OPA: Grimshaw House - City of Anaheim

State of California )
) ss.
County of )
On , , before me,
personally appeared
(name(s) of signer(s))
Q personally known to me —OR—
Q proved to me on the basis of satisfactory evidence
(name, title of officer, e.g., Jane Doe, Notary Public")
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 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.
Witness my hand and official seal.
(Signature of Notary)
Capacity claimed by signer: (This section is OPTIONAL.)
Q Individual
Q Corporate Officer(s):
Q Partner(s):
Q General Q Limited
Q Attorney-in-fact
Q Trustee(s)
Q Guardian/Conservator
Q Other:
Signer is representing:
(name of person(s) or entity(ies))
Attention Notary: Although the information requested below is OPTIONAL, it could prevent
fraudulent attachment of this certificate to an unauthorized document.
THIS CERTIFICATE Title or Type of Document:
MUST BE ATTACHED
TO THE DOCUMENT Number of Pages: Date of Document:
DESCRIBED AT RIGHT: Signer(s) Other than Named Above: