ࡱ> FHE#` +bjbjmm =r HHH8Ddd"4$hT QV"VV 8qfffVXfVfff NǬHf0f6ffxfVVV  XVVVVVVVDHH  SURVEY AFFIDAVIT AND AGREEMENT STATE OF NORTH CAROLINA COUNTY OF  FORMTEXT       1. The undersigned hereby states that  FORMDROPDOWN   FORMDROPDOWN  owner(s) of the property shown on the attached survey dated  FORMTEXT      , by  FORMTEXT      , PLS, said property being further identified as and located at  FORMTEXT      . 2. That said lot is being mortgaged to  FORMTEXT      . That said lender requires title insurance without exception to matters of survey and said borrowers have requested that SOUTH ATLANTIC LAND TITLE, INC. and any title insurer for which it is acting as agent (hereinafter collectively TITLE COMPANY), use the attached survey. 3. For the purpose of inducing Lender to make disbursement of the proceeds of such loan, and inducing TITLE COMPANY to issue its policies without exception to matters of survey and with knowledge that Lender and TITLE COMPANY will and are relying upon the statements and representations herein made in paying out the proceeds of such loan and issuing of such title insurance, the undersigned say(s) that the above referenced survey has been examined and that there have been no improvements added, no encroachments upon nor alterations made from the date of said survey to the present. The undersigned further certifies that the survey represents an accurate and complete representation of the physical status of the premises as it currently exists. 4. That the undersigned have no knowledge of any dispute of any kind concerning the boundary lines as shown on the above referenced survey. 5. That the undersigned agree(s) to indemnify and hold the said Lender and TITLE COMPANY harmless of and from any and all loss, cost, damage and expense of every kind, including attorneys fees which said Lender or TITLE COMPANY shall or may suffer or incur or be liable for under its said policy or policies directly or indirectly, out of reliance on the above referenced survey or in connection with enforcement of their rights under this agreement. This the  FORMTEXT       day of  FORMDROPDOWN , 20 FORMTEXT   . ________________________________________ (SEAL) (Owner) ________________________________________ (SEAL) (Owner)  FORMTEXT       (corporation, LLC, LLP, partnership, etc.) BY@B Ƶx_ƵM?hNCJOJQJ^JaJ#jhNCJOJQJU^JaJ1jhQ&CJOJQJU\^JaJmHnHu2jhQ&htlPCJOJQJU\^JaJhQ&CJOJQJ\^JaJ&jhQ&CJOJQJU\^JaJ hh7CJOJQJ^JaJ#hh7CJOJQJ\^JaJ&hh75CJOJQJ\^JaJ&hh75CJOJQJ\^JaJ@Br (n{  d gdl  vdx^`gdlC$ ; vdx^`a$gd<}\$ ; vdx^`a$gd d dd w wd d r*+   " > @ B     նČ~fNČ~6N/j8hQ&htlPCJOJQJU^JaJ.jhQ&CJOJQJU^JaJmHnHu/jhQ&htlPCJOJQJU^JaJhQ&CJOJQJ^JaJ#jhQ&CJOJQJU^JaJ/jhNh`)CJOJQJU^JaJhNCJOJQJ^JaJ hh7CJOJQJ^JaJ#jhNCJOJQJU^JaJ/jhNh`)CJOJQJU^JaJ    " $ . 0 6 @ V t\K: h dh7CJOJQJ^JaJ hhCJOJQJ^JaJ/j hQ&htlPCJOJQJU^JaJhCJOJQJ^JaJ.jhQ&CJOJQJU^JaJmHnHu/jhQ&htlPCJOJQJU^JaJhQ&CJOJQJ^JaJhCJOJQJ^JaJ hh7CJOJQJ^JaJhJSCJOJQJ^JaJ#jhQ&CJOJQJU^JaJV X  " $ & , - 0 2 3 h    ! s ޿ޱޱޱޱޠziQz/jhNhtlPCJOJQJU^JaJ hNhQ&CJOJQJ^JaJ)jhNhQ&CJOJQJU^JaJ hNh7CJOJQJ^JaJ hh7CJOJQJ^JaJhCJOJQJ^JaJ hdhdCJOJQJ^JaJhdCJOJQJ^JaJ h dh7CJOJQJ^JaJ h dhCJOJQJ^JaJ ">@BJL`bdhjlnòԡwiQw9w.jhNCJOJQJU^JaJmHnHu/j4hNh`)CJOJQJU^JaJhNCJOJQJ^JaJ#jhNCJOJQJU^JaJ/jhNhtlPCJOJQJU^JaJ hNhQ&CJOJQJ^JaJ hNh7CJOJQJ^JaJ hNhCJOJQJ^JaJ)jhNhQ&CJOJQJU^JaJ,jhNhQ&CJU^JaJmHnHun\jz|(((>(J(Z(\(j(l(uudbdddTh7CJOJQJ^JaJU hh7CJOJQJ^JaJhNCJOJQJ^JaJ.jhQ&CJOJQJU^JaJmHnHu/jhQ&htlPCJOJQJU^JaJhQ&CJOJQJ^JaJ#jhQ&CJOJQJU^JaJhlCCJOJQJ^JaJ hhlCJOJQJ^JaJhlCJOJQJ^JaJ Zln\(((((()*)))*/*$ da$gdlC   dd d^`gdl  d gdl$ i#da$gdl: ____________________________________ (SEAL) Title:  FORMTEXT       Attest: _________________________________________ (___________ Secretary) SWORN TO AND SUBSCRIBED before me this _____ day of ______________________, 20__. ______________________________________________ Notary Public My Commission Expires: _____________________ (AFFIX NOTARIAL SEAL)     South Atlantic Land Title, Inc. 112 W. 5th Street, P.O. Box 656, Lumberton, NC 28359 TeL: 910-272-0950 Fax: 910-671-0093 Email: mail@salti-nc.com Agent for Lawyers Title Insurance Corporation and Stewart Title Guaranty Company Survey Affidavit and Agreement l((((((((((())))**!*.*/*[*\*r*ȰȢrn]L>h dCJOJQJ^JaJ hlChlCCJOJQJ^JaJ hlCh7CJOJQJ^JaJhl hhlCJOJQJ^JaJh7CJOJQJ^JaJ hh7CJOJQJ^JaJhlCJOJQJ^JaJ.jhQ&CJOJQJU^JaJmHnHu#jhQ&CJOJQJU^JaJ/jhQ&htlPCJOJQJU^JaJhQ&CJOJQJ^JaJ/*r*t*u*w*x*z*{*}*~***++i+j+++++ !B(gd !B( gd # %dgdd#$ %da$gd 8`8gd 8`8gddr*s*u*v*x*y*{*|*~********++i+j++++++˻so^Po? hh7CJOJQJ^JaJhCJOJQJ^JaJ hhCJOJQJ^JaJh#hdhCJOJQJ\^JaJhCJOJQJ^JaJ(hj(hB*CJH*OJQJaJph%hj(hB*CJOJQJaJphhB*CJOJQJaJph%hj(hB*CJ OJQJaJ ph(jhj(hCJ UaJ mHnHuh`)jh`)U< 00&PP:pP / =!"#$%@@ n ]2q}8%PNG  IHDR=} WbsRGB PLTE@*Z 9IDATx=7,`hohȁ}!{ t4Gp!pFQ~(Qˮ 4K?|TuK`$|H^ *꠬CuA]B%ֶ(l >aX.Ucc*s- ÒQwt5,^$/ʠ|y^T- AUĆ @ OUA K5iˠpx.t: y;QA8DARPp΀0tk^@ . 7p TZAs!pU6Kn]wT$@8md.4{'35\Ƙ`%m?HO,pKsm4kTk։ۏmk#zXf2|w" ˆ xjHVoMVV&;ɆTʅ\+(Hq3ɐOŃd@Vd ِfJuڷk%`&/j`ui4;PQbVu5ژHL;}< .`?ftӽ7w}G (PO;h]xv?[*\:w Oۏtb;i*Tz_wx )\̒!^~ qTD{8.ZA{ Z@p}mp|3KR-k8@އhq&ˢ `l6.C;Pb MJMd:xQxk餴(!Z6OU@mZLC݁|RmnY>bA7I3+@mﵹYfB.Dq;?K'JHvck!.6u)P˱=GhͶxFX*A@n̛jræCJ Z_R-^ |Kxtr)pjm &ύrT|o_>َ?-y va{73bRLpRF9F |h3A52?w&~㚾΁F G[ `7fw.?n^5 n}p)i;[q1n,7wZ:q$85=%qۻ018mѨ n~5&1n\| aƻR'iA;шٯy`{l2Jz~NpK= a>0>Nu;RAΠ<}A@j1% 4dFlHSܽuL ؇~/m>N]|2ϡԥ#-sn{ڟ/2HO^@H&40ݖ~0OUP<(* k 0P9"~ P>TWAx&hk| O_A_y(^TEP?kCmP_elk[栬 (/UU@SA\\@&~90/F°:X~z.i9( 0,᩠ bP?tqݔ깠bP>OU>ou1ۆ \caXl*0,B׍@*{%PjM05VWKo ,Q/d_lL Ó`Sck4L :ecRlɨ/Y ]Xl騗wD9 6e*T%0< ]x'E]끼\ #Q*ޅ4e]&$@/9lY(ݯ>\m sA^ AϗG] 6-!G] Qj.^X8 )%?_8 lY0t9࠹6@!y)o>em9荩: PE< = A`CAoH΀^vdU6W@ɣ.`CͳS#ς&2;! 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