STATE OF ALABAMA



STATE OF ALABAMA

COUNTY OF ______________________

COMMERCIAL REAL ESTATE BROKERS AFFIDAVIT

Before me, the undersigned Notary Public in said state, personally appeared _________________________ (“Deponent”), who is known to me, and being first duly sworn by me, deposes and says that Deponent is the (CHECK ONE)

____ BUYER ____ SELLER

____ BROKER OF THE BUYER ____BROKER OF THE SELLER

(circle one) of the real property (the “Property”) described on Exhibit “A” attached hereto and made a part hereby of reference and knows the facts contained herein of his/her knowledge.

PLEASE INITIAL ONE OF THE FOLLOWING:

_____ Deponent states that no brokers have been retained for their services and therefore that there are no commissions owed any broker for licensed brokerage services including, but not limited to, those for selling, buying, leasing, or management of the Property and that no such commission shall arise resulting from this transaction pursuant to the Commercial Real Estate Broker Lien Act (the “Act”) Section 35-11-450, Code of Alabama (1975).

_____Deponent states the brokers have been paid in full all amounts owed the broker for licensed brokerage services including, but not limited to, those for selling, buying, leasing, or management of the Property.

This affidavit is given to induce any purchaser to purchase, any lender to accept a mortgage on the Property and to induce Title Company (and/or its agency) to issue its title insurance policy or policies in reliance upon any of the statements contained herein, and should the Title Company (and/or its agency), in its sole discretion, issue insurance in reliance upon such representations, affiant agrees to indemnify and hold Title Company (and/or its agency) harmless of and from any and all loss, cost, damage and expense of every kind, including attorneys’ fees, which Title Company (and/or its agency) shall or may suffer or incur or become liable for under its said policy or policies now to be issued, or any reissue, renewal or extension thereof, directly or indirectly, as a result of any misrepresentation herewith.

Sworn to and subscribed before me

this _____ day of ____________, _____. By:_____________________

Name:____________________

_________________________________

NOTARY PUBLIC Title:____________________

My Commission Expires:

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