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Property OWNER'S AFFIDAVIT <br />I hereby certify that I am the legally authorized owner of all property involved in this <br />application or have been empowered to sign as the property owner on behalf of a <br />corporation, partnership, business, etc., as evidenced by separate instrument attached <br />herewith. I hereby grant to the applicant submitting this form full power to sign all <br />documents related to this application, including any conditions or litigation measures as <br />may be deemed necessary. <br />I declare under penalty of perjury that the foregoing is true and correct. <br />Executed on (Date) 1a 1,015 at 915y od 4iM California <br />Property Owner's Signature c✓ <br />Property Owner's Printed Na Sohalll Bokhad / <br />Director of Land <br />APPLICANT'S AFFIDAVIT <br />I hereby certify that the statements furnished above and in the attached exhibits <br />represent the data and information required for this initial evaluation and that the facts, <br />statements and information presented are true and correct to the best of my knowledge <br />and belief. Further, should the stated information be found false or insufficient, I agree <br />to the return of this form for appropriate revisions, understanding the City of Santa Ana <br />cannot process this form until all applicable information is corrected or provided by the <br />applicant. I hereby certify that I have been legally authorized by the property owner to <br />present this application and to sign on behalf of all documents related to this application, <br />including any conditions or litigation measures as may be deemed necessary. <br />Note: When the applicant is a corporation, partnership, business, etc., a separate <br />document verifying the authorization to sign for such applicant is required, <br />I declare under penalty of perjury that the foregoing is true and correct. <br />Executed on (Date) at , California <br />Applicant's Signature <br />Applicant's Printed Name <br />Page 4 of 4 <br />S:p1ann1nglC1erica6,Counler Forms \HOOapplication <br />1/15 <br />