2. 
4. The undersigned is the only owner / are all of the owners of the property identified in the attached legal description (including street address and tax map / parcel number), and hereby petitions the City of Murfreesboro to annex such property into the City.

   Signatures must be by owners or those with an appropriate written Power of Attorney from an owner. If the owner is not an individual (eg. corporation, trust, etc.), list the entity’s name, the name of the individual signing on behalf of the entity and the status of the individual (eg. president, trustee, partner). If you are signing this Petition based on a Power of Attorney, you must also attach a copy of the Power of Attorney. 

6. 1) Printed First Name of Owner (and Owner's Representative, if Owner is an entity)First Name*
7. Printed Last Name of Owner (and Owner's Representative, if Owner is an entity)First Name*
9. Signature:
   1. Electronic Signature Agreement
      By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
10. Electronic Signature

    1. I Agree
    2. I Do Not Agree
11. Status:
12. Date:
    Date:
14. Mailing Address (if not address of property to be annexed)*
16. City*
17. State*
18. Zip*
20. Daytime Phone Number*
21. Cell Phone Number
23. Work Phone Number
24. Extension
26. Email Address*
28. 2) Printed First Name (and Owner's Representative, if Owner is an entity)
29. Printed Last Name of Owner (and Owner's Representative, if Owner is a entity.
31. Signature:
    1. Electronic Signature Agreement
       By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
32. Electronic Signature:

    1. I Agree
    2. I Do Not Agree
33. Status:
34. Date:
    Date:

    Date:
36. Mailing Address (if not address of property to be annexed)
38. City
39. State
40. Zip
42. Daytime Phone Number
43. Cell Phone Number
45. Work Phone Number
46. Extension
48. Email Address
50. 3) Printed First Name of Owner (and Owner's Representative, if Owner is an entity)
51. Printed Last Name of Owner (and Owner's Representative, if Owner is an entity)
53. Signature:
    1. Electronic Signature Agreement
       By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
54. Electronic Signature:

    1. I Agree
    2. I Do Not Agree
55. Status:
56. Date:
    Date:

    Date:
58. Mailing Address (if not address of property to be annexed)
60. City
61. State
62. Zip
64. Daytime Phone Number
65. Cell Phone Number
67. Work Phone Number
68. Extension
70. Email Address
72. 4) Printed First Name of Owner (and Owner's Representative, if Owner is an entity)
73. Last Name
75. Signature:
    1. Electronic Signature Agreement
       By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
76. Electronic Signature:

    1. I Agree
    2. I Do Not Agree
77. Status:
78. Date:
    Date:
80. Mailing Address (if not address of property to be annexed)
82. City
83. State
84. Zip
86. Daytime Phone Number
87. Cell Phone Number
89. Work Phone Number
90. Extension
92. Email Address
94. (Attach additional signature pages if necessary)
95. Upload Files
97. Legal Description is attached

    1. Yes
98. Upload File
99. Power of Attorney applies and is attached:

    1. Yes
    2. No
100. Upload File
Leave This Blank:


102. 1. Receive an email copy of this form.
103. Email address

     This field is not part of the form submission.

104. Submit

* indicates a required field