| 
      
        |  |  
        |  |  
        |  |  
        |  |  
        | GENERALAFFIDAVIT |  
        |  |  
        |  |  
        |  |  
        | GENERAL AFFIDAVIT 
 State of __________________
 
 County of _________________
 
 Before the undersigned, an officer duly commissioned by the laws of ____________, on this_____day of _____________, 19____, personally appeared ______________________________ who having been first duly sworn depose and say:
 
 ___________________________________________________________________
 ___________________________________________________________________
 ___________________________________________________________________
 
 Witness:_______________________________________________
 
 Sworn and subscribed before me this ___day of ___________A.D. 19__
 
 __________________________
 
 __________________________
 |  
        |  |  
        |  |  
        |  |  
        |  |  
    	|  |  
        |  |  
        |  |  
        |  |  
        |  |  |  |  |