FORM OF IDENTIFICATION AFFIDAVIT/ MORTGAGORS
STATE OF: ¬¬¬¬¬¬ _____________________
COUNTY OF: _____________________
On this the _____day of ___________, 20____, before me __________________________________, a notary public, the undersigned officer, personally appeared the following:
______________________________________________ (Mortgagor’s Name)
______________________________________________ (Co-Mortgagor’s Name)
Known to me (or satisfactorily proven) to be the person__ whose name __ __he__ subscribed to the
within instrument, and acknowledged that __he__ executed the same for the purposes therein contained.
Mortgagor’s Proof of IDENTIFICATION was provided using:
___State Photo Driver’s License ___ State Photo I.D. ___ Other [Describe] _____________________
Name As Shown On ID_________________________________ ID Number_______________________
Issue Date ____________ Expiration Date ____________ DOB ____________
Address _______________________________________________
________________________________________________
SS#_________________ Signature of Mortgagor: ____________________________________
Co-Mortgagor’s Proof of IDENTIFICATION was provided using:
___State Photo Driver’s License ___ State Photo I.D. ____ Other [Describe] _____________________
Name As Shown On ID_________________________________ ID Number_______________________
Issue Date ____________ Expiration Date ____________ DOB ____________
Address _______________________________________________
_______________________________________________
SS#_________________ Signature of Co-Mortgagor: ____________________________________
In witness whereof, I hereunto set my hand and official seals.
_______________________________________
Notary Public
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