Affidavit Authorizing Execution of Settlement Check

AFFIDAVIT AUTHORIZING EXECUTION OF SETTLEMENT CHECK

STATE OF NEW YORK )

) SS.:

COUNTY OF __________ )

I hereby authorize __________ [Name] to execute my signature on the settlement check for the purpose of negotiating it through his escrow account so he can draw the appropriate checks to disburse the funds in accordance with our retainer.

_______________

[Signature]

Sworn to before me

this ___ day of _________, 20__.

__________...