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Epic Land Solutions, Inc, <br />FULL ACQUISITION OFFSET STATEMENT <br />(Conforms to Caffrans Rshibit. SZX•l 8A) Page t orz <br />F PERSONAL WORMATIONNO'f10E <br />Pursuont to the Federal Privacy Act (PI. 93-579) raid die Infonn;ition Practices Act of 1977 (Civil Code Sections 1759, et seq.), notice is hereby given for the request <br />of personal information by this form. The requested personal information is volumary. The principal purpose ofihe voluntary hrronamion is to fmcllitdte the processing <br />of this roan, The failure toprovide all or any part of the requcsted information may delay processing of this form. No disclosure of personal information will be made <br />unless permissible under Article 6, Section 1798.24 of Elie 1PAof 1977. Each individual has the rightupon request mid proper identlfleatlon, to inspect all personal <br />information in any record maintained on the individual by an Identilying partkhdar. Direct any inquiries oa information maintmnaade to your IPA Office. <br />Co Rte Past Parcel No. <br />Granter <br />WHEREAS, The City of Santa Ana (City) seeks to acquire the fee - simple title to certain lands and buildings, <br />including that certain buildinglarci as; 1 n <br />and, <br />(Address) <br />WHEREAS, the City and the owner of said building are negotiating a sale of said building. <br />NOW, THEREFORE, The undersigned makes the following statement of facts and represents to the City that <br />each of said facts are trite and correct in every detail. <br />That the undersigned are the tenants in possession under the terms of: <br />1, O An oral lease from month -to -month <br />() written lease for a tern ending �D' `C at a monthly rental of <br />$ �0 and that the undersigned has paid all rents to and including the _ day of <br />year , and has paid no rents beyond said date except <br />2. That the last rental payment was made to and that the next rental payment of $ will be due and <br />payable on the day of , year <br />3. ( ) That no offsets are claimed by the undersigned tenants and /or lessees against any rents which have been <br />paid or which may hereafter become duo. <br />( ) That the following offsets are claimed by the undersigned tenants ( ), lessees ( ), against future rents: <br />25D -16 <br />