Example Affidavit Form printable pdf download

Example Affidavit Form

EXAMPLE AFFIDAVIT

BEFORE ME, the undersigned authority, personally appeared

(Name of Chief Financial Officer of the

Entity), who being duly sworn,

deposes and says on oath that:

I am the Chief Financial Officer of

(Name of the Entity)

which is a local governmental entity of the State of

Florida;

(Name

the

Entity)

adopted

(Ordinance

No.

___________or Resolution No. __________) implementing an

impact fee; and

(Name of the Entity)

has complied and, as of the date of

this

Affidavit,

remains

compliance

with

Section

163.31801, Florida Statutes.

FURTHER AFFIANT SAYETH NAUGHT.

____________________________________

(Chief Financial Officer of the

Entity)

STATE OF FLORIDA

COUNTY OF

(Name of County)

SWORN TO AND SUBSCRIBED before me this ____ day of

___________, 2008.

______________________________

NOTARY PUBLIC

Print Name _____________________

Personally known ____ or produced identification _______

Type of identification produced: ___________________________________

My Commission Expires:

Example Affidavit Form