FORM 4

GENERAL AFFIDAVIT

STATE OF___________________________

COUNTY OF___________________________

PERSONALLY came and appeared before me, the undersigned Notary, the within named________________________________, who is a resident of ________________ County, State of ________________________, and makes this his/her statement and General Affidavit upon oath and affirmation of belief and personal knowledge that the following matters, facts and things set forth are true and correct to the best of his/her knowledge:

LI’L ABNER MOBILE HOME PARK HAS ADVISED___________________________ AT ____________________ MIAMI, FL 33172. THAT THEY MUST GO TO THE CITY OF SWEETWATER OR MIAMI DADE COUNTY TO APPLY FOR A BUILDING PERMIT FOR ANY REMODELING OR CONSTRUCTION DONE TO THEIR MOBILE HOME AND THAT ANY ALTERATIONS DONE TO THE MOBILE HOME WITH OUT A PERMIT IS ILLEGAL. ___________________ HAS ACCEPTED ANY RESPONSIBILITY OVER HIS ACTIONS TO THE MOBILE HOME.

DATED this the ____ day of _______________, 20__

________________________Signature of Affiant

SWORN to subscribed before me, this ___ day ____ __________, 20__

____________________________NOTARY PUBLIC

My Commission Expires:

______________________