Small Estate Affidavit And Order Page 7

THE STATE OF TEXAS

COUNTY OF ________ §

I have no interest in the estate of Decedent and am not related to

Decedent under the laws of descent and distribution of the State of Texas. I

have personal knowledge of the facts stated in the foregoing Affidavit. To

the best of my knowledge, the facts contained in the Affidavit are true.

___________________________

[Address]

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 7

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