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20B - AA - RESTROOM 3RD AND BIRCH
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06/21/2016
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20B - AA - RESTROOM 3RD AND BIRCH
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Last modified
7/28/2016 11:13:09 AM
Creation date
6/16/2016 3:09:04 PM
Metadata
Fields
Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
20B
Date
6/21/2016
Destruction Year
2021
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A notary public or other officer completing this certificate verifies only the identity of <br />the individual who signed the document to which this certificate is attached, and not <br />the truthfulness, accuracy, or validity of that document. <br />State of California <br />County of t- ' /woi -S <br />4 (^ <br />Subscribed and sworn to (or affirmed) before me on this l day of <br />. r <br />20 (b- by Jo y <br />proved to me on the basis of satisfactory evidence to be the personal who appeared <br />before me. <br />r \ <br />Signature (seal) <br />[43:6111 ' tie] ? /_\111111I I3i ;1T7rifi il�7a <br />DESCRIPTION OF THE ATTACHED DOCUMENT <br />{Title or description of attached document) <br />(Title or description of attached document confined) <br />Number of Pages — Document Date <br />Additional information <br />201E Version v,ww,RiotaryClass,.oain 80CG$73 -A865 <br />RICARDC MAGNt3 <br />COMM. #2123529 z <br />X. Orr Notary Public • California b <br />z �± Los Angeles County <br />M . Ccmmm- <br />, y Ezpiros Sep. 11, 2pi8 <br />INSTRUCTIONS <br />The wording of all Jurats completed in California after January 1, 2015 must be in the to= <br />as set forth within this Jurat. Thera are no exceptions. If a Jmat to be completed does not <br />follow this form, the notary must correct the verbiage by using a just stamp containing the <br />correct warding or attaching a separate jurat form such as this one with does contain the <br />proper wording. In addition, the notary must require an oath or affirmation from the <br />document slgner regarding the truthfulness of the contents of the document, The <br />document must be signed AFTER the oath or affirmation. If the document was previously <br />signed, Nmust he ra- signed in front of the notarypubllc during thejuret process. <br />• State and county information must be the slate and county where the <br />document signers) personally appeared before the notary public. <br />• Date of notarization must be the date the stgner(s) personally <br />appeared which must also be the same date the jurat process Is <br />completed. <br />• Print the names) of the document signer(s) who personally appear at <br />the time of notarization. <br />• Signature of the notary public must match the signature on file with the <br />office of the county clerk, <br />• The notary seal impression must be dear and photographically <br />reproducible, Impression must not cover text or lines. If seal Impression <br />smudges, re -seal if a sufficient area permits, otherwise complete a <br />different just form. <br />Additional information Is not required but could help <br />to ensure this jurat is not misused or attached to a <br />different document. <br />Indicate title or type of attached document, number of <br />pages and date, <br />• Securely attach this document to the signed document with a staple. <br />20B -13 <br />
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