COMPREHENSIVE AFFIDAVIT

STATE OF 						)
COUNTY OF 						)

The undersigned, being the owner(s) of certain premises located in the ________ of 							, County of 				 and State of Connecticut and known as, ____________________________________ being duly sworn, hereby depose(s) and say(s):

SECTION I	OWNERS AFFIDAVIT

Within the last ninety (90) days, including the date hereof, no person, firm and/or corporation has furnished any labor, services or materials in connection with the construction or repair of any buildings or improvements on the above-described premises for which a lien could be filed.

No security interest which secures payment or the performance of any obligation has been given by the undersigned, or to the knowledge of the undersigned, been granted, in any personal property or fixtures placed upon or installed in said premises.

At the date hereof there are no tenants or other parties who are in possession or have the right to be in possession of said premises except: (If none, please state "NONE")
					
                                
SECTION II	CONDOMINIUM AFFIDAVIT
INTENTIONALLY OMITTED

SECTION III			     SURVEY UPDATING AFFIDAVIT
INTENTIONALLY OMITTED



SECTION IV	AFFIDAVIT IN LIEU OF SURVEY
I/We are in possession of the above premises and are familiar with its physical characteristics.
No buildings, structures, fences or improvements on the above premises extend or appear to extend onto any neighboring properties.
No buildings, structures, fences or improvements on neighboring property extend or appear to extend onto the above premises.
There are no mutual driveways, community wells, party walls, or other structures, facilities or improvements on or used by the above premises and shared with other properties (other than public utilities).
There is no evidence on the above premises of any roads, trails or rights of way nor have others used the premises for passing and repassing.
There is no evidence on the above premises of any poles, wires, pipes or other facilities (except public utilities servicing the premises) nor have others exercised or claimed any rights or easements in or to the above premises.
There are no lakes, ponds, rivers or streams on or bordering the above premises.
The above premises adjoin and have access to a public street or highway.
The above statements are true to the best of my/our knowledge.
NOTE: This Section may be used in lieu of a survey to delete the standard survey exception.  Its use, however, is limited ONLY to Loan policies insuring residential property (1-4 families) where there has not been new construction.  Any statements which are inaccurate should be altered; however, matters disclosed thereby must be excepted on Schedule B of the Loan policy.  The standard survey exception must be excepted on Schedule B of the Owner's policy.
As to sections I, II, III and IV, (delete inappropriate sections) the undersigned hereby make(s) this affidavit for the purpose of inducing OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY to issue its policy or policies of title insurance on the above premises, knowing that it will do so in reliance upon the truth and accuracy of the statements herein made.


Subscribed and Sworn before me this 	 day of 		 , 20	    .	

x							
Notary Public:



NOTICE TO PURCHASER
The Affidavit in Lieu of Survey (Section IV) is designed only to provide survey coverage to the Lender in certain instances.  It should not be relied on by you as a substitute for an accurate survey.  In order to obtain survey coverage in an Owner's policy you must obtain a Class A2 survey with a "long form" certification.  Old Republic recommends that you obtain an Owner's policy and a Class A2 survey to give yourself full title protection.
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY

I/We the undersigned purchaser(s) have read and understand the above NOTICE TO PURCHASER.

Signed and sealed This 	 day of		, 20	


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Print Name:

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