Florida Affidavit Form printable pdf download

Florida Affidavit Form

State of FLORIDA

County of _______________

The foregoing instrument was acknowledged before me this _____ day of _______________________20____ by

___________________________________________ whose identification was relied upon by a sworn written

statement of two credible witnesses:

____________________________________ who provided ___________________________ as identification and

____________________________________ who provided ___________________________ as identification.

___________________________

(SEAL)

notary public signature

___________________________

notary public printed name

Although the information below is not required by law, the identification of the document being referenced by this acknowledgment could be valuable

to persons relying on the document and could prevent fraudulent removal and reattachment of an unrelated document.

Description of Attached Document

Document Title: ______________________________________________________________________________

Document Date: _________________________________ Number of Pages: _____________________________

Signer(s) Other Than Named Above: ______________________________________________________________

Capacity(ies) Claimed by Signer

[ ] Individual

[ ] Corporate Officer / Partner – Title(s): ___________________________________________________________

[ ] Attorney in Fact

[ ] Trustee [ ] Co-Trustee

[ ] Guardian or Conservator

[ ] Other: ___________________________________________________________________________________

FL-2143-ACK

provides this form pursuant to Florida Statutes §117.05(5)(b)1, §117.05(13)(b)

Florida Affidavit Form