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i <br />ii <br />CALIFORNIA JHRAT WITH AFFIANT S'1'ATHMENT GOVERNMENT COOP 6 8202 <br />' 64QO Attached Dgoument (Notary to arcs Out lines 1-8 below) <br />p Bee Statement taelOw Pass 1-6 to be aelnplated Only by (1ocument.signar(s), not Notary) <br />ll <br />Siggatora of t)ePumenf 6lgnar Nb.9 5lgnattlYa aff3Patsnant Stgtyon NP. 27(ll anYl <br />A notary pbllo or dtha- officer omrroieIW this senlllosle uorlor's only the Identity of iho individual who 0100eq the <br />CIOUmont to whbh INSWcedllidate is attached; and not the taQhfuliross, aonuraoy, orvaltdity'of IhatOooumettt. <br />; a[e of vanfomla <br />Oounfyof prmrwa <br />i Nri r ,r <br />Co rmr <br />.. vp <br />n� 1 � e unry a <br />i.N rr rci i„ a 5aG zo, 20'IU <br />e0scribad and swont to (or affirmed) before me <br />on this l5' day Of 01-7 n('Ch ,., , 20 L, <br />by ^Date / t Month year <br />year <br />(1)_ <br />(and (2). �_ •--_'__��-------..._. ), <br />Name O/Slgn�T..� <br />proved to ms on the beats of setisfoctory evidence <br />to be the p000nlrf who appeared before me. <br />6lgnatura r:Z72 t-3�,,7t <br />ftnat mofNatal Ph <br />seal <br />Place Notary Seal Above <br />OPTIONAL --� <br />Though thls section Is opgone( OOMP1664b Pr/s Myonhatloh can dater elforarfao of the document or <br />fraudalent reattachment of this form to an tmlt'rtonded document. <br />Desorlptlon of Attached Donuuurnom <br />TWO or Type of Doeument:vuur" i��IRlvr7_ ,T{a v�'F � Document Date: ,,„„,,,_,,,,,,,,,� <br />. <br />Number of Pages:__ 5lgnsr(e) Other Than Named Above: <br />02014 National Notary Association • www.NatlonalNotory,or8 � 1� NOTARY (1.80M?(1 8827) Ite # <br />