GIFT AFFIDAVIT
I, , attest:
That I reside at ,
my telephone number is and I am
(relationship) of urchasin the
known as
That the amount of $50,000 is a bona fide gift and no repayment, in
any form, is expected.
That the funds were given on April 20, 2010
That my gift funds were deposited in:
Citibank
Account Name:
Account Type: Checkin
Account Number:
That your deponent makes this affirmation knowing that you will rely
on this affidavit.
Date:
Notarized By:
EFTA00732933