GENERAL AFFIDAVIT

The within named person (Affiant), ______________________________, who is a resident of

____________________ County, State of ____________________, personally came and appeared

before me, the undersigned Notary Public, and makes this his/her statement, testimony and General

Affidavit under oath or affirmation, in good faith, and under penalty of perjury, of sincere belief and

personal knowledge that the following m atters, f acts, and things set forth are true and correct, to the best

of his/her knowledge:

Dated this __________ day of ___________ _________ , 20______,

______________ ________________