Property Owner Notary Form - City Of Rocky Mount printable pdf download

Property Owner Notary Form - City Of Rocky Mount

Property Owner Notary Form

______________________, 2005

Board of Adjustment Secretary

Department of Planning and Development

City of Rocky Mount

PO Box 1180

Rocky Mount, North Carolina 27802

Dear Madam/Sir:

The undersigned hereby certifies that he/she/they own(s) the property known as/located at

______________________________________ which is the subject of an appeal before the Board

of Adjustment for the issuance of ___________________________________________________.

I do not desire to personally appear before the Board of Adjustment and I authorize

_______________________________________ to appear on my behalf.

________________________________

(Owner)

________________________________

(Owner)

________________________________

(Owner)

North Carolina, _________________ County

I, ___________________________________________, a Notary Public for said County and

State, do hereby certify that _________________________ and ___________________________

personally appeared before me this day and acknowledged to due execution of the foregoing

instrument.

Witness my hand and official seal, this the _________________ day of ______________, 2005.

________________________________

(Notary Public)

My commission expires ________________________.

Property Owner Notary Form - City Of Rocky Mount