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Page 6 of 6 City of Jerome 152 East Ave A Jerome, ID 83338 Affidavit of Legal Interest State of Idaho) ) ss County of Jerome) I, Printed Name Address City State being first duly sworn upon oath, depose and say: (If Applicant is also Owner of Record, skip to B) A. That I am the owner of record of the property described on the attached application, and I grant my permission to Printed Name Address City State to submit the accompanying application pertaining to the property described on the attached application. B. I agree to indemnify, defend and hold the City of Jerome 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 of Signature Subscribed and sworn to before me the day and year first written above. Notary Public for Idaho Residing at: My Commission expires: