SCHOOL DISTRICT
The undersigned, the Owner of the land shown on the attached plat, entitled ____________, does hereby certify and state to the best of their knowledge and belief the property is within SCHOOL DISTRICT NO._________.
Dated this _________ day of _________________ A.D., 20____.
___________________________
OWNER
By: ________________________
Its: ________________________
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 said instrument a their free and voluntary act. Given under my hand and Notarial Seal this _____________________day of ___________, A.D., 20____.
(SEAL) _________________________________
NOTARY PUBLIC
(Prior Code, § 153.115) (Ord. 06-01-01, passed 1-9-2006)