256 AFFIDAVIT FOR INDEFINITE MORTGAGE

State of ___________ }
County of _________ }ss:

_________________________ being duly sworn, deposes and says:

That he is the __________________ of ________________________ , the mortgagee
in a certain mortgage instrument to be recorded herewith, made by _________________ , Mortgagor to _______________________ , Mortgagee, dated ___________________
affecting real property know as ________________________________ in the County of ________________ .

That the aforesaid instrument was given to secure an indebtedness or obligation in the sum of $ ; that the maximum amount secured at the execution of the said instrument or which under any contingency has since been or may be secured thereby at any time thereafter, including any and all advances, readvances, loans or reloans that may be made thereunder is $ ________________ .

_________________________

Sworn to before me this
_____ day of _______ 19 ___

________________________
Notary Public