HomeMy WebLinkAboutOwners AffidavitI 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: vt
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(Proerty Owner, Attorney, or Power of Attorney)
Printed Name: LA,
L-_iL r+7'--' Dav--,
STATE OF INDIANA
SS:
County of ��l t 1+n^,-- Before me the undersigned, a Notary Public
(County in which notarization takes place)
for
Mrs-+�{ rsvy
(Notary Public's county of residence)
Vi V,C-. �- t)O ram,
(Property Owner, Attorney, or Power of Attorney)
this 'ZU-fh day of � W14-17 —
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Page 12 of 12
County, State of Indiana, personally appeared
and acknowledge the execution of the foregoing instrument
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No ry Public --Signature
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ary Public —Printed Name
My commission expires: -71)�n