Affidavit Of Gift

AFFIDAVIT OF GIFT

STATE OF ____________________
COUNTY OF ____________________

I, ____________________, residing at ____________________, in the county of ____________________ in the state of ____________________ and being duly sworn, do hereby depose and attest that:

1. I gave the following gift to the recipient, ____________________, who holds the title ____________________ at ____________________
2. The gift consisted of ____________________.
3. The gift was/will be given on ____________________.
4. The gift was worth ____________________ and was given without the expectation or pursuit of personal benefit, favor or monetary gain.

____________________
AFFIANT

Subscribed and sworn to before me this ____________________ day of ____________________ 20 ____________________

____________________
(Notary Public),

____________________ County.

My commission expires ____________________ 20 ____________________