Laserfiche WebLink
2575 Country Club Blvd. <br /> Stockton, CA 95204 <br /> 1 certify under penalty of law that this document and all attachments were prepared under my <br /> direction or supervision in accordance with a system designed to assure that qualified personnel <br /> properly gather and evaluate the information. submitted. Based on my inquiry of the person or <br /> persons who manage the system, or those persons directly responsible for gathering the information, <br /> the information submitted is, to the best of my knowledge and belief, true, accurate,and complete <br /> 1 am aware that there are significant penalties for submitting false information, including the <br /> possibility of fine and imprisonment for knowing violations. <br /> O'P-- <br /> CORPOkAflfOFFI ER <br /> PRINT NAME <br /> TITLE s <br /> - °� - 0IA <br /> DATE <br />