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Application to Repurchase after Forfeiture <br /> Applicant Name: Robert Haack <br /> Applicant's relationship to the property: Owner <br /> Mailing Address 14431 Ventura Blvd. #375 <br /> City,State,Zip Sherman Oaks, CA 914 <br /> Signature -t7 - Date 7/2.2- ft <br /> 5 <br /> The foregoing instrument was acknowledged before me this 7'7 day of sit"/ <br /> 20/3by ?Dt A-A/ <br /> Given ynder my hand and official seal of this <br /> '7--o�3 <br /> NOTARY STAMP/SEAL /' 1 1// <br /> Signat of Notary Public <br /> NALYN A.WIRATUNGA <br /> Commission# 1982149 <br /> ��.�.`� V D� `� <br /> ••�� Notary Public•Calliornia > Notary Commissioner Expires <br /> i Ventura County <br /> M Comm.Expires Jul 12,2018 <br /> Return application to: Department of Property Records and Revenue,Attn:Tax Forfeited Lands Section, <br /> PO Box 64097,St.Paul, MN 55164-0097 <br />