AFFIDAVIT OF SIGNATURE

I, …………Moslem Adult of P.O. Box 21147, Dar es Salaam do here by

solemnly affirm and state as follows:

1. That I am the owner of the property standing on Plot No. 39, Block
15, Mwananyamala, Dar es Salaam City held comprised under
Certificate of Title No. 34340 and I have been the registered owner
of the Certificate of Title mentioned hereinabove.

2. That I am about to presented an Application for a Lost Certificate of

Title under. 38 of the Land Registration Act (CAP 334) so that I can
be issued with a duplicate copy of the said Certificate due to the
fact that the original one has been lost.

3. It appears that, the signature appeared in the said application

differs from the one which appeared in the Certificate of Title.

4. That due to passage of time and old age I have been incapable of
producing the signature which appeared in Certificate of Title in the
current Application.

AND, I the said ……………………… make this solemn declaration

conscientiously believing the same to be true and in accordance with the
Oaths (Judicial Proceedings) and Statutory Declaration Act 1966.

AFFIRMED and DELIVERED at ]

Dar es Salaam by the said ………..
who is known to me personally/ ]
identified to me by …………………… ] _________________
The latter being known to me personally this ]
…………….day of …………………2007 . ] DEPONENT

SIGNATURE: .……………………………..,..
FULL NAME:……….………………………...
POSTAL ADDRESS:………………………….
…………………………..
QULIFCATIONS:…………………………….