HomeMy WebLinkAboutHomeowners Affidavit his/her attorney.
AFFIDAVIT
I 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: A *
itikAOtk
(Property Owner,
Attorney, or Power of Attorney)
Printed Name:
STATE OF INDIANA
SS:
County of ct,v-v t l� V` Before me the
undersigned, a Notary Public
(County in which notarization takes place)
for H, Q' l L v�
County, State of Indiana,
personally appeared
(Notary Public's county of residence)
wA l Ci a'UV`% and acknowledge the
execution of the foregoing instrument (Property Owner, Attorney, or Power of
Attorney)
this day of /(LL U SA--- 20 2 Z
J_ l'XA_ Ifvue_'4- I LISA MOTZ
' Notary Public-Seal
NotaryPublic--Signature Hamilton County-State of Indiana 1
gnaure � Commission Number NP0734178
(SEAL) I My Commission Expires Jun 9, 2029
L i VVI--0
Notary Public—Printed Name
My commission expi :