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.
STATE OF INDIANA
SS. -
Signed Name:
(Property Owner, Attorney, or Power of Attorney)
Printed Name: AC-0
County of _J Ohr, snr-1 Before me the undersigned, a Notary Public
(County in which notarization takes place)
for --I'n `j a y(3 r ' County, State of Indiana, personally appeared
(Notary Public's county of residence)
r1 f%441-1 1- [Q3-0_be k and acknowledge the execution of the foregoing instrument
(Property Owner, Attorney, or Power of Attorney)
' RCLIrA,
this ,� day of
�GAY RAINS
1"ry Public, State Of Indiana
SEAL Johnson County
' commission Number NP0W164
%* * My Commission ExPires
0111212030
Page 12 of 12
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Notary Publica- ignature
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Notary Public --Printed Name
My commission expires: