HomeMy WebLinkAboutOwner AffidavitAFFIDAVIT
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
Printed
STATE OF INDIANA
o
SS:
County of _ ffi,( 6V-\ Before me the undersigned, a Notary Public
(County in which notarization takes place)
for _ 1/ County, State of Indiana, personally appeared
(Notary Public's county of residence)
Me, and acknowledge the execution of the foregoing instrument
(Property er, Attorney, or ower of Attorney)
this day of 20�
KRISTIN S SHELLMAN 9, a
NOTARY PUBLIC - SEAL Notary ublic--Signature
(SEAS ..!TE'OF INDIANA
COMMISSION NUMBER NP0741,385 �V{q,
MY COIAMfSSIQAI.EXPfRES MAYAY 23,2D3o(�1 S, Sm6o
Notary Public —Printed Name
My commission expires: V 51dcf lao3 b
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