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REQUIRED SIGNATURES ALL QUALIFIERS AND AN OFFICER CURRENTLY LISTED-ON CSLB'S RECORDS MUST SIGN Qualifiers include Responsible Managing Officers and Responsible Managing Employees This application cannot be used to add or remove license personnel,or to change the title of license personnel. Personnel on License #850703 Title(s) JORGE CABRERA RES BLE MANAGING OFFICER/CHIEFEXECUTIVE OFFICER/PRESIDENT ROBBI'LYNN CABRERA CORPORATE OFFICER THE FOLLOWING CERTIFICATION MUST BE COMPLETED WHETHER RENEWING AS ACTIVE OR INACTIVE I/we certify under penalty of perjury under the laws of the State of California that all statements, answers,and representations made in this renewal application, including all supplementary statements attached hereto, are true and accurate, and that I/we have reviewed the entire contents of this renewal application.(The definition of"perjury" is telling a lie while under oath.) I/We acknowledge that, for sole proprietors and partnerships, the law allows the State Board of Equalization and the Franchise Tax Board to share taxpayer information with CSLB. In addition, if I am a qualifier and the license is being renewed as active, I certify that I am performing one or more of the duties specified in CCR section 823 (see "Duties and Responsibilities of a Qualifying Individual" on additional information). The date and•pr nt."na e(s) must be typed or in ink. The signature(s) must be in black or blue ink. Signatur9— Print Name �13 C�� Date 1 Signature Print Name Date Signature Print Name Date Signature Print Name Date Signature Print Name Date Signature Print Name Date ---771 Signature Print Name Date`. THIS RENEWAL APPLICATION IS A LEGAL DOCUMENT. YOU MUST SIGN YOUR FULL LEGAL NAME. FALSIFICATION OF ANY APPLICATION IS CAUSE FOR DISCIPLINARY ACTION IMPORTANT: It may take 4 weeks to process the renewal after it is rPcaivPri at f'.CI R [,—.A—..wi►....