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BULK
SALES AFFIDAVIT
State of _________________________________
County of ________________________________
____________________________, of lawful age, being
first
duly sworn, on oath states:
_________________________________________
_________________________________________
_________________________________________
That he is the Seller in that certain contract for
the
sale of assets dated ___________,19__ between
himself, as
Seller,
and ___________________ as Buyer;
That this Affidavit is made pursuant to the terms
and
provisions of the Uniform Commercial Code and is
furnished
to the
above named Buyer in connection with the sale and
transfer
described and referred to in the above mentioned
contract;
That the following is a true, complete and accurate
list
of all of the creditors of affiant and of all
persons who,
to the
knowledge of affiant, assert or have claimed to
assert one
or
more claims against affiant, together with the
correct
business
addresses of each such creditor or claimant and the
amounts
due
and owing to such creditors and claimants, to wit:
Name of
Business
Amount
Admitted or
Creditor
Address
Of Claim
Disputed
1.____________
___________
___________
______________
2.____________
___________
___________
______________
3.____________
___________
___________
______________
__________________________
(Signature)
SUBSCRIBED and sworn to before me this _______ day
of
_________, 19__.
_________________________
Notary Public
My commission expires:
_____________________________
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