Free California Notary

STATE OF CALIFORNIA
COUNTY OF LOS ANGELES
CERTIFICATE OF ACKNOWLEDGMENT
Document Title: Government Form for Permit Application
Date: August 27, 2050
Name of Signatory: Johnathan Smith
I, [Your Name], a Notary Public in and for the State of California, hereby certify:
That Johnathan Smith, whose name is subscribed to the within document, personally appeared before me this day and acknowledged that he executed the same for the purposes therein contained.
WITNESS my hand and official seal.

[Your Name] Notary Public
Commission Number: CA-902154
Commission Expiration Date: January 1, 2055
Notary Seal: [Seal Imprint]
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