Seller's Affidavit
Home Equity Theft Protection Act
(Not Seller's Residence)

Seller's Affidavit Home Equity Theft Protection Act (Not Seller's Residence)

State of )
) to wit:
County of )

Title No.:
Premises:

The undersigned, does hereby swear, depose and state as follows:

I am the seller of the above-referenced Premises.

I reside at .

I have not resided at or occupied the Premises since .

Since this sale is not the sale of a "residence" as defined in HETPA, this sale is not affected by or covered by HETPA.

I make this Affidavit realizing that and (hereinafter together referred to as "Companies") are relying upon, and are fully entitled to rely upon, the truth of the statements contained as a basis for the issuance of the title policy under the Title Number referenced above. I hereby agree to protect, defend, indemnify from any loss, liens, claims and costs (including, but not limited to court costs, legal fees and expenses) which the Companies may incur as a result of the Companies' reliance upon this Affidavit.

Given under my hand and seal this day of , 20.

By:

Sworn to before me on

Notary Public