5. I am executing this affidavit for whatever purpose it may serve. FURTHER AFFIANT SAYETH NAUGHT. IN WITNESS WHEREOF, I have hereunto affixed my signature this _______ day of ________________________. ___________________________ Affiant SUBSCRIBED AND SWORN to before me this ____ day of ___________________, affiant exhibiting to me his/her Comm. Tax Cert. No. ________________ issued on ________________ at ________________________, 20___. NOTARY PUBLIC Page No. ____________: Page No. ____________: Book No. ___________: Series of ____________: