HomeMy WebLinkAboutOwners AffidavitAFFIDAVIT
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:
(Property Owner, Attorney, or Power of Attorney)
Printed Name:
STATE OF INDIANA
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County of
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(County in which notarization takes place)
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Before me the undersigned, a Notary Public
County, State of Indiana, personally appeared
(Notary Public's county of residence)
n (\(‘CISCA-e-t ---Rc.\n‘r1,0 LA-kV-AA- and acknowledge the execution of the foregoing instrument
(Property Owner, Attorney, or Po er of Attorney)
cee"—
this day of , 20 2./2-
(SEAL)
My commission expires:
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L PA
otary Public
Malian nr+Liniy, State of Indiana
CommisSioVin gOR-ENsifted Name