I hereby affirm under the penalties for perjury that I do not owe delinquent taxes,special assessments, penalities, initial interest, costs
directly attributable to a prior tax sale, amounts from a final adjudication in favor of a political subdivision in the county, any civil
penalties imposed for the violation of a building code or ordinance of the county, or any civil penalties imposed by a health department
in this county. Further, I hearby acknowledge that any sucessful bid I make in violation of this statement is subject to forfeiture.
In the event of forfeiture, the amount of my bid shall be applied to the delinquent taxes, special assessments, penalties, interest, costs, judgments,
or civil penalties I owe, and a certificate will be issued to the county executive.(summarized, see IC6-1. 1-24-5.3 for complete details.