Texas.

The disposal site is a trench or pit at least 3 to 5 feet deep with stable slopes,

_____ feet wide, and _______ feet long, and located _____________________

_____________________________ (Include specific description of burial site

such as: 500 feet north and 2000 feet west of SE corner of Section 55 or list

G.P.S. coordinates). In addition, the burial occurred at least 300 feet from the

nearest drinking water well, creek, stream, pond, lake or river and at a sufficient

distance from standing, flowing, or ground water to prevent its contamination, not

likely to be disturbed in the near future, not in a flood plain, and 200 feet from

adjacent property lines. All dead animals were covered the same day of burial

with a minimum of 2 feet of cover.

SIGNED this _____ day of ___________________, 2011.

Signed, _______________________

Print name___________________)

(

STATE OF TEXAS

COUNTY OF __________________

Sworn to and subscribed to before me on the ______ day of ___________, 2011 by

________________________.

____________________________

SEAL

Notary Public, State of Texas

Affidavit Form