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CITY OF SANTA ANA Planning and BuildingAgency CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDG Approved 'PERMIT ISSUA CE IA notary public or other officer completing this certificate verifies only the identity of tle individual who signed) the document to which this certificate is attached, and not the truthfulness, accuracy, or v Wfli at document. State of California County of ;-;vev"$i 4p- On it / m bob q before me, Michael Tannar, Notary Public (Here insert name and title of the officer) personally appeared /A rzflo u. & a o Vt who proved to me on the basis of satisfactory evidence to be the person44-whose name(&-) is/ere-subscribed to the within instrument and acknowledged to me that he/may-executed the same in his/fir authorized capacity(ics), and that by his/ha0 lreh-Signature(&) on the instrument the person(s}, or the entity upon behalf of which the person(sl'a-cted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. 00-0-00-0-00 WITNESS my hand and official seal. Signature of Notary Public (Notary Seal) MICHAEL TANNAR COMM. # 2376861 F -�d NOTARY PUBLIC - CAUFORNIA; SAN BERNARDINO COUNTY My Comm. E*kw SepWnbw 2a, 202s ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT lR0#10',41' eg f,04 Tv /v 1r/ (Title or description of attached document) (Title or description of attached document continued) Number of Pages , Document Date/J (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California mast contain verbiage exactly as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is ij' a document is to be recorded outside of California. In such instances, any alternative acknowledgment verbiage as may he printed on such a document .ro long as the verbiage does not require the notary to do something that is illegal fur a notary in California (i.e. certif ing the attthuri=ed capacity of the signet). Please check the document carefully for proper notarial wording and attach this form if required. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect fortes (i.e. he/she/they,— is /ere) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document 2008 Version CAPA v12.10.07 800-873-9865 www.NotayClasses.com