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Loan Purpose Affidavit
LOAN PURPOSE AFFIDAVIT
I, the undersigned, [Name of undersigned], being duly sworn hereby declare that the proceeds of the loan made by [Person that made loan], in the amount of $ [Amount of loan], given to me this day, [Date amount was paid], will be used for and only for the following purpose(s): [Purpose of loan].
Under penalty of perjury, I affix my signature to the foregoing this [Date signed].
Signed Date