Affidavit for Ownership

RE: Birth CertificateI, the undersigned, of lawful age and being first duly sworn on oath, depose and state that I am familiar with the facts recited, and the party named in said birth certificate is the same party as one of the owners named in said certificate of title.Signature: __________________________________

State of Colorado)) ss.JURAT___________ County)

On the ___ day of ________, 20________, ________________________________ personally appeared before me and proved to me on the basis of satisfactory evidence to be the person whose name is subscribed hereto and acknowledged to me that he/she executed the same under oath or asseveration, and accepts the facts thereof. Subscribed and affirmed before me this day. Witness my hand and seal this _____ day of _____________, 20_____.

Seal:

Notary Signature