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RecDoc 2014-069042 LMA Kaiser 1100 Veterans
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RecDoc 2014-069042 LMA Kaiser 1100 Veterans
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Last modified
9/4/2014 11:15:15 AM
Creation date
8/22/2014 4:12:31 PM
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Recorded Docs
Recorded Docs - Type
Agreement
Subject
Kaiser Permanente RWC Medical Center
Doc Num
2014-069042
Rec Date
8/1/2014
APN
053-202-140, 053-204-050, 052-376-030
Address
1100 Veterans Blvd
Parties
Kaiser Foundation Hospitals
MO Ref
14-121
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT <br /> �a�t�S�---�.'c�z;'�R�.s�.'S;-T¢�-.^�.':;z�t�S�c�c �.•;a:;s�N'`!s�. �S�S�.�.s�.'S�,.--�.'.;�a.�t<s�Y'�.',r�-�S�t�N�:;��vT�,�a�i<-,•a <,'a>`:�t;�.y•S;��t�v� <br /> State of California �n <br /> County of c�+✓t I7 /�'CGt <br /> On j":)(7 31,20(y before me, 31),i•e 11' ck )SCCS �1' 7U7(ft <br /> , <br /> Date Here Insert Name and4itle of the Officer <br /> personally appeared c�Lj.€J-� • �j - t <br /> Nam of Signerie) <br /> who proved to me on the basis of satisfactory evidence to <br /> be the person(k) whose name43 is/**e subscribed to the <br /> within instrument and acknowledged to me that <br /> he/s'p /tl,ey executed the same in his/W/tripe authorized <br /> capacity(*), and that by his/hKetive1 signatureM on the <br /> JULIE MA ROSAS instrument the person(), or the entity upon behalf of <br /> Commission # 1931141 which the person( acted, executed the instrument. <br /> Notary Public -California z <br /> z 9 San Mateo County I certify under PENALTY OF PERJURY under the laws <br /> My Comm.Expires Apr,17,2015 t of the State of California that the foregoing paragraph is <br /> true and correct. <br /> WITNES and and official seal. <br /> iz <br /> Signature C -`'0 /)5� <br /> Place Notary Seal Above Signature of Notary Public <br /> OPTIONAL <br /> Though the information below is not required by law, it may prove valuable to persons relying on the document <br /> and could prevent fraudulent removal and reattachment of this form to another document. <br /> Description of Attached/Document / fJ <br /> Title or Type of Document: h-0/1.1SC GC/ Mlc/rl�l- c,7014 617 - l.Ser- <br /> Document Date: SU IN 3/r 2 C)l 7 Number of Pages: C b <br /> Signer(s) Other Than Named Above: it y4 <br /> 4 <br /> Capacity(ies) Claimed by Signer(s) <br /> igner's Name: S'fgger's Name: <br /> dividual ❑ Ind 3idial <br /> ❑ Cor ate Officer—Title(s): ❑Corporates ficer—Title(s): <br /> ❑ Partner- Limited ❑ General 1 ' Partner—❑ Li •ed ❑ General <br /> RIGHT THUMBPRINT RIGHT THUMBPRINT <br /> ❑ Attorney in Fact OF SIGNER ❑Attorney in Fact OF SIGNER <br /> ❑ Trustee Top of thumb here ❑Trustee Top of thumb here <br /> ❑ Guardian or Conservator ❑ Guardian or Conservator <br /> ❑ Other: r I Other: <br /> Signer Is Representing: Signer Is Representing: <br /> a'0.y�4'es1'�,5��6\✓.\✓•.�A✓..`✓.4�.�✓a�✓,.�✓<�G�✓.��✓.�=!'+�'✓va�✓.�a�✓�'✓��'9va�a�vti.�ti✓sv'.�'�.<�✓6�'•�U..�va�6��..�✓..�✓'�.� <br /> ©2007 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.NationalNotaryorg Item#5907 Reorder:Call Toll-Free 1-800-876-6827 <br />
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