HomeMy WebLinkAboutOwners AffidavitI hereby swear that I am the owner/contract purchaser of property involved in this application and that the foregoing
signatures, statements, and answers herein contained and the information herewith submitted are in all respects true
and correct to the best of my knowledge and belief. I, the undersigned, authorize the applicant to act on my behalf
with regard to this application and subsequent hearings and testimony.
Signed Name:
ot �� 60A(�M L__,
(Property Owner, Attorney, or Power of Attorney)
Printed Name: ! a Ae �6t i + h
rcx�ev t o pr oyet ma ptay'r
STATE OF INDIANA c;L Kr -er J_ggq
ra.r�s.
SS: Lea1, IN a3�
County of ^ RA)" l'uL Before me the undersigned, a Notary Public
(County in which notarization fakes place)
for gin;160W County, State of Indiana, personally appeared
(Notary Public's county of residence)
_�iL[Nt`e l �r CJ !� —�iY YL.lw11fCG� T6�r
and nd acknowledge the execution of the foregoing instrument
(Property Owner, Attorney, or Powdf of Attorney)
this Za th day of �Z{-o�cl� 20 3.1
(SEAL)
'R ��d
W a.
NotaryPublic--Signature
Notary Public —Printed Name
My commission expires `tJ
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1lrmiitop Cou�ttY
Commission Expires Jul! 1$, 2il 4
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