HomeMy WebLinkAboutAFFADAVIT - 22-00127 - Ethereal VR LLC Arcadeubmit by E-mai[
d� Noriri I'',C$;
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f#id ovit of legal Interest
City of Rexburg
Prione; Sr,3 '20
StAte of Idaho
Counry of Madisan
N'amc Addrrd�A
_ -0 -9
City
Being duly Sworn upon onth, AepOSf� and say,
(If Applicant iS a]sa Ownct of Record, ;kip to B
REXB U1 �
,� .
A. That I am the record owtwr of the pioper Gy described on tho attauhcxi, and 1;�Mnr my
percussion LQ: Jamal Taylor 125 Malley River Dr. Unit C4
Name
to submit Lhc accu:ripanving application perraining rn rhqr pmperty..
li, 1 agree to Mdumnifv, dc:cnd and hold Rexburg Dry and ivs emplovees hare-r.Les5 from any
Claim or liability• resu]ririg from in disp ,jre 11s to 01C s1.arements contaiiiQ6 herein or as to the
O'vvnership Of thrt propzrt}- which is the subject of Lije apphcadun.
Datcd this, -!eK day of —1 2i] `
5igt,ararc — V ..
'Subscribed and sworn to before me the day- : r:ti V-Ar Irst abovc %,,'ritrcn.
orary Pubbc of Idaho
Residing ar:
My cornlylission cxpires, -
notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate
is attached, and not the truthfulness, accuracy, or
:is
of that document,
State of California
ounly of .,,E, + �
Subscribed and sworn to (or affirmed) before me on this
d a it of W 0 z`, by C-LMO A
r
craved to me on the basis of satisfactory evidence to be the
person(s) who appeared before me.
2 2JE55IC.a ML"'6Z
Notary Public • Cali'C'.7iI .
= I mission Santa ion County
Carr. A 23543'7
r My Carr m. Egli PS A.;.' 13. 2125
(Seal) Signature