Florida Affidavit Form

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Witness: X______________________________
_____________________________________
SIGNATURE AFFIXED BY NOTARY
_________________________________
PURSUANT TO §117.05(14),
PRINT:
FLORIDA STATUTES
______________________________________
(Street Address)
______________________________________
(City, State, Zip)
Witness: X______________________________
_________________________________
PRINT:
______________________________________
(Street Address)
______________________________________
(City, State, Zip)
State of FLORIDA
County of _________________
The foregoing instrument was acknowledged before me this _____ day of ____________________ 20_____,
by ___________________________________, who q is personally known to me or q produced a
person acknowledging
___________________________________ as identification and subscribed by _______________________
identification produced
name of notary
at the direction of and in the presence of ____________________________ and in the presence of these
person acknowledging
witnesses. Notary affixed signature of person making acknowledgement under the following circumstances:
______________________________________________________________________________________
_______________________________________________________________________________________.
______________________________
(SEAL)
notary public signature
_____________________________
notary public printed name
Description of instrument attached: ___________________________________________________________
_______________________________________________________________________________________
FL-2091-ACK
provides this form pursuant to Florida Statute §117.05(14)(e)(2)

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