AFFIDAVIT

The undersigned _(name of debtor)_,   (legal age)_,  (legal status) ,   (citizenship)   , and a resident of  (current address)_,   hereinafter Affiant, does solemnly swear, declare and state as follows

That Affiant is competent to state the matters set forth herein

2.   That Affiant has knowledge of the facts stated herein

3.   That all the facts herein are true, correct and complete, admissible as evidence and if called upon as a witness, Affiant will testify to their veracity

4.   That there is no evidence that there are any violations of the New York UCC Law Section 3-501 of the New York Code with regards to the conditions pertaining to Presentment, Notice of Dishonor, and Protest and no violations are contained within the loan documents of and relating to the Loan Agreement, Document Number __________, corded on or about ___(date)___ in the official records in the office of __(name of Company and its address), hereinafter referred to as the LOAN AGREEMENT, and Affiant believes that no such evidence exists

5.   That there is no evidence that there are no violations under the Right of Rescission in accordance with the 3-day rescission period which commences on the day the loan contract is signed by the parties as provided under The Truth and Lending Act and contained within the loan documents of and relating to the LOAN AGREEMENT and Affiant believes that no such evidence exists

6. That there is no evidence that the Creditor committed fraud and that the terms of the said Loan Agreement are null and void and Affiant believes that no such evidence exists.

IN WITNESS WHEREOF, I hereunto set my hand and seal on this ____ day of _________, ____ and hereby certify that all the statements made above are true, correct and complete.

Date __________________ Signed _______________________________


JURAT
State of California ) ) ss
County of ___________ )

Subscribed and sworn to (or affirmed) before me on this ________ day of ___________, ________, by ____________________________, proved to me on the basis of satisfactory evidence to be the person who appeared before me.

___________________________________
(seal) Signature

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