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CLOVER FAMILY TRUST, HSSM 2006 FAMILY TRUST, AND REZA FASSIHI-2011
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CLOVER FAMILY TRUST, HSSM 2006 FAMILY TRUST, AND REZA FASSIHI-2011
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Last modified
4/23/2021 3:23:33 PM
Creation date
3/10/2011 5:30:21 PM
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Contracts
Company Name
CLOVER FAMILY TRUST, HSSM 2006 FAMILY TRUST, AND REZA FASSIHI
Contract #
A-2011-034
Agency
PUBLIC WORKS
Council Approval Date
2/22/2011
Destruction Year
p
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III CALIFORNIA ALL-PURPOSE III <br />CERTIFICATE OF ACKNOWLEDGMENT <br />State of California <br />County of (omat" C <br />On () 2 beforeme, �Q1 12�Qt , Ak®l <br />// (here insert name a d title of the <br />personally appeared `JO nos U �l Ig nJ kp S CI ®V f1C Q /U-C?I f <br />kk <br />who proved to me on the basis of satisfactory evidence to be the persorio whose namdM isAR)subscribed to <br />the within instrument and acknowledged to me that he/ a o executed the same in his� authorized <br />capacity and that by -his/her lIe signature on the instrument the person , or the entity upon behalf of <br />which the perso>4s -.Acted, 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 />�� <br />DANIELA BORBE <br />WITNESS my hand and official seal. N =1 <br />CommJ 1878676 in <br />NOTARY PUBLIC <br />ORANGE COUNTY <br />NY COMM. EXP. JAN. 21, 2011 of <br />Signature of Notary Public (Seal) <br />ADDITIONAL OPTIONAL INFORMATION <br />DESCRIPTION OF THE ATTA 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 />(Title) <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 on 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 />li tania (i.e. certifying the authorized capacity of the signer). Please check the <br />docu t carefully for proper notarial wording and attach [his form if required. <br />• State and Cou information must be the State and County where the document <br />signer(s) personal/ eared before the notary public for acknowledgment. <br />• Date of notarization mus a the date that the signer(s) personally appeared which <br />must also be the same date tbb4cknowledgment is completed. <br />• The notary public must print hiilr her name as it appears within his or her <br />commission followed by a comma an en your title (notary public). <br />• Print the name(s) of document signer(s) o personally appear at the time of <br />notarization. <br />• Indicate the correct singular or plural forms by cro g off incorrect forms (i.e. <br />he/she/they— is /are) or circling the correct forms. Failure correctly indicate this <br />information may lead to rejection of document recording. <br />• The notary seal impression must be clear and photographical eproducible. <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 with 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 />
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