Laserfiche WebLink
CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 <br />❑ See Attached Document (Notary to cross out lines 1-6 below) <br />❑ See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) <br />Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) <br />A notary public or other officer completing this certificate verifies only the identity of the individual who signed the <br />document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. <br />State of California <br />County of <br />Commission 4t 2147269 <br />Notary Public - California <br />oAngelesCounty <br />I Comm. E i ea 14c 2 020 <br />Subscribed and sworn to`� (or affirmed) before me <br />on this ,/ day of �� ; � 11 <br />by Date Month Year <br />(1)�.................. <br />(and <br />Name(s) of Signer(s) <br />proved to me on the basis of satisfactory evidence <br />to be the person(s) who appeared before me. <br />Signature <br />Signature of Notary Public <br />Seal <br />Place Notary Seal Above <br />OPTIONAL <br />Though this section is optional, completing this information can deter alteration of the document or <br />fraudulent reattachment of this form to an unintended document. <br />Description of Attached Document <br />Title or Type of Document: <br />Document Date: <br />Number of Pages: Signer(s) Other Than Named Above:. .................... <br />02014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5910 <br />