Affidavit of Ownership - Texas

Revised Version 4/4/2013 Page 1 of 1
Texas General Land Office Disaster Recovery
Affidavit of Ownership
Sworn Statement Notary Required
BLOCK 1: Owner/Co-Owner Information
Owner: Co-Owner:
Owner/Co-Owner Address:
City: State: Texas Zip:
BLOCK 2: Statement of Facts
I/We , being first duly sworn, do affirm the facts presented herein
are true and complete:
A) There is no other person entitled to claim any ownership interest in the property; or
B) Each person who may be entitled to claim an ownership interest in the property has given
consent to the application or was not located after a reasonable effort.
BLOCK 3: Signatures (Notarization required.)
Under penalties of perjury, I/We certify that the information presented in this Affidavit is true and
accurate to the best of my/our knowledge and belief. I/We further understand that providing false
representations herein constitutes an act of fraud. False, misleading or incomplete information may
result in my/our ineligibility to participate in Programs that will accept this affidavit in accordance with
Government Code, Chapter 2306.
Owner Signature Co-Owner Signature
Before me personally appeared the person(s) whose signature(s) appear above, who by being sworn,
upon oath say that the statements set forth hereinabove are true and correct. Subscribed and sworn
before me this
day of 20 .
Signature of Notary
NOTARY’S SEAL
Notary Public, State of Texas - Printed name
Date Notary’s Commission Expires
Page 1/1
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