HomeMy WebLinkAboutOwner 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, Attorni6y, or Plower of Attorney)
Printed Name: tti
County of `�—�_. Before me the undersigned, a Notary Public
(County in which notarization takes place)
for
(Notary Public's county of residence)
County, State of Indiana, personally appeared
and acknowledge the execution of the foregoing instrument
(Property Owner, Attorney, or Power of Attorney)
r
this 5 day of 20n4
r ,
Notary Publ c- ignature
(SEAL)
o� Y PU$G Stacy L Marsh, Notary Public
Z SEAL* Commission Number: NP0742538
My Commission Expires: 7/21 /2030
6LL00 Residing in Hamilton County, IN
J �o Vic, rs
Notary Publi Printed Name
1. a My commission expires:' �° 3a