Cashier's Check Stop Payment Affidavit

STATE OF NEW YORK           )

ss:

COUNTY OF ____________   )

I, __________________________(Remitter's or Payee's name) being duly sworn, depose

and say:

1.   That I am the remitter/payee of Cashier's Check No.________, drawn by me from

account number _______________ at ____________________ Credit Union, in the

amount of $ _______________, dated ____________________, 20 ___, and made

payable to ____________________________________(the "Cashier's Check").

2.  That at least (90) days have passed from the date the Cashier's Check was issued.

3.  That the Cashier's Check was either (i) destroyed or (ii) its whereabouts cannot be

determined or (iii) it is in the wrongful posession of an unknown person or person that cannot

be found or a person that is not amenable to service of process.

4.  That a written stop payment order on the Cashier's Check was made on

________________, 20___ and a copy of said order is attached hereto.

5.  That this adffidavit is a made pursuant to Section 4-403 (2) of the Uniform Commercial

Code of New York.

6.  The the undersigned will continue to be obligated to pay, subject to available defenses,

and amount of the Cashier's Check to any subsequent holder or indorser who takes it up.

_________________________________

Remitter/Payee Signature

_________________________________

Remitter/Payee Printed Name

Sworn to before me this_______ day of

__________________, 20____

_________________________________

Notary Public