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CALIFORNIA JURAT WITH AFFIANT STATEMENT <br />201203856 <br />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 <br />State of California <br />County of <br />J.BARTHOLDY <br />Commission # 1958697 <br />Notary Public • California <br />Sonoma County <br />Comm. Expires Oct 30. 2015 <br />Place Notary Seal Above <br />Signature of Document Signer No, 2 (i1 any) <br />Subscribed and sworn to (or affirmed) before me <br />on this day ofq-20 , <br />Oato Month Year <br />by <br />Lj <br />Name of Signer <br />proved to me on the basis of satisfactory evidence <br />to be the person who appeared before me (.) (,) <br />(2) <br />Name of Signer <br />graved_ t -evidence-- <br />to-be-tie--paraoTr-who—appeared - before me.) <br />Signaturc <br />jSignature of Notary Pu <br />OPTIONAL <br />Though the Information below is not required by law, it may prove valuable <br />to persons relying on the document and could prevent fraudulent removal <br />and reattachment of this form to another document. <br />Further Description of Any Attached Document <br />Title or Type of Document: <br />Document Date: <br />Signer(s) Other Than Named Ahnve: <br />Number of Pages: <br />02016 National Notary Association - NationalNotary.org • 1 -000 -US NOTARY (1-800-676-6827) nam fDviu <br />