Affidavit (AU-GU Exception)

(Space reserved for Clerk) ______________________________________________________________________________________________________ AFFIDAVIT (AU/GU Exception) STATE OF ______________________ COUNTY OF ____________________ Folio # ____________________________ Before me, the undersigned authority, personally appeared, hereinafter called the Affiant(s), who being by me first duly sworn, on oath, depose(s) and say(s): 1. That on April 12, 1974, at 12:01 A.M., the affiant(s) was (were) the owner(s) of the following described property, to wit: That the Affiant(s) did not, in any manner, own any property contiguous to the above described property on April 12, 1974, at 12:01 A.M. The Affiant(s) further state that on the basis of this affidavit the Miami-Dade County Department of Regulatory and Economic Resources can except the above described property from the requirement of a minimum area of five (5) acres for a building site as required in Miami-Dade County Code Section 33-280 (Ordinance #74-16) or #33-196 (Ordinance #74-17). That the Affiant(s) further state that this affidavit can and may be placed in the Public Records of Miami-Dade County, Florida. Affiant(s) further state that they are each familiar with the nature of an oath and with the penalties as provided by the laws of the state aforesaid for falsely swearing to statements made in an instrument of this nature. Affiant(s) further certify that they have read, or have heard read to them, the full facts of this affidavit, and fully understand its context and meaning. (See Footnote) ___________________________________ Signature ___________________________________ Print Name Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 2. 3. 4. 5. __________________________________ Signature __________________________________ Print Name [f:\:forms\Affidavit AU-GU (4/24/13)] Sworn to and subscribed before me this ________________ day of __________________________, _________. Affiant(s) is/are personally known to me or produced _______________________________ as identification. _________________________________________ Signature Notary Public, State of ________________ ___________________________________ Print Name My Commission Expires: Copy of Deed or Contract for Deed must be furnished by person(s) signing Affidavit and attached hereto. [f:\:forms\Affidavit AU-GU (4/24/13)] Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com