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80A - JOINT - ACQUISITION 1126-1146 WASHINGTON
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80A - JOINT - ACQUISITION 1126-1146 WASHINGTON
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Last modified
6/30/2016 4:16:59 PM
Creation date
6/30/2016 3:36:28 PM
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
80A
Date
7/5/2016
Destruction Year
2021
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EXHIBIT C <br />FIRPTA CERTIFICATE <br />TRANSFEROR'S CERTIFICATE OF NON - FOREIGN STATUS <br />To inform the City of Santa Ana, California, a charter city and municipal corporation <br />organized under the Constitution and laws of the State of California ( "Transferee "), that withholding <br />of tax under Section 1445 of the Internal Revenue Code of 1986, as amended ( "Code ") will not be <br />required upon the transfer of certain real property to the Transferee by the Housing Authority of the <br />City of Santa Ana (the, "Transferor°'), the undersigned hereby certifies the following: <br />1. The Transferor is not a foreign person or citizen, foreign corporation, foreign <br />partnership, foreign nest, or foreign estate (as those terns are defined in the Code and the Income <br />Tax Regulations promulgated thereunder); <br />2. The Transferor's social security number or U.S. employer identification number is as <br />follows: <br />3. The Transferor's home or office address is: <br />Housing Authority of the City of Santa Ana <br />20 Civic Center Plaza (M -26) <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />The Transferor understands that this certification may be disclosed to the Internal Revenue <br />Service by the Transferee and that any false statement contained herein could be punished by fine, <br />imprisonment or both. Under penalty of perjury, I declare that I have examined this certification and <br />to the best of my knowledge and belief it is true, correct and complete, and I further declare that I <br />have authority to sign this document. <br />Housing Authority of the City of Santa Ana <br />Robert C. Cortez <br />Special Assistant to the City Manager <br />C -1 <br />80A -31 <br />
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