Affidavit Of Ownership

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                       AFFIDAVIT OF OWNERSHIP State of _____________         }                                                 }      SS County of ____________        }   RE: Birth Certificate   I, the undersigned, of lawful age and being first duly sworn on oath, depose and state that I am familiar with the facts recited,  and the party named in said birth certificate is the same party as  one of the owners named in said certificate of title.                                                              __________________________________ Signature

Signed and sworn to before me this ________ day of _____________________, 20_____. ________________________________         ________________________________ Notary Public                                                       My Commission Expires

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