Survey Affidavit (Prior Policy)

Survey Affidavit (Prior Policy)

STATE OF FLORIDA

COUNTY OF __________________

Before me, the undersigned authority, personally appeared_____________ who, being duly sworn, depose(s) and say(s):

1. Affiant(s) herein reside(s) at _____________________________________and is/are the present owner(s) of ________________________________________________ which are the same lands described in that certain title insurance policy number, __________________ dated  ___________________, attached hereto and made a part hereof as Exhibit “A”.

2. Affiant(s) has/have examined the above referenced policy.

3. As the owner(s) of the land described in said policy, Affiant(s) is/are familiar with the land, building(s) and other improvements located upon the land.

4. Affiant(s) know(s) that no buildings, fences, driveways or other improvement have been constructed upon the land that are not shown on the aforesaid survey and that to Affiant’s belief and knowledge, there has/have been no buildings, fences, driveways or other improvements constructed upon adjoining land since the date of the aforesaid policy EXCEPT FOR THE FOLLOWING:

A.

B.

5. Affiant(s) further state that they are each familiar with the nature of an oath and with the penalties as provided by the laws of the State of Florida for falsely swearing to statements made in an instrument of this nature.  Affiant(s) further certify that they have read, or have had read to them, the full facts of this Affidavit, and understand its context.

This Affidavit is given to induce _____(Agency Name)_____  and Stewart Title Guaranty Company to issue its policy or policies of title insurance covering the above-described premises.

Further Affiant(s) saith not.                                                                                                                                       

_______________________________________

                                                                                    (Signature)

                                                                                    _______________________________________

                                                                                    (Printed Name and Address)

                                                                                    _______________________________________

                                                                                    (Signature)

                                                                                    _______________________________________

                                                                                    (Printed Name and Address)

STATE OF FLORIDA

COUNTY OF   

Sworn to (or affirmed) and subscribed before me by means of ☐ physical presence or ☐ online notarization, this ___ day of ________, 20___, by _______________________ (name of person making statement).

Personally Known ☐ OR Produced Identification ☐  

Type of Identification Produced: ____________________ 

_____________________________________
(Signature of Notary Public)  

_____________________________________  
(Print, Type, or Stamp Commissioned Name of Notary Public) 

Affix Notary SEAL

Online Notary: ☐ (Check Box if acknowledgment done by Online Notarization)