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CALIFORNIA ALL-PURPOSE <br />CERTIFICATE OF ACKNOWLEDGMENT <br />State of California <br />County of (QJ (Q'Lt �J <br />On IrnAI.l()W4 — before me, <br />insert name and title <br />personally appeared K�?A y�rzS I In I <br />who proved to me on the basis of satisfactory evidence to be the person( whose name(�t we subscribed to <br />the within instrument and acknowledged to me tha&sire/they executed the same in(�her/their authorized <br />capacity(ieli), and that b is her/"r signatures} on the instrument the person(s), or the entity upon behalf of <br />which the person(-s) acte , executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph <br />is true and correct. <br />WITNESS my hand and official seal. DANIELA BO! <br />emycM.W.JAN.3120141 <br />N07APr PUBLIC-CCALI OMA OPANOE camr1 CA!5 gV � � , <br />Signature o Notary Public (Seal) <br />ADDITIONAL OPTIONAL INFORMATION <br />DESCRIPTION OF THE ATTACHED DOCUMENT <br />(Title or description of attached document) <br />(Title or description of attached document continued) <br />Number of Pages _ Document Date <br />(Additional information) <br />CAPACITY CLAIMED BY THE SIGNER <br />❑ Individual (s) <br />❑ Corporate Officer <br />❑ Partner(s) <br />❑ Attorney -in -Fact <br />❑ Trustee(s) <br />❑ Other <br />INSTRUCTIONS FOR COMPLETING THIS FORM <br />Any acknowledgment completed in California must contain verbiage exactly as <br />appears above in the notary section or a separate acknowledgment form must be <br />properly completed and attached to that document. The only exception is if a <br />document is to be recorded outside of California. In such instances, any alternative <br />acknowledgment verbiage as may be printed an such a document so long as the <br />verbiage does not require the notary to do something that is illegal for a notary in <br />California (i,e. certifying the authorized capacity of the signer). Please check the <br />document carefully for proper notarial wording and attach this form ifrequired. <br />• Slate and County information must be the State and County where the document <br />signers) personally appeared before the notary public for acknowledgment. <br />• Date of notarization must be the date that the signer(s) personally appeared which <br />must also be the same dale the acknowledgment is completed. <br />• The notary public must print his or her name as it appears within his or her <br />commission followed by a comma and then your title (notary public), <br />• Print the morels) of document signer(s) who personally appear at the time of <br />notarization. <br />• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. <br />he/she/they-r is /ere) or circling the correct forms. Failure to correctly indicate this <br />information may lead to rejection of document recording. <br />• The notary seal impression must be clear and photographically reproducible. <br />Impression must not cover text or lines. If seal impression smudges, re -seal if a <br />sufficient area permits, otherwise complete a different acknowledgment form. <br />• Signature of the notary public must match the signature on file wish the office of <br />the county clerk. <br />Additional information is not required but could help to ensure this <br />acknowledgment is not misused or attached to a different document. <br />Indicate title or type of attached document, number of pages and date. <br />Indicate the capacity claimed by the signer. If the claimed capacity is a <br />corporate officer, indicate the title (i.e, CEO, CFO, Secretary). <br />• Securely attach this document to the signed document <br />CAPA 02.10.07 800-873- 5 www. otary asses.com <br />