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RAPHAEL, AMY
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Last modified
4/4/2022 4:02:10 PM
Creation date
10/8/2021 4:09:20 PM
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Template:
Contracts
Company Name
RAPHAEL, AMY
Contract #
A-2021-115
Agency
Planning & Building
Council Approval Date
7/6/2021
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CAUFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL <br />.. <br />Ak notary public or other officer completing this certificate verifies only the Identity of the individual who signed the <br />document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. <br />State of <br />County of <br />On U �I til 2°i before me, N "°'2'rA/t� cJi�T%K r /1%USA ��(�v°b <br />�G <br />Date n P ,Heel Insert Name and Title of the Officer <br />personally appeared 1 j/ <br />Name(s) of Signers) - <br />who proved to me on the basis of satisfactory evidence to be the person(s�whose name(4 is/are' <br />subscribed to the within instrument and acknowledged to me that he/she/they executed the same in <br />his/her/then authorized capacity(ies), and that b Ns/her/their signature(s),on the instrument the person(sr <br />or the entity upon behalf of which the person(d) acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws <br />of the State of Cplif�mis that the foregoing paragraph <br />Is true and corn ct <br />WITNESS <br />RAMZAN JATTALA <br />ConlAa. # 2142155 <br />N C NOTARY P111IC-CALff0RNiA N <br />"�^' MY CoMM�ExP, BOUTy <br />NNE 8, 2U2t '• <br />of Notary Public <br />Place Notary Seal Above <br />OPTIONAL <br />Though this section is optional, completing this information can deter alteration of the document or <br />fraudulent reattachment of this forrr9 to an unintended document. <br />Description of Attached Document <br />Title or Type of Document: <br />Number of Pages: <br />Document Date: <br />Signer(s) Other Than Named Above: <br />Capacity(ies) Claimed by Signer(s) <br />Signer's Name: <br />❑ Corporate Officer — Title(s): <br />❑ Partner — ❑ Limited ❑ General <br />❑ Individual CJ Attorney in Fact <br />❑ Trustee ❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />Signer's Name: <br />CI Corporate Officer — Title(s): <br />❑ Partner — ❑ Limited ❑ General <br />❑ Individual I Attorney in Fact <br />❑ Trustee ! ] Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />02014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 <br />
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