Laserfiche WebLink
Epic Land Solutions, Inc. <br />FULL ACQUISITION OFFSET STATEMENT <br />(Conforms to CalTrans Exhibit 8 -EX -18A) <br />loft <br />PERSONAL INFORMATION NOTICE <br />Pursuant to the Federal Privacy Act (P.L. 93-579) acid the Information Practices Act of 1977 (Civil Code Sections 1789, at seq.), notice is hereby given for the request <br />of personal information by this form, The requested personal information is voluntary. The principal purpose of the voluntary information is to facilitate the processing <br />of this form. The failure to provide all or any part of the requested information may delay processing of this form, No disclosure of personal information rvill be made <br />unless permissible under Article 6, Section 1798.24 of the IPA of 1977. Each individual has the right upon request and proper identification, to inspect all personal <br />information in any record maintained on the individual by an identifying particular, Direct any inquiries oil infomration maintenance to your IPA Office. <br />Co Rte Post Parcel No. <br />vi, e'T Z_e <br />Grantor <br />WHEREAS, The City of Santa Ana (City) seeks to acquire the fee -simple title to certain lands and buildings, <br />including that certain,building known as: I — - <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 true 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 />O written lease for a term ending �'e `� 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 due. <br />( ) That the following offsets are claimed by the undersigned tenants ( ), lessees ( ), against future rents: <br />