AFFIDAVIT

WITNESS OF SIGNATURE BY MARK

 

 

_________________________________________________ (affiant's name), being unable to write, made ________________ (his or her) ______________ (X) mark

in my presence and I wrote _________________________________ (his or her) name

at ___________ (his or her) request.

 

 

 

_____________________________________                   ____________________

Signature of Witness writing Affiant’s Name               Dated

 

 

 

_____________________________________                   ____________________

Signature of Other Witness                                                    Dated