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20B - AGMT AND AA - FOSAZ
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02/18/2014
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20B - AGMT AND AA - FOSAZ
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Last modified
2/13/2014 3:09:52 PM
Creation date
2/13/2014 3:05:20 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Parks, Recreation, & Community Services
Item #
20B
Date
2/18/2014
Destruction Year
2019
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STATE OF CALIFORNIA \)`5(NC <br />BUSINESS, TRANSPORTATION AND HOUSING AGENCY .to <br />DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT ® "„ <br />DIVISION OF CODES AND STANDARDS qk <br />REGISTRATION AND TITLING PROGRAM 1%oEU�4o <br />POWER OF ATTORNEY <br />SECTION I. DESCRIPTION OF UNIT <br />This unit is a: <br />7 Manufactured Home /Mobilehome Commercial Modular E] Floating Home ❑ Truck <br />Camper <br />The Decal (License) No, (s) of the unit is: _ C U-31-7 5 <br />l •. 0 1 lA n_ 1 A_ <br />The Trade Name of the unit is: <br />The Serial No. (s) of the unit is: <br />SECTION ll. APPOINTMENT OF ATTORNEY -IN -FACT <br />To the Department of Housing and Community Development, and to whom it may concern: <br />(PRINT FULL NAME) <br />fLest) <br />the <br />(Middle) <br />first) <br />M <br />Mrso p (Middle) <br />® <br />do hereby duly appoint the following named person, a lane Mcf+, <br />to act Via' my attorney in fact, only to sign papers and documents that may be necessary in order to <br />secure California registration of or to transfer my interest in the above described unit. <br />SECTION 111, ASSIGNOR'S CERTIFICATION <br />I agree to guarantee and save harmless the State of California and the Director of Housing <br />and Community Development from all responsibility which might accrue from the issuance <br />of California registration or transfer of such unit. <br />NOTE:. An attorney in fact cannot make an affidavit or certificate of the truth of facts <br />unknown to him. <br />Signed Date <br />Signed <br />HC61475A,(rmv 0306) <br />r1- <br />Date <br />Date <br />
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