AFFIDAVIT AND ACKNOWLEDGEMENT OF DEBT
AND CONDITIONAL RELEASE OF LIABILITY
STATE OF ___________________________
COUNTY OF ___________________________
BEFORE
ME,
the
undersigned
authority,
on
this
day
personally
appeared
___________________________ who being first duly sworn, depose and say that:
1. According to an agreement dated ______________________ (hereinafter “Agreement”),
Affiants (hereinafter “Seller”) have voluntarily agreed to sell property located at
___________________________
to
___________________________
(hereinafter
“Buyer”).
2. According to Agreement, Seller has agreed to pay to Buyer a sum equal to
$___________________ according to a properly executed Promissory Note (hereinafter
“Note”) of even date with this document.
3. Seller understands that Seller must comply with every particular of Note.
4. In the event that Seller fails to comply with any single term of the Note, whether or not said
term is cured, Seller shall thenceforth forevermore grant to Buyer (and to Buyer’s heirs,
executors, administrators and assigns) a permanent and complete release from all liability,
claims, causes of action or losses with regard to any and all agreements between the parties
from the beginning of time to this date, including but not limited to the following covenants:
<< NAME AND DATE OF ALL DOCUMENTS YOU HAVE SIGNED WITH SELLER >>
5. Buyer’s continued compliance with the Agreement subsequent to Seller’s breach of the Note
shall not be deemed as waiver of the release offered herein.
6. Affiants/Seller expressly agree that this instrument may be treated as a defense to any action
or proceeding that may be brought, instituted, or taken by Affiants/Seller or in their behalf, and
shall for ever be a complete bar to the commencement or prosecution of any action or
proceeding whatever against the Buyer and/or assigns, any future purchasers, mortgagees,
title insurance companies, any heir, legal representative, assignee or any other person, entity
or firm claiming by or through them.