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City of Santa Ana City Clerk's Office Use Only <br /> City Clerk <br /> AGREEMENT TERMINATION FORM <br /> Please complete this form in its entirety when the attached agreement and all <br /> amendments (if any) are no longer in effect. <br /> Note: If your agreement is grant related,please ensure that all grant retention requirements <br /> have been satisfied prior to signing the termination form. <br /> Is the agreement(s)a permanent record?Yes No CLERK <br /> Return form to the City Clerk's Office (M-30). `° 24 ` <br /> 30 <br /> Call 647-6520 if you have any questions. <br /> PROPERTY REGISTRATION CHAMPIONS, LLC <br /> The agreement with (PROCHAMPS) <br /> No. A-2017-377 was completed on and final payment has been made. <br /> (List all amendments. Use space below if needed.) <br /> PLANNING AND BUILDING AGENCY <br /> Department: <br /> Phone/Ext.: <br /> Signature: ollan <br /> Date: • <br /> iaagreementslformslform-agreement termination form_goldenrod.doc <br />