Introduction

I, [YOUR NAME], of legal age, residing at [YOUR ADDRESS], hereby declare and affirm under penalty of perjury under the laws of [STATE NAME] that:

Statement of Facts

1. I am the creditor in the matter pertaining to the indebtedness referenced herein.

2. The recipient of this affidavit, [RECIPIENT'S NAME], with a known address at [RECIPIENT'S ADDRESS], is the debtor who has incurred a debt owed to me.

3. The nature of the debt arises from a Mortgage Agreement entered into between myself, as the lender, and the recipient, as the borrower, on [AGREEMENT DATE], pursuant to which the recipient obtained a loan in the amount of [LOAN AMOUNT] for the purpose of financing the purchase of real property located at [PROPERTY ADDRESS].

4. Pursuant to the terms of the Mortgage Agreement, the recipient is obligated to repay the loan in accordance with the specified terms, including but not limited to the principal amount borrowed, any accrued interest, and any other applicable fees or charges.

5. As of the date of this affidavit, the outstanding balance owed by the recipient under the Mortgage Agreement is [BALANCE AMOUNT], which represents the total amount of the indebtedness.

6. This affidavit is being provided to the recipient for the purpose of formally documenting the existence of the debt owed, as well as to provide clarity regarding the terms and obligations associated with the Mortgage Agreement.

Sworn Oath

I certify that the information provided in this affidavit is true, accurate, and complete to the best of my knowledge and belief.

Signature Block

[YOUR NAME]

Sworn to and subscribed before me this [DATE].

[NOTARY PUBLIC NAME]

[NOTARY PUBLIC COMMISSIONER NUMBER]

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