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:
(Pro rty Owner, Attorney, or RoVer of Attorney)
Printed Name: �►- �mc�i �4 1�rc-.1
STATE OF INDIANA
SS:
County of
Before me the undersigned, a Notary Public for Marion County, State of Indiana, personally appeared
/2oon&=:4 and acknowledge the execution of the foregoing instrument
this /8� day of T-, , 20 1--1
y
Notary Public --Signature
(SEAL)
ANDREW VANE
�n "'��
" 0.
:�,�"Y• °6s''-, Notary Public,
o; ry c, State of Indiana
Notary Public —Printed Name
ry
=;SEAL-"E Marion County
3tr •, x� Commission Number NP0749034
My Commission Expires
/YID
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May 22,2031
My commission expires:
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