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, a(n) , Owner(s) of <br /> the real estate described above who acknowledged the execution of the foregoing instrument in <br /> such capacity and who, having been duly sworn, stated that any representations therein contained <br /> are true. <br /> Witness my hand and Notarial Seal this day of <br /> Signature <br /> Printed <br /> County of Residence <br /> My Commission expires: <br /> This instrument was prepared by Jordan Wyatt, Area Plan Commission. I affirm under penalties <br /> for perjury, that I have taken reasonable care to redact each Social Security number in this <br /> document, unless required by law. Jordan Wyatt. <br /> E:\ZONING\2018\Petitions(Active)\2881-18(SB)1405 and 1505 Howard\2881 Written Commitments.DOC <br />