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IN THE MAGISTRATE COURT OF DOUGLAS COUNTY STATE OF GEORGIA CARES ACT AFFIDAVIT Case No. Plaintiff Address City State Zip Email Address Defendant(s) Property Address City State Zip Personally appeared before me, the undersigned officer, the Plaintiff, his agent or attorney who on oath deposes and says as follows: I am personally familiar with the residential property occupied by the Defendant, the Defendant’s tenancy, the property’s ownership, the financing arrangements and any and all liens that may exist on the property. The property is not a “covered property” as defined by section 4024 of the CARES Act, or the property is otherwise exempt from the moratorium imposed therein. It is not part of a covered housing program (as defined in section 41411 of the Violence Against Women Act of 1994 (34 USC § 12491 or the rural housing voucher program under section 542 of the Housing Act of 1949 (42 USC § 1490r). There are no mortgages, deeds to secure debt, nor liens of any other sort which are made in whole or in part, or insured, guaranteed, supplemented, or assisted in any way, by any officer or agency of the United States Government or in connection with a housing or urban development program administered by the U.S. Secretary of Housing and Urban Development or a housing or related program administered by any other such officer or agency, or is purchased or securitized by the Federal Home Loan Mortgage Corporation or the Federal National Mortgage Association. The debt on the property is not receiving a forbearance pursuant to section 4023 of the CARES Act. I swear under penalty of perjury that the above information is true and correct and made of my own personal knowledge. I understand further proof may be required at trial. Sworn to /Subscribed/ filed before me this day of , . This day of , . Deputy Clerk/ Notary Public Attorney/ Owner/ Agent Phone#