Affidavit Form - Wyoming Real Estate Commission
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WYOMING REAL ESTATE COMMISSION
2020 CAREY AVENUE, SUITE 100
CHEYENNE, WYOMING 82002-0180
(307) 777-7141
State of __________________________)
) ss.
County of ________________________)
A_F_F_I_D_A_V_I_T
This is to certify that I, the undersigned, occupy the position of _____________________________________
Title
of ______________________________________, and that I will not participate in any real estate transaction
Corporation/LLC
effectuated by ____________________________________, in the State of Wyoming that would require me
Corporation/LLC
to be licensed as provided in the Wyoming Real Estate License Act of 1971.
I further certify that I have read and am aware of the penalties set forth for violation of the Wyoming
Real Estate Act of 1971.
______________________________________________________
Signature and Title
______________________________________________________
Name of Corporation/LLC
______________________________________________________
Street Address
______________________________________________________
City
State
Zip Code
Subscribed and sworn to before me this ________ day of ________________________ , ________ .
___________________________________________
Notary Public
SEAL
My Commission Expires: ________________________.
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