HomeMy WebLinkAboutC-6392 - Grant of Easement for Pedestrian PurposesK�' RECORDING REQUESTED AND
M� WHEN RECORDED RETURN TO:
'J CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
POST OFFICE BOX 1768
NEWPORT BEACH, CA 92659-1768
Recorded in Official Records, Orange County
Hugh Nguyen, Clerk -Recorder
1111 � � $1 � 11 1 11 11 Hj� ]�j 111 (11 NO FEE
*$ R 0 0 0 7 5 8 1 6 4 3$
201500029278110:37 am 06/05/15
227 406 E01 14
0.00 0.00 0.00 0.00 39.00 0.00 0.00 0.00
Recording Fee: Exempt (Space above this line Recorder's use)
(Government Code — Section 6103)
GRANT OF EASEMENT FOR
PEDESTRIAN PURPOSES
FOR VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, UPTOWN
NEWPORT JAMBOREE, LLC, a Delaware limited liability company, owner of certain real property
described herein situated in the City of Newport Beach, County of Orange, State of California, hereby
grants to the CITY OF NEWPORT BEACH, a municipal corporation, for public purposes, a permanent,
non-exclusive pedestrian easement in, over, under, along, and across said certain real property described
in Exhibit "A" and shown on Exhibit "B", which exhibits are made part of this document.
Dated: e'aer� _, 201
UPTOWN NEWPORT JAMBO , LLC, a elaware limited liability company
By: eA 4
William A. Shopoff, Manag
RECORDING REQUESTED AND
WHEN RECORDED RETURN TO:
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
POST OFFICE BOX 1768
NEWPORT BEACH, CA 92659-1768
Recording Fee: Exempt (Space above this line Recorder's use)
(Government Code — Section 6103)
GRANT OF EASEMENT FOR
PEDESTRIAN PURPOSES
FOR VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, UPTOWN
NEWPORT JAMBOREE, LLC, a Delaware limited liability company, owner of certain real property
described herein situated in the City of Newport Beach, County of Orange, State of California, hereby
grants to the CITY OF NEWPORT BEACH, a municipal corporation, for public purposes, a permanent,
non-exclusive pedestrian easement in, over, under, along, and across said certain real property described
in Exhibit "A" and shown on Exhibit "B", which exhibits are made part of this document.
Dated: . _, 2014.
UPTOWN NEWPORT JAMBO , LLC, a elaware limited liability company
By:
William A. Shopoff, Manag
CALIFORNIA -PURPOSE ACKNOWLEDGMENTr
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California )
County of ,- nt-11 r) -,j)
, I' J�
On Gl o�0 before me, `%�✓t' (N
Date H redoAh
rt Name a d itle of the
personally appeared J 1(f A r-
1-
Name(s) of
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s),
or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
TERRI HOVDESTAD WITNESS my hand nd ici a .
commission # 2070020
a° rm . Notary Public - California D
Z Orange County
Signature
M Comm. Ex ires Jun 28, 2018
u
Place Notary Seal Above
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Do ument -_
Title or Type of Document: r rt>1, CCAOr .IJ�— Document Date: af-Acj01�-
Number of Pages: Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
02014 National Notary Association • www.NationaiNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907
EXHIBIT "A"
LEGAL DESCRIPTION
LEGAL DESCRIPTION
PEDESTRIAN WALKWAY EASEMENT
Parcel "A"
EXHIBIT 66A"
Sheet 1 of 2
Being a portion of Parcel 4 of Parcel Map No. 2013-108, in the City of Newport Beach, County of
Orange, State of California, per map filed in Book 378 of Parcel Maps at Pages 10 through 12,
inclusive, described as follows:
Commencing at the most westerly corner of Parcel 1 of said Parcel Map; thence North 40038'21"
East, 70.34 feet along the common line of said Parcel 1 and Parcel 4 to the POINT OF BEGINNING,
said point also being the beginning point of a non -tangent curve, concave easterly, having a radius of
100.00 feet, a radial line to said point bears South 84°51'47" West; thence northerly, along said
curve, through a central angle of 06026'42" a distance of 11.25 feet to the beginning point of a
reverse curve, concave westerly, having a radius of 42.00 feet, a radial line to said point bears South
88°41'31" East; thence northerly along said curve, through a central angle of 50°40'08" a distance of
37.14 feet; thence North 49°21'39" West, 33.94 feet to the beginning point of a non -tangent curve,
concave southwesterly, having a radius of 54.00 feet, a radial line to said point bears North 01 041'48"
East, said curve being concentric with and 12.00 feet northeasterly of said curve having a radius of
42.00 feet; thence easterly and southerly along said curve, through a central angle of 86052'46" a
distance of 81.88 feet to a point on said common line; thence South 40038'21" West, 17.84 feet
along said common line to the POINT OF BEGINNING.
Containing 841 square feet more or less.
See Exhibit "B" for a plat depicting the above described land.
Parcel "B"
Being a portion of Parcel 4 of Parcel Map No. 2013-108, in the City of Newport Beach, County of
Orange, State of California, per map filed in Book 378 of Parcel Maps at Pages 10 through 12,
inclusive, described as follows:
Commencing at the most easterly corner of said Parcel 4; thence South 40°38'21" West, 577.33 feet
along the boundary of said Parcel 4 to an angle point therein; thence South 40°38'21" West, 10.04
feet along the southwesterly projection of said boundary to the POINT OF BEGINNING; thence
continuing South 40038'21" West, 15.02 feet along said projection to the beginning point of a non -
tangent curve, concave southwesterly, having a radius of 55.00 feet, a radial line to said point bears
North 36057'31" East; thence northwesterly, along said curve, through a central angle of 23°19'54" a
distance of 22.40 feet to a point in a line parallel with and 30.05 feet northeasterly of the northeasterly
line of Parcel 3 of said Parcel Map; thence North 49°21'39" West, 25.01 feet along said parallel line
to the beginning point of a non -tangent curve, concave southwesterly, having a radius of 70.00 feet,
a radial line to said point bears North 04056'02" West, said curve being concentric with and 15.00
feet northeasterly of said curve having a radius of 55.00 feet; thence easterly, along said curve,
through a central angle of 42040'55" a distance of 52.15 feet to the POINT OF BEGINNING.
Containing 570 square feet more or less.
See Exhibit "B" for a plat depicting the above described land.
S:\100288\Mapping\Legals-Plats\Sidewalk Easements\Sidewalk Easment.doc
EXHIBIT "A"
Sheet 2 of 2
Parcel "C"
Being a portion of Parcel 4 of Parcel Map No. 2013-108, in the City of Newport Beach, County of
Orange, State of California, per map filed in Book 378 of Parcel Maps at Pages 10 through 12,
inclusive, described as follows:
BEGINNING at the most northerly corner of Parcel 1 of said Parcel Map; thence course "A", South
49°21'39" East, 235.85 feet along the common line of said Parcel 1 and Parcel 4; thence course "B",
North 85°38'21" East, 72.96 feet; thence course "C", North 40°38'21" East, 161.24 feet to the
beginning of a curve, concave southeasterly, having a radius of 168.00 feet, hereafter referred to as
curve "A"; thence northeasterly, along said curve, through a central angle of 19°33'25" a distance of
57.34 feet; thence course "D", North 60011'46" East, 113.56 feet to the beginning of a curve,
concave northwesterly, having a radius of 132.00 feet, said curve being concentric with and 18.00
feet northwesterly of a curve, having a radius of 150.00 feet in the boundary of said Parcel 4,
hereafter referred to as curve "B"; thence northeasterly, along said curve, through a central angle of
19033'09" a distance of 45.05 feet; thence North 03°23'11" East, 24.63 feet to the beginning point of
a non -tangent curve, concave southeasterly, having a radius of 70.00 feet, a radial line to said point
bears North 46°27'40" West; thence southwesterly, along said curve, through a central angle of
02053'59" a distance of 3.54 feet to a line parallel with and 33.00 feet northwesterly of the boundary
of said Parcel 4; thence South 40038'21" West, 16.06 feet along said parallel line to the beginning of
a curve, concave northwesterly, having a radius of 117.00 feet, said curve being concentric with and
15.00 feet northwesterly of said curve "B"; thence southwesterly, along said curve, through a central
angle of 19°33'09" a distance of 39.93 feet to a point in a line parallel with and 15.00 feet
northwesterly of said course "D"; thence South 60°11'46" West, 113.56 feet along said parallel line to
the beginning of a curve, concave southeasterly, having a radius of 183.00 feet, said curve being
concentric with and 15.00 feet northwesterly of said curve "A"; thence southwesterly, along said
curve, through a central angle of 19033'25" a distance of 62.46 feet to a point in a line parallel with
and 15.00 feet northwesterly of said course "C"; thence South 40038'21" West, 155.03 feet to a point
in a line parallel with and 15.00 feet northerly of said course "B"; thence South 85°38'21" West, 64.78
feet along said parallel line to a point in a line parallel with and 12.00 feet northeasterly of said course
"A"; thence North 49°21'39" West, 226.63 feet along said parallel line; thence South 40°38'21" West
12.00 feet to the POINT OF BEGINNING.
Containing 9,566 square feet more or less.
See Exhibit "B" for a plat depicting the above described land.
This real property description has been prepared by me, or under my direction, in conformance
with the Professional Land Surveyors Act.
Signature A�— /I -A&
William G. Hoff, PLS 6685
License Expires 6/30/16
Date ! a , l �--
S:\100288\Mapping\Legals-Plats\Sidewalk Easements\Sidewalk Easment.doc
EXHIBIT "B"
GRAPHIC DEPICTION OF PEDESTRIAN EASEMENT AREA
P.O.C. /
MOST W'LY
CORNER
PARCEL 1
LINE TABLE
NO. BEARING DISTANCE
L1 N40°38'21 "E
70.34'
L2 N49°21'39"W
33.94'
L3 S40'38'21 "W
17.84'
L1
L3
`PcP�,•J
�,`� 12.00'
_G
F
P.O.B./�
TITLE: PEDESTRIAN WALKWAY
EASEMENT
CITY OF NEWPORT BEACH
moos. Hall & Foreman, Inc.
Engineering - Planning - Surveyinc
14297 CAJON AVE, SUITE 101 VICTORVILLE, CA 92392 760-524-9100
DATE OF PREPARATION: 10/01/2014
EXHIBIT "B"
SHEET 1 OF 3
CURVE TABLE
NO. DELTA
RADIUS
LENGTH
C1 06°26'42"
100.00'
11.25'
C2 50°40'08"
42.00'
37.14'
C3 86°52'46"
54.00'
81.88'
PARCEL "A»
841± S.F.
10
4�Zp��$�1p.12
� �B
LEGEND
P.O.C. POINT OF COMMENCING
P.O.B. POINT OF BEGINNING
PEDESTRIAN WALKWAY
EASEMENT
LINE TABLE
NO. BEARING DISTANCE
L1 S40°38'21 "W
10.04'
L2 S40°38'21 "W
15.02'
L3 N49°21'39"W
25.01'
EXHIBIT "B"
SHEET 2 OF 3
CURVE TABLE
NO. DELTA RADIUS LENGTH
C1 42'40'55" 70.00' 52.15'
C2 23'19'54" 55.00' 22.40'
1`0$
Z�13,
`�Pp1
PARCEL OT
570± S.F.
30.05'i
S40°38'21 "W 577.33'
L2 L1
P.O.B.
TITLE: PEDESTRIAN WALKWAY
EASEMENT
CITY OF NEWPORT BEACH
moor Hall & Foreman, Inc.
Engineering • Planning o Surveying
14297 CAJON AVE, SUITE 101 VICTORNLLE, CA 92392 760-524-9100
DATE OF PREPARATION: 10/01/2014
P.O.C.
MOST E'LY
CORNER
PARCEL 4
LEGEND
P.O.C. POINT OF COMMENCING
P.O.B. POINT OF BEGINNING
PEDESTRIAN WALKWAY
EASEMENT
ki
P.O.B• /
MOST N'LY
CORNER
PARCEL 1
CURVE TABLE
NO.
DELTA
RADIUS
LENGTH
C1
19°33'25"
168.00'
57.34'
C2
19°33'09"
132.00'
45.05'
C3
02°53'59"
70.00'
3.54'
C4
19°33'09"
117.00'
39.93'
C5
19°33'25"
183.00'
62.46'
L11
12.00'
_o
_ J
J
�RG�L 1
� o0
509n
NRSE "B"
EXHIBIT "B"
SHEET 3 OF 3
LINE TABLE
NO.
BEARING
DISTANCE
L1
S49'21'39"E
235.85'
L2
N85°38'21 "E
72.96'
L3
N40'38'21"E
161.24'
L4
N60'11'46"E
113.56'
L5
NO3'23'11"E
24.63'
L6
S40°38'21 "W
16.06'
L7
S60*11'46"W
113.56'
L8
S40°38'21"W
155.03'
L9
S85°38'21 "W
64.78'
L10
N49'21'39"W
226.63'
L11
S40'38'21 "W
12.00'
� PRC�L 013-1�$-12
PARCEL "C"
9,566± S.F.
0
L8 C5
L3 C1t"'D"'
COURSE "C"CURVE "A"COUR
Agc.�L3 CURVE "B"
C2 M5L5 I
1
09
0 0
I
Q
Cti I�
1�
1�
TITLE: PEDESTRIAN WALKWAY
1
EASEMENT
CITY OF NEWPORT BEACH !�
Moor Hall &ForemanLEGEND
MMIr ,, Inc. P.O.B. POINT OF BEGINNING
Engineering • Planning • SurveyingPEDESTRIAN WALKWAY
14297 CAJON AVE, SUITE 101 • 41CTORVILLE, CA 92392 760-524-9100 F/71 EASEMENT
DATE OF PREPARATION: 10/01/2014
CONSENT AND SUBORDINATION
The undersigned, as Beneficiary under that certain Deed of Trust, Assignment of Leases and Rents
and Security Agreement made by UPTOWN NEWPORT JAMBOREE, LLC, a Delaware limited liability
company, as "Trustor", to FIRST AMERICAN TITLE INSURANCE COMPANY, as "Trustee", in favor
of PFP HOLDING COMPANY III, LLC, a Delaware limited liability company, as `Beneficiary," dated
March 21, 2014, and recorded on March 21, 2014 in the Official Records of Orange County, California,
as Instrument No. 2014000107704 ("Deed of Trust"), hereby expressly and unconditionally consents to,
and subordinates the Deed of Trust and all of its beneficial interests thereunder to the foregoing Grant of
Easement For Pedestrian Purposes between Uptown Newport Jamboree, LLC, a Delaware limited
liability company, and the City of Newport Beach, a municipal corporation, to which this Consent and
Subordination is attached.
U�®��
Dated: I►F , 201
PFP HOLDING COMPANY III, LLC, a Delaware limited liability company
By: Prime Financa'partners III, Inc.,
a Maryland/gr/poration, its Managing Member
By: t/
Name: / " Jon W. Brayshaw
Titl �: / Authorized Signatory
STATE OF 7c
'K e lfZJ7Q�%k ) ss.
COUNTY OF 6- )
On Z , 2014, before me, the undersigned, a Notary Public in and for said State,
personally a eared illy. U� who proved to me on the basis of satisfactory evidence
to be the person(s) w se name(s) is%are subscribed to the within instrument and acknowledged to me that
he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted,
executed the instrument. �, ^
I certify under PENALTY OF PERJURY under the laws of the She-livor-rr that the
foregoing is true and correct.
WITNESS hand/and official seal.
Signature (Seal)
TEODOUNDA DU84ALLARI
NOTARY PUBLIC STATE OF NEW YORK
NEW YORK COUNTY
IJC. #01 DU6 162
CDAR EXP
CONSENT AND SUBORDINATION
The undersigned, as Beneficiary under those certain documents referenced below ("Deeds of
Trust") made by UPTOWN NEWPORT JAMBOREE LLC, a Delaware limited liability company, as
"Borrower", to FIRST AMERICAN TITLE INSURANCE COMPANY, as "Trustee", in favor of TPG
(UPTOWN NEWPORT) FUNDING, LLC, a Delaware limited liability company, as "Lender," both dated
February 14, 2014, and recorded on February 14, 2014, 2014 in the Official Records of Orange County,
California,
1. Deed of Trust With Assignment of Leases and Rents, Security Agreement and Fixture Filing
(Phase II — Senior) Instrument No. 2014000060974
2. Deed of Trust With Assignment of Leases and Rents, Security Agreement and Fixture Filing
(Phase II— Junior (Park Parcel Loan)) Instrument No. 2014000060975
hereby expressly and unconditionally consents to, and subordinates the Deeds of Trust and all of their
beneficial interests thereunder to the foregoing Grant of Easement For Pedestrian Purposes between
Uptown Newport Jamboree, LLC, a Delaware limited liability company, and the City of Newport Beach,
a municipal corporation, to which this Consent and Subordination is attached.
Dated.Z�um, 201K
TPG (UPTOWN NEWPORT) FUNDING, LLC,
a Delaware limited liability company
By: (-)LALJ
N e: ,SON >&MOIQ�51`
Title: eve
STATE OF CALIFORNIA )
COUNTY OF ORANGE j ss. a�JuJ
On , 2014, before me, the undersigned, otary Public in and for said State,
personally appeared , who proved t e on the basis of satisfactory evidence
to be the person(s) whose name(s) is/are subscribed to the ' in instrument and acknowledged to me that
he/she/they executed the same in his/her/their auxh rized capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s), or he entity upon behalf of which the person(s) acted,
executed the instrument.
I certify under PENALTY OF
foregoing is true and correct.
WITNESS my hand.atid official seal.
Signature
Y under the laws of the State of California that the
(Seal)
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189
:�(';c-E',car!'�.<-�C�.M�.F.F.I,-!>�-Y.�^l+phi-;�+c,l+,-J+,'.1+�-.l.,�l..-.l,,.,r,>_„ �r.. �s..,�.�-.i+�.l.�.P�-F+,�`f.�-,t.�.:F.�I+.Mi-•f..F-l. n.. ^...
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of
On Q-0 15' before me,1X01")e
Date Here Insert Name and Title of the fficer
r
personally appeared , dry\- Pt icor-A
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person{sj whose name(s) is/ar&
subscribed to the within instrument and acknowledged to me that he/sheAftey executed the same in
his/heNfttrelr authorized capacity(ies"nd that by his/ e9 signature(s�on the instrument the persons)
or the entity upon behalf of which the person(syacted, executed the instrument.
4�+�r.�+
ROMELY T. LEVEZOW
Commission # 2032462
< Notary Public - California z
Z Orange County
My Comm. Expires Jul 4,2017
Place Notary Seal Above
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
Signature "\
Signature of leo ary Public
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: CDr+SeKf c nd Document Date: Fe &rmn-1 f 9-ot+
Number of Pages: Signer(s) Other Than Named Above: `_
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
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02014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907
CERTIFICATE OF ACCEPTANCE
This CERTIFICATE OF ACCEPTANCE is to certify that the interest in real property conveyed
by Grant of Easement from UPTOWN NEWPORT JAMBOREE, LLC, A Delaware limited
liability company, as Grantor and the CITY OF NEWPORT BEACH, a California municipal
corporation, as Grantee, is hereby accepted on 7_ , 2015, by the undersigned
officer on behalf of the City of Newport Beach pursuant to authority conferred by Resolution No.
1992-82 of the City Council adopted on July 27, 1992. The City of Newport Beach consents to
the recordation of said document in the Office of the Recorder of Orange County, State of
California.
APPROVED AS TO FORM:
OFFICE OF THE CITY ATTORNEY
By.aM. V�&
City Attorney
ATTEST:
Date:
By:
Leilani:�, Brown
City Clerk
h
U
CITY OF NEWPORT BEACH,
A Municipal Corporation
By: !)�� C�i.�--�.�1
David Kiff
City Manager
RECOMMENDED FOR ACCEPTANCE
Date: (tom
By-
m
David A. Webb
Public Works Director
CALIFORNIA• • •D
e.car:�eri,•rcr�er�gr--�C . N-�ersi�.r-�er�Sr�erTN^�N^�c-
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of
On -TUAIC ZtJ/,-r before me, l `t t e. -t O
Date Here 10seri Name and Title of & Officer
personally appeared
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person* whose name0y is/are-
subscribed to the within instrument and acknowledged to me that he/sj;ieth,ey executed the same in
his/17,er/th,eif authorized capacity(jos), and that by his/he.0t4&'signaturejs)-on the instrument the person
or the entity upon behalf of which the person(a)'acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
_—
KIM— RIEF
Commission # 1967536 %
z `� Notary Public - California i Si nature l
Orange County g
M Comm. Ex ires Jan 26, 2016 + Signature of Nq4fl6ublic
Place Notary Seal Above
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document:
Number of Pages:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
L✓:\`✓1`�4�✓G�✓.�✓�A'`�.fC✓tiG�6V.=�G�. Jam. J✓'�Uti Vi✓S"✓.��,titi�.`J..ti.�✓tiG�✓G�✓.�✓tii ✓q"�.6�✓•i'✓Ay.A
@2014 •nal Notary Associationwww.NationalNotary.org 811 " -800-8 76-6827) 91