Authorized Signature

2-10-1 Signature and Date
2-10-2 Penalty

2-10-1 Signature and Date:

A. The application form must be signed and dated by the applicant or an individual authorized to act on the applicant's behalf.

2-10-2 Penalty:

A. By signing the application, the signatory is attesting under the penalty of perjury that all information stipulated on, or submitted with, the application is true, accurate and complete. This includes the public notice requirements specified by the "Procedures Governing Certain Licenses Act", IC 14-11-1.