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25B - AGMT - HOUSING M AND A GABAEE
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25B - AGMT - HOUSING M AND A GABAEE
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Last modified
8/10/2017 6:32:46 PM
Creation date
8/10/2017 6:23:13 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Community Development
Item #
25B
Date
8/15/2017
Destruction Year
2022
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Property OWNER'S AFFIDAVIT <br />I hereby certify that i am the legally authorized owner of all property Involved in this application <br />or have been empowered to sign as the property owner on behalf of corporation, partnership, <br />business, etc., as evidenced by separate Instrument attached herewith. I hereby grant to the <br />applicant submitting this form full power to sign alldocuments related to this application, <br />sures <br />including any conditions or litigation meaas rt be deemed necessary, <br />I declare under penalty of perjury that the foreg i 1 i 66 and correct. <br />Executed on (Date) June za, zoiset s An ele California <br />Property Owner's Signature <br />Property Owner's Printed Name Arman Gabay <br />APPLICANT'S AFFIDAVIT <br />I hereby certify that the statements furnished above and in the attached exhibits represent the <br />data and Information required for this Initial evaluation and that the facts, statements and <br />information presented are true and correct to the best of my knowledge and belief. Further, <br />should the stated Information be found false or Insufficient, I agree to the return of this form for <br />appropriate revisions, understanding that the City of Santa Ana cannot process this form until all <br />applicable information is corrected or provided by the applicant. I hereby certify that I have <br />been legally authorized by the property owner to present this application and to sign on behalf of <br />all documents related to this application, including any conditions or litigation measures as may <br />be deemed necessary. <br />Note: When the applicant is a corporation, partnership, business, etc., a separate document <br />verifying the authorization to sign for such applicant is required. <br />I declare under penalty of perjury that the foregoing is true and correct. <br />Executed on (Date) June 2 at Los Angeles California <br />Applicant's Signature <br />Applicant's Printed Name p n Lao <br />Page 4 of 4 <br />S;PldnninpiClc�iaal•Oounle� FormMQOappftauoo <br />11119 <br />25B-30 <br />
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