Laserfiche WebLink
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 <br />A notary publ ic or other officer completing this certificate verifies only the identity of the individual who signed the <br />document to which th is certificate is attached, and not the truthfulness, accuracy, or validity of that document. <br />State of California <br />County of _H_u_m_b_o_ld_t ________ _ <br />On~ 1./hJt df)i71 before me, Danika L. Mott, Notary Public <br />Date Here Insert Name and Title of the Officer <br />personally appeared ---"-'M'"""a=-n.;....:u=e'--'-l ~M-=--=e=ll-=o ________________________ _ <br />Name(s) of Signer(s) <br />who proved to me on the basis of satisfactory evidence to be the person~ whose name~) is/~ <br />subscribed to the within instrument and acknowledged to me that he/~ executed the same in <br />his/~ authorized capacity(~, and that by his~r signature~ on the instrument the person~), <br />or the entity upon behalf of which the person(!) acted, executed the instrument. <br />......... I <br />DANIKA L. MOTT <br />No t ary Pub li c • California <br />Humbo ldt County z <br />Commission ft 2429963 <br />Place Notary Seal Above <br />-I certify under PENAL TY OF PERJURY under the laws <br />of the State of California that the foregoing paragraph <br />is true and correct. <br />WITNESS my hand and official seal. <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: _____________ Document Date: _______ _ <br />Number of Pages : ___ Signer(s) Other Than ~amed Above : ___________ _ <br />Capacity(ies) Claimed by Signer(s) <br />Signer's Name : ____________ _ <br />D Corporate..Q.fficer -Title(s): ______ _ <br />~ <br />Partner -LI Lim ited D General <br />Individual B Attorney in Fact <br />Trustee Guardian or Conservator <br />Other: _____________ _ <br />Signer's Name: ____________ _ <br />D Corporate Officer -Title(s): ______ _ <br />D Partner -D Limited D General <br />0 Individual BAttorney in Fact <br />B <br />Trustee Guardian or Conservator <br />Other: _____________ _ <br />Signer Is Representing : _________ _ Signer Is Representing : ________ _ <br />©2014 National Notary Association· www .NationalNotary .org • 1-800-US NOTARY (1 -800 -876 -6827) Item #5907 <br />Docusign Envelope ID: 79841C54-82E6-4BAA-9720-C2DA6E20B8F6