IN Affidavit of No Broker 2006

STATE OF INDIANA )

) SS:

COUNTY OF__________ )

FILE NUMBER __________________

AFFIDAVIT OF NO BROKER

__________________________ (“Affiant”), upon first being duly sworn upon his oath, says:

1. That Affiant is the ___________________[owner, lessee, buyer,] of the following described property:

[Insert legal description]

Commonly known as:

2. Affiant states that there is no written agreement by and between Affiant and a commercial real estate broker for the sale, purchase, lease or other conveyance of the above-described property.

3. Affiant has no knowledge of any other brokers involved in the sale, purchase, lease or other conveyance of the above-described property.

4. The aforementioned statements are made for the purpose of inducing [name of title insurance company and title insurer] to insure the sale, purchase, lease or other conveyance of the above-described property without taking exception to a broker's lien pursuant to I.C. 32-28-12.5

5. That furthermore Affiant saith not.

_____________________________________________

ACKNOWLEDGMENT

STATE OF INDIANA )

)SS:

COUNTY OF ________________ )

Subscribed and sworn to before me the undersigned Notary Public in and for said County and State this ____ day of ______________, 200_, personally appeared ______________________, ___________________. and acknowledged the execution of the foregoing Scrivener's Affidavit, and who, having duly been sworn, stated that any representations therein contained are true.

My Commission Expires: ___________________________________

Notary Public

___________________________________

Printed

Residing in _______________ County,

State of Indiana