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
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County of
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Signed Name
Printed Name:
(County in which notarization takes place)
(Notary Public's county of residence)
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(Property OwrFer, Attorney, or Power of Attorney)
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Before me the undersigned, a Notary Public
County, State of Indiana, personally appeared
and acknowledge the execution of the foregoing instrument
(Property Owner, Attorney, or Power of Attorney)
this day of At .20 23
DINA L RANDALL
Notary Public - Seal
Hamilton County - State of Indiana
Commission Number NP0727332
My Commission Expires Jun 16, 2028
Page 12 of 12
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Notary Public —Printed Name
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