Dissolution of Public and Association Libraries in New York State

S A M P L E
AFFIDAVIT: NO REMAINING DEBTS

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The University of the State of New York
The State Education Department
New York State Library / Division of Library Development
10B41 Cultural Education Center
Albany, NY 12230

AFFIDAVIT: NO REMAINING DEBTS

State of New York             )
            :ss
County of             )

_____________________________________, president and

_____________________________________, treasurer of

_____________________________________ Library, which was incorporated by the Regents of the University of the State of New York with a charter on _____________________________________, under the corporate name of __________________________________

Being duly sworn depose and say, each for him/herself, that the _________________________________ library, has no remaining property and no debts.

________________________________________
President (Signature and Printed Name)

________________________________________
Treasurer (Signature and Printed Name)

State of New York             )
            :ss
County of             )

On this __________day of ____________, 20___ before me personally came _________________________(insert name of trustee) to me known to be the person described in and who executed the foregoing application, and (s)he duly acknowledged to me that (s)he executed the same.

(Typed name, stamp and signature of notary public)

Last Updated: August 31, 2009