Zoning Application, Petitions And Affidavits Packet Page 5

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AFFIDAVIT RELATED TO REZONING REQUEST
FORM B
Authority for Agent to Petition for Rezoning on Behalf of Property Owner(s)
Your affiant(s), _________________________ (print name(s)), being duly sworn, affirm(s) as follows:
Where the property to be rezoned is owned by a corporation or similar entity:
I am the _________________________ (title or position) of _________________________ (name of owner
entity), and am authorized to appoint, and do so appoint, _________________________ (name of agent) to
petition on behalf of that entity for rezoning of the property identified below to the _____ zoning district.
OR
Where the property to be rezoned is owned by one or more individuals (all owners must be listed as an affiant):
I/We authorize _________________________ (name of agent) to petition on my/our behalf for the rezoning of
the property identified below to the _____ zoning district.
ADDRESS OF PROPERTY TO BE REZONED
PROPERTY ID NO. OF PROPERTY TO BE REZONED
Affiant’s signature
Subscribed and sworn to before me this _______ day
of _________________________________________
Affiant’s signature
Notary Public:
County of:
My commission expires:
5

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