OWNERSHIP CERTIFICATE
STATE OF ILLINOIS )
COUNTY OF SANGAMON )
This is to certify that the undersigned is (are) the Owner(s) of the land described in the plat, and the he (they) has (have) caused the same to be surveyed and subdivided as indicated hereon, for the uses and purposes herein set forth, and do hereby acknowledge and adopt the same under the style and title hereon indicated.
Dated this ___________ day of _________________, A.D., 20_____.
______________________________
OWNER
STATE OF ILLINOIS )
COUNTY OF SANGAMON )
I, ___________________________________, a Notary Public in and for the County of ________, do hereby certify that ______________________, personally known to me to the same person(s) whose name(s) is (are) subscribed to the foregoing instrument, appeared before me this day in person and acknowledged that he (they) signed, sealed and delivered the said instrument as their free and voluntary act. Given under my hand and Notarial Seal this _________day of _____________A.D., 20____.
(SEAL)
__________________________________
NOTARY PUBLIC
(Prior Code, § 153.113) (Ord. 06-01-01, passed 1-9-2006)