BULK SALES AFFIDAVIT

I, , the undersigned, being

(title) of (Seller), of lawful age and
first sworn, on oath state:
1. The Undersigned executes this affidavit on behalf of the Seller under an intended bulk
sale of inventory of a certain business known as , to
(Buyer).
2. This affidavit is furnished pursuant to Article 6 of the Uniform Commercial Code, and is
provided to the above named Buyer in connection with the sale described under said contract,
and for purposes of providing creditors notice of said intended sale and transfer, pursuant to the
Bulk Sales Act.
3. That the attached is a true, complete and accurate list of all the creditors of Seller, which
to the knowledge of the undersigned, assert or claim to assert one or more claims against the
S e l l e r, together with the correct business address of each such creditor or claimant and the
amounts due and owing or otherwise claimed to be due as of this date.
Signed under seal this day of , (year).
___________________________________
Sellers Representative
STATE OF
}
COUNTY OF
On before me, , personally appeared
, personally known to me (or
proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same
in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument
the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signature___________________________
Affiant _____Known _____Unknown
ID Produced________________________
(Seal)
AHAAAZAZ