Partial Release Of Mechanics Lien Page 2

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CERTIFICATE OF ACKNOWLEDGMENT
State of California, County of _____________________
Capacity claimed by signer:
On ____________ 20 ____, before me_______________a notary public, personally
[ ] Individual
Appeared ________________________________, personally known to me (or proved to me on
[ ] Corporate Officer(s)
the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed
Titles: _______________
to the within instrument and acknowledged to me that he/she/they executed the same
[ ] Partner(s) __Limited__General
in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the
[ ] Attorney-in-fact
instruments the person(s), or the entity upon behalf of which the person(s), or the
[ ] Trustee(s)
entity upon behalf of which the person(s), acted, executed the instruments.
[ ] Guardian/Conservator
WITNESS my hand
[ ] Other: _____________________
and official seal:
Signer is representing: names of
person(s) or entity(ies):
__________________________
Signature: ___________________________
__________________________

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