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CROCKETT, DAVID C. & GLORIA J.-2015
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CROCKETT, DAVID C. & GLORIA J.-2015
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Last modified
12/3/2015 2:13:15 PM
Creation date
12/2/2015 5:05:44 PM
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Contracts
Company Name
CROCKETT, DAVID C. & GLORIA J.
Contract #
A-2015-189
Agency
PLANNING & BUILDING
Council Approval Date
9/1/2015
Expiration Date
9/1/2025
Destruction Year
0
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if cMN <br />CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT CIVIC CODE § 1189 <br />A notary public or other officer completing this certificate verifies only the identity of the individual who signed the <br />document to which this certificate is attached, and not the truthfulness, accurac , or validity of that document. <br />State of California <br />County of Orange SS. <br />On October 14, 2015 , before me, Karen C. Gerardo, Notary Public <br />Date Name and Title of Officer (e.g., "Jane Doe, Notary Public ") <br />personally appeared David Crockett and Gloria Jetter Crockett <br />� Narre(s) of Signer(s) <br />who proved to me on the basis of satisfactory evidence to be the person(s) whose name (s) <br />-rsr subscribed to the within instrument and acknowledged to me that - he/she e <br />executed he same in i°rislher ei authorized capacity(ies), and that by <br />Kk,�4heh heir signature(s) on the instrument the person(s), or the entity upon behalf of which <br />the person(s) acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under <br />w- the laws of the State of California that the <br />IGOKAREN C:aERAROO foregoing paragraph is true and correct. <br />Commission N 2111280 <br />Notary range County WITNESS my hand and official seal. <br />Mv Orange County <br />Comm. E im Jun 10 20121 <br />Signature of Notary Public <br />Place Notary Seal Above <br />OPTIONAL <br />Though this section is optional, completing this information can deter alternation of the document or fraudulent <br />reattachment of this form to an unintended document <br />Description of Attached Document <br />Title or Type of Document: <br />Document Date: Number of Pages: <br />Signer(s) Other Than Named Above: <br />Signer's Name: <br />b <br />Capacity(ies) Claimed by Signer(s) <br />H ❑ Individual ❑ Individual <br />❑ Corporate Officer— Title(s): ❑ Corporate Officer — Title(s): <br />❑ Partner -- ❑ Limited ❑ General ❑ Partner -- ❑ Limited ❑ General <br />❑ Attorney in Fact ❑ Attorney in Fact <br />❑ Trustee ❑ Trustee <br />❑ Guardian or Conservator ❑ Guardian or Conservator <br />❑ Other: ❑ Other: <br />Signer is Representing: Signer is Representing: <br />e <br />K <br />W9149 �S •S J S <br />
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