Small Estate Affidavit And Order Page 5

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THE STATE OF TEXAS
§
§
COUNTY OF ________ §
The undersigned Distributee states that she has personal knowledge of
the facts stated in the foregoing Affidavit and that, to the best of her
knowledge, the facts contained in the Affidavit are true.
__________________________
_ _
SUBSCRIBED AND SWORN TO BEFORE ME by the said
________________________________ on this ____ day of
_________________, 199__, to certify which witness by hand and seal of
office.
[SEAL]
Notary Public, State of Texas
SMALL ESTATE AFFIDAVIT AND ORDER
PAGE 5

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