Bulk Sales Affidavit : Please fill out the following form. Please print your completed form if you would to have a copy for your records.




I, (Name of the person representing the seller), the undersigned, being (title) of (Name of the company - 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 (name of buyer) 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 (DATE) :


Seller’s 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 :





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