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CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 <br />,"/See Attached Document (Notary to cross out lines 1 -6 below) <br />❑ See Statement Below (Lines 1 -6 to be completed only by document signer[s], not Notary) <br />Signature of Document Signer No. 1 <br />State of California p <br />County of 1 <br />] ARIANA V S <br /># 195 <br />7 ",� Commission # 1958023 <br />Notary Public • California z <br />Riverside County n <br />M Comm. Expires Oct 24, 2015 <br />Place Notary Seal Above <br />Signature of Document Signer No. 2 (If any) <br />Subscribed and sworn to (or affirmed) before me <br />on this day of HWQAA 20 , <br />Date Month Year <br />by <br />(1) <br />Name of Jigner <br />proved to me on the basis of satisfactory evidence <br />to be the person who appeared before me <br />(and <br />(2) Name of Signer <br />proved to me on the basis of satisfactory evidence <br />to be the person who appeare efore me.) <br />Signature <br />Signature of Notary Public <br />OPTIONAL <br />Though the information below is not required by law, it may prove valuable <br />to persons relying on the document and could prevent fraudulent removal <br />and reattachment of this form to another document. <br />Further Description of Any Attached Document <br />Title or Type of Document: <br />Document Date: <br />Named Above: <br />Number of Pages: <br />Top of thumb here <br />2010 National Notary Association • NationalNotary.org • 1- 800 -US NOTARY (t- 800 - 878 -6827) Item #5910 <br />