AFFIDAVIT
STATE OF FLORIDA
COUNTY OF LEE
BEFORE ME, the undersigned authority, personally appeared ____________________, who being
duly sworn under penalty of perjury, hereby states the following:
1. Affiant has personal knowledge of the matters set forth herein and is over the age of (18)
eighteen years.
2. Affiant is the _______________ of the following described real property, to wit:
Lots __________ and Block __________, Unit No. __________, as recorded in __________
Book __________ Page __________, Public Records of Lee County, Florida (hereinafter the
“Real Property”). (PIN/Strap Number: ( ______________________________).
3. Affiant, ________________________, is the owner of Mobile Home VIN
______________________________ and the original State of Florida Motor Vehicle Certificate of
Title/Manufacture Certificate of Origin is attached hereto (hereinafter the “Mobile Home”).
4. Affiant states the Mobile Home is permanently affixed to the Real Property in accordance with the
laws of the State of Florida.
5. Affiant states that he/she is familiar with the nature and meaning of an oath and the penalties as
provided by the laws of the State of Florida for falsely swearing to statements made under oath.
6. Affiant hereby swears that the facts and statements set forth above are true and correct to the
best of his/her knowledge and belief.
_______________________________________ _______________________________________
Signature of Affiant Signature of Affiant
SWORN TO AND SUBSCRIBED before me this _______________ day of __________________ 20 ,
by _________________________________________ who is:
(Print or Type Name of the Person making the above Statement)
Personally known __________ OR Produced Identification __________
Type of Identification Produced: ___________________________________________________
_________________________________________________________
(Print, Type or Stamp Commissioned Name of Notary Public)
Commission Expires: ________________________________________
