SIMILAR NAME AFFIDAVIT - Safe Harbor Title Agency



SIMILAR NAME AFFIDAVIT

STATE OF NEW YORK )

) ss.: Title #:

COUNTY OF SUFFOLK )

being duly sworn, deposes and says:

That reside at

and that I have not been known by any other name for the last ten (10) years except

That there are no judgments, tax liens or outstanding warrants unsatisfied against me in any court of New York State or of the United States. Further we are not presently involved in any bankruptcy proceeding.

The judgments, tax liens, if any, referred to in the title report are not against me but against someone of a similar name. I have never resided nor done business at any of the addresses associated with the judgment debtor.

That make this affidavit to induce the Title Insurance Company to issue its policy of title insurance, knowing they will rely on the truth of the statements contained herein.

__________________________________

___________________________________

Sworn to before me this

day of ,20

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