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<br />,,", <br /> <br />- <br /> <br />STATEMENT OF INFORMATION <br /> <br />Fidelity Tille &.Escrow maintains procedural safeguards thLlt comply with feeier-al slandards 10 protect the confidentiality and security of non-pubfic personal <br />infonnatlon. I hiS statement will serve to establish ide~tlly. eliminate matters affeding persons of similar name, proted you against forgeries, and speed <br />the completion of YOlJrfitle and escrow services. <br /> <br />rOMPLh'TlON OF T"TS FORM WTLT, HXPTiDTTE YOUR ORDER AND WILL "ET,P PROTHer VOTI. <br /> <br />Confidential information to be used in conjunction with order no. <br /> <br />NAME <br /> <br />FIRST <br /> <br />MILlDLE <br /> <br />LAST <br /> <br />YEAR OF BIRTH <br /> <br />SOC!Al. SF:CURITY NUMBER <br />lAX ..-i) =- <br /> <br />BIRTIIPALCF <br /> <br />J HAVE LIVED IN CALIFORNIA SINO:': <br /> <br />FIRST <br /> <br />MIDDLE <br /> <br />LAST <br /> <br />HIRTHPALCE <br /> <br />YFAR OF BIRTH <br /> <br />SOCIAL SECURITY NUMBER <br /> <br />I HAVE LIVED IN CALIFORNIA SINCE <br /> <br />WE WERE N1ARRfED ON ---1--1_AT <br /> <br />WIFE'S MAIDEN NAME <br /> <br />MY DmVER'S LICENSE NUMBER (STATE) <br /> <br />MY SPOUSE'S DRIVFR'S LICENSE NUMBEK (STATE) <br /> <br />RESIDENCE'S) FOR LAST 10 YEARS <br /> <br />---......................................... <br /> <br />NUMBER AND STREET <br /> <br />Glry <br /> <br />mOM <br /> <br />TO <br /> <br />~ <br /> <br />NUMBFR AND STREET <br /> <br />CI <br /> <br />FROM <br /> <br />TO <br /> <br />NUMBER AND STRI:.I:. T <br /> <br />Gny <br /> <br />FROM <br /> <br />TO <br /> <br />..--- <br /> <br />NUMBER,,~STREET <br /> <br />CITY <br /> <br />FROM <br /> <br />........................... ................................---......--................................................ <br /> <br />TO <br /> <br />HUSBAND <br /> <br />OCCUPATION(S) FOR LAST 10 YEARS <br /> <br />PRESENT OCCUPATION <br /> <br />FIRM NAME <br /> <br />ADDRESS <br /> <br />~' <br />-~ <br /> <br />NO. YEARS- <br /> <br />PRESENT OCCUPATION <br />WirE <br /> <br />FIRM NAME <br /> <br />DDRI::SS <br /> <br />NO. YEARS <br /> <br />PRESf::NT OCCUPATION <br /> <br />ME <br /> <br />ADDRESS <br /> <br />NO. YEARS <br /> <br />PRESENT occur <br /> <br />FIRM NAME <br /> <br />ADDRESS <br /> <br />NO. YEARS <br /> <br />~- <br /> <br />............................ <br />FORMER MARRIAGES <br /> <br />IF NO FORMER MARRIAGES, WRITE "NONE" <br /> <br />NAME Of- fORMER WIFE <br /> <br />DECEASED ( ) 0 <br /> <br />/ / <br />DATE FINAL <br /> <br />WHERE <br /> <br />NAMF OF FORME <br /> <br />AND <br /> <br />DECEASED ( ) DIVORCED ( <br /> <br />/ / <br />DATE FINAL <br /> <br />WHERE <br /> <br />-.................................. ...... <br />T I:: STREET ADDRESS or TilE PROPERTY IN THIS TRANSACTION IS: <br /> <br />SIGNATlJRF <br /> <br />DATE_f_f~ <br /> <br />SIGNATURE <br /> <br />DATE_f _/~ <br /> <br />~ <br /> <br />HOME TELEPHONE <br /> <br />L-J <br /> <br />BUSINESS PI-IONI:;: <br /> <br />PURPOSE OF THIS FORM <br />!l Is necessary to fill aut this form completely. as the information cont;'!ined IleJein wJII assist us to process you escrow more accurately and avoid lime delays. The <br />gr~1wirlg population or-Califomia has gre311y ot1e:clcd the processing of rea! esti'ite t~nsaCUOIl$, in that that are many people: With names thOlt are the silm: OJ ~imilar <br />10 YOIJr OWI1. Wlu:'rJ the title company searches the title of the property in this escrow, they want to make $ure that they there are no Judgments. bankruptcies, Income <br />lax lIens or any other sitlJC'ltiolllhallllay effect you or the property. The information on thiS form allows them 10 rejecl ail matters that do not effect you. <br />