IN THE COUNTY COURT OF POLK COUNTY, FLORIDA

CIVIL DIVISION

CASE NO. __________________________

 Plaintiff,

 vs.

 Defendant.

__________________________________________/

AFFIDAVIT OF NON- IDENTITY

   BEFORE ME, the undersigned authority, personally appeared _______________________, who after being duly sworn, deposes and says:

    1. That the undersigned party/parties is/are legally known as _________________ and has/have never resided at ___________________.
    2. That the undersigned certify and swear under oath that they have no knowledge of that certain County Court case No. __________________
      as recorded in the Official Records of __________________ County, Florida, Book ________, Page ________.
    3. That this Affidavit of Non-Identity applies to the undersigned for all purposes to include the removal of that certain cloud of title on the following described real property: 

                                                                                                                                                                                    _____________________________________

    SWORN TO, subscribed and acknowledged before me this _____ day of ________________, 19____.

                                                                                                                                                                      RICHARD M. WEISS, CLERK
                                                                                                                                                                      Circuit and County Courts

(SEAL)                                                                                                                                                           By__________________________________________

                                                                                                                                                                                Deputy Clerk/Notary Public

                                                                                                                                                                                My Commission Expires:

____    Personally Known

____    Produced Identification

           Type of identification presented: _________________________

 REV. 06/97                                                                                                                                                                                                                  101.DOC (06/97)