HomeMy WebLinkAbout25_0123 Affidavit of Legal Interest (1)Submit by E-mail
35 North 1" East
Rexburg, ID 83440
Affidavit of Legal Interest
State of Idaho
County of Madison
I, Jared G. Killpack
Name
Tetonia
City
City of Rexburg
Phone: 208.359.3020
www.rexburg.org Fox: 208.359.3022
Being first duly swom upon oath, depose and say:
4733 Heads Up RD
Address
Idaho
State
(If Applicant is also Owner of Record, skip to B)
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REXBURG
Arnrriau PJmdv fnrnrnnnity
That I am the record owner of the property described on the attached, and I grant my
permission to:
Name Address
to submit the accompanying application pertaining to that property.
B. I agree to indemnify, defend and hold Rexburg City and its employees harmless from any
claim or liability resulting from any dispute as to the statements contained herein or as to the
ownership of the property which is the subject of the application.
Dated this 22 day of a 202�
l�
Subscribed and sworn to before me the 4f and year first above written.
ENOTARY
CNAIR
N 20170623
PUBLICF IDAHO
XPIRES 10/02/20 99
Notary Public of Idaho
Residing at: R c L-�O""fzi)
My commission expires: I- 'A 25 �Cn