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CDP 2020-0046; DECHAMPLAIN ADU; Coastal Development Permit (CDP)
{'city of Carlsbad .... LAND USE REVIEW APPLICATION P-1 Di•velooment .Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov APPLICATIONS APPLIED FOR: {CHECK BOXES) Development Permits ~ Coast.al Development Pennit D Conditional Use Permit D Minor D Extension 0 Day Care (Large} ~ Minor 0 Environment.al Impact Assessment 0 Habitat Management Permit O Minor D Hillside Development Permit 0Minor 0 Nonconforming Construction Pennit 0 Planned Development Permit D Minor D Residential D Non-Residential D Planning Commission Determination 0 Reasonable Accommodation 0 Site Development Plan 0 Special Use Permit D Minor D Tentative Parcel Map (Minor Subdivision) 0 Tentative Tract Map (Major Subdivision) 0 Variance O Minor (FOR DEPT. USE ONLY) Legislative Permits vl>P 7,JJ 7,() ,,, o Oq, 11 ! 0 General Plan Amend~ent 0 Local Coastal Program Amendment D MasterPlan 0 Specific Plan 0 Zone Change [] Amendment []]Amendment 0 Zone Code Amendmfnl South Carlsbad Coastal Review Area Permits ' D Review Permit . 0 Administrative O Minor O Major Vil/age Review A,y Permits D Review Pennit 0 Administrative D Mihor O Major ' i .• (FOR DEPT. USE ONLY) NOTE: A PROPOSED PROJECT REQUIRING APPUCA TION SUBMITTAL MUST BE SUBMITTED BY APPOINTMENT'. PLEA~E CONTACT THE APPOINTMENT SPECIALIST AT (760) 602-2723 TO SCHEDULE AN APPOINTMENT. ASSESSOR PARCEL NO(S): LOCATION OF PROJECT: NAME OF PROJECT BRIEF DESCRIPTION OF PROJECT: PROJECT VALUE (SITE IMPROVEMENTS) FOR CITY USE ONLY A *SAM DAY APPOINTMENTS ARE NOT AVAILABLE 2 \ 't -3.C 6 -06 ·-0 0 9l7 bvc:..J-" J Wa.. (4.,-l .s: lo cvt\ '1e,OJJ ( TREET ADDRESS) ; I Oe C h c.. ..-... el ..., , ;,__ A-()'-"-I <,_ l -s i C., '> }--dl'l I .h.htW ir9 sf AD~ I ESTIMATED COMPLETION DATE Development No. ~ l?V Z,,t) W -() 2, 1 ·'l, Lead Case No. P-1 Page 1 of 6 Revised 03117 OWNER NAME INDIVIDUAL NAME (if applicable): COMPANY NAME (if applicable): MAILING ADDRESS: CITY, STATE, ZIP· TELEPHONE: EMAIL ADDRESS: (PLEASE PRIN1) APPLICANT NAME INDIVIDUAL NAME & Ch o.~k J,if applicable): -~k:n'f~~=-<-..,~c~o...~~;~~~,,.,,,_:;::-~~~c,c,i,E•:.: coMPANYNAME _ 'f,-4 •0.,,'L Toe st t}::} 2. -1 (if applicable} q,, o J i,. L ~4. MAILINGADDRESS: C"'; \ > ~:j l;;: 11 0, ' CITY, STATE, ZIP: (:,' I 'i -8 I 1 ~ CJ J7 '7 TELEPHONE: j e:tl;;::, j c..f f cl h O ~ ~, ( 0 EMAIL ADDRESS: (Pl SE PRINT) I CERTIFY THAT I AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I CERTIFY AS LEGAL OWNER THAT THE APPLICANT AS I CERTIFY THAT I AM THE LEGAL REPRESENTATIVE OF THE OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO SET FOR REIN IS MY AUTHORIZED REPRESENTATIVE FOR PURP SE T PP TION. APPLICANT'S REPRESENTATIVE (Print): MAIUNG ADDRESS: CITY, STATE. ZIP: TELEPHONE EMAIL ADDRESS Ut <& U'l,() DATE I CERTIFY THAT I AM THE REPRESENTATIVE OF THE APPLICANT FOR PURPOSES OF THIS APPLICATION ND THAT ALL THE ABOVE INFORMATION S TRUE AND COR ECT TO THE BEST OF MY KNOV\ DGE. ~~~ Y\€ ' ' DATE IN THE PROCESS OF REVIEWING THIS APPLICATION IT MAY BE NECESSARY FOR MEl\J1BERS OF CITY STAFF, PLANNING COMMISSIONERS OR CITY COUNCIL MEMBERS TO INSPECT AND ENTER THE PROPERTY THAT IS THE SUBJECT OF THIS APPLICATION. I/WE CONSENT TO ENTRY FOR THIS PURPOSE. i NOTICE OF RESTRICTION: PROPERTY OWNER ACKNOWLEDGES AND CONSENTS TO A' NOTICE OF RESTRICTION BEING RECORDED ON TITLE TO HIS PROPERTY IF CONDITIONED FOR THE APPLICANT. NOTICE OF RESTRICTIONS RUN WITH THE UINDAND ND Y SUCC IN IN::~s-r ~f1!-Q. ' P-1 Page 2 of6 NOV l O 2020 ci·, YU,-...::.t\f1i.-3BAD oArf M~~.JJ~tJ~\RW6~1~~E1vEo Revised 03/17 l i i i c···cicyof Development Services DISCLOSURE STATEMENT ; Planning Division . Carlsbad P-1(A) 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov Applicant's statement or disdosure of certain ownership interests on all applications which will · require discretionary action on the part of the City Council or any appointE1d Board, Commission or Committee. I The following information MUST be disclosed at the time of application submittal. Your project cannot be reviewed until this information is completed. Please print I I ;:~n is defined ~ ... ~!illtfJ':ri):~ic1f club, frater~al organization,·doi:p dian -. ·-· . . ... ; city and county, ci~:municipaHty,••• icijp'or attbri•acting1;1i; .J unit" . ~fi~::.ii~:~o/•~J,)~••fr;~~\':~;~~·~~~.~ ~~,pmparty·owrn,r 1. 2. P-1(A) APPLICANT (Not the applicant's agent) ! Provide the COMPLETE, LEGAL names and addresses of & persons having a financial interest in the application. If the applicant includes a con:joration or partnership, include the names, titles, addresses of all individuals owning more than 10% of the shares. IF NO INDIVIDUALS OWN MORE THAN 10% OF TH~ SHARES, PLEASE INDICATE NON-APPLICABLE (NIA) IN THE SPACE BELOW. If a publicly-owned corporation, include the names, titles. and addresses of the o,orporate officers. (A separate page may be attached if necessary.) ' Person ""J?f,/<.,._~ ~~-L.>)-er Corp/Part At)~ f y-1.a S. Title ___ f_r-e_s_, _J...r-=-...,_,_·1':---Title ____________ _ Address H'1'> ,;.,,. ..... ,\-st-b pc Address l.."1'15 1-&r"' ... t )t JJ.s..-1, ",. ""... \9 •'.: 'j v UI\ Cf ).._1 o ( 5 ,., .0 r ~ ,(\ Cl\ q 2 OWNER (Not the owner's agent) . I I 1) I Provide the COMPLETE, LEGAL names and addresses of All persons having any ownership interest in the property involved. Also, provide the nature of the legal ownership (i.e., partnership, tenants in common, non-profit, corporation, etc.). If the ownership includes a corporation or partnership, include the names, titles, addresses of all individuats owning more than 10% of the shares. IF NO INDIVilDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON-APPLl~ABLE (N/A) IN THE SPACE BELOW. If a publicly-owned corporation, include t$ names, titles, and addresses of the corporate officers. (A separate page may be atta~hed if necessary.) Jtff ,;:,,:rc:..HA-t'-'\(IL~1t.:i : Person CPtn...r·•".f£"""' occt-tA""f'\..ln,J Corp/Part. ____ .... : _______ _ Title f /ltfl\ll,,""'( ""f(l..v(\ Title ------~------- Address 'it, c:,r ,k.:-J... w:7 Address ____ __.. _______ _ . c"'" ,·ls '--. ,,--~.l • ~ <!f 1-_c l~I _ Page i of 2 Revised 07/10 3. NON-PROFIT ORGANIZATION OR TRUST If any person identified pursuant to (1) or (2) above is a non rofit r anization or a trust, list the names and addresses of ANY person serving as an officer or director of the non- profit organization or as trustee or beneficiary of the. ! Non Profit/Trust________ Non Profit/Trust. _________ _ Title____________ Title ______ _,__ ______ _ Address _________ _ Address ____ -______ _ 4. Have you had more than $500 worth of business transacted with any member of City staff, Boards, Commissions, Committees and/or Council within: the past twelve (12) months? · D Yes ~o If yes, please indicate person(s): __________ _ NOTE: Attach additional sheets if necessary. c...~e t"'-~,.,.._ "02"t:-M.At'\pc.., ,,._.;~ Print or type name of owner Print or type name of cllPPlicant 4A tA.JcPI:: I 0/, S. / 2-o Signatur« of owner/applicant's agent if applicable/date Print or type name of owner/applicant's agent P-1(A) Page 2 of 2 }o(ll/2 O Revised 07/10 ..--------------""""'-------------✓~------------ (city of Carlsbad DISCLOSURE STATEMENT P-1(A) Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov Applicant's statement or disclosure of certain ownership interests on all applications which will require discretionary action on the part of the City Council or any appointed Board, Commission or Committee. The following information MUST be disclosed at the time of application submittal. Your project cannot be reviewed until this information is completed. Please print. Note: Person is defined as "Any individual, firm, co-partnership, joint venture, association, social club, fraternal organization, corporation, estate, trust, receiver, syndicate, in this and any other county, city and county, city municipality, district or other political subdivision or any other group or combination acting as a unit." Agents may sign this document; however, the legal name and entity of the applicant and property owner must be provided below. 1. 2. P-1(A) APPLICANT (Not the applicant's agent) Provide the COMPLETE, LEGAL names and addresses of ALL persons having a financial interest in the application. If the applicant includes a corporation or partnership, include the names, titles, addresses of all individuals owning more than 10% of the shares. IF NO INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON-APPLICABLE (N/A) IN THE SPACE BELOW. If a publicly-owned corporation, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Person "J-'.)V' ... frl."14 ~ t, lo> H:' r Corp/Part A,1) Vl f Y~ S. Title f Ks, J..,ei k Title ____________ _ Address 1,.-l.{'15"" t;r~ \--s-t-b s:? ( Address l.. ~"15 is re,_ t )1--l:J s.-1 f s ..... 'bi'cr:,~ u/\q)_,of 5 11, l)r~o Cl\ q,2 0 OWNER (Not the owner's agent) ' ' I Provide the COMPLETE, LEGAL names and addresses of ALL persons having any ownership interest in the property involved. Also, provide the nature of the legal ownership (i.e., partnership, tenants in common, non-profit, corporation, etc.). If the ownership includes a corporation or partnership, include the names, titles, addresses of all individuals owning more than 10% of the shares. IF NO INDIVIDUALS OWN MORE THAN 10% OF THE SHARES, PLEASE INDICATE NON-APPLICABLE (NIA) IN THE SPACE BELOW. If a publicly-owned corporation, include the names, titles, and addresses of the corporate officers. (A separate page may be attached if necessary.) Person -----------Corp/Part ___________ _ Tit I e ------------Title ______________ _ Address _________ _ Address ____________ _ Page 1 of 2 Revised 07/10 "\ -.-I 3. NON-PROFIT ORGANIZATION OR TRUST If any person identified pursuant to (1) or (2) above is a nonprofit organization or a trust, list the names and addresses of ANY person serving as an officer or director of the non- profit organization or as trustee or beneficiary of the. Non Profit/Trust Non Profit/Trust ------------------ Tit I e ------------Tit I e _____________ _ Address Address ------------------------ 4. Have you had more than $500 worth of business transacted with any member of City staff, Boards, Commissions, Committees and/or Council within the past twelve (12) months? D Yes D No If yes, please indicate person(s): ___________ _ NOTE: Attach additional sheets if necessary. I certify that all the above information is true and correct to the best of m~ )o(/1/2 D Signature of owner/date Si ature of applicant/date Print or type name of owner Print or type name of applicant IAJ~ )o/, !./2_0 Signatu of owner/applicant's agent if applicable/date Print or type name of owner/applicant's agent P-1(A) Page 2 of 2 Revised 07/10 ( City of Carlsbad PROJECT NAME: PROJECT DESCRIPTION P-1{8) Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov APPLICANT NAME: _ __._fr-+---Ol)..__.._lA..._____._'f ...... v:_~..,..S----------------- Please describe fully the proposed project by application type. Include any details necessary to adequately explain the scope and/or operation of the proposed project. You may also include any background information and supporting statements regarding the reasons for, or appropriateness of, the application. Use an addendum sheet if necessary. Description/Explanation: P-1(8) Page 1 of 1 Revised 07/10 ENVIRONMENTAL INFORMATION FORM / (To be Completed by Applicant) Date Filed: l I / / D /1.,,i:,'ll> (To be completed by City) Application Number(~): ( \:)f {).a'){) -ODY 6 General Information 1. 2. 3. Name of project: ------'~"'-=_c_h----="' ...... r,.,....,D.fl-,L-"L....;,ll___,, V)<-,.-'-----'-A_n __ 4__._ _______ _ Nameofdeveloperorprojectsponsor: r l+Dh f',rus Js>Y7PJ-i.,,,,.._ W~..r /.er. Address: ,I I fr 'f 1'1'1L 4ra,.,.± st :tt ~ I I I'.! , s'---____ c;_&;._vi_O ____ ) =%--01_-----C--A ___ q--'--,,z... 1 0 1 Phone Number: 6 I C, -I 1· I,-2-Z. l.f Y -----=:;__-----''-----'----------='-------------- $1 Ir J City, State, Zip Code: Name of person to be contacted concerning this project: Address: ___ J---_Lf_\.f~[....____~_____,,a.l_o_ ... _t'---_5_t_# ________ ~_1 '------- City, State, Zip Code: s{r. ~ 'Y) > ~.s <J > cJ.... 'f ]_ t O I Phone Number: t I 9~ 7 '? 6 -2 L '-1 i 4. Address of Project: q / 7 0,/4) & iJa,,7 ) {_ ~r) s ~ a.~ Assessor's Parcel Number: '214-56~ -of, ~~O 5. List and describe any other related permits and other public approvals required for this project, including those required by city, regional, state ar,d federal agencies: 6. 7. 8. 9. Existing General Plan Land Use Designation: -~j2_·_t ____________ _ Existing zoning district: __ r_✓_t ____________________ _ Existing land use(s): __ 5q_, __ {_e.._~-~-~ _____ 1 _\ 1--------------,------ Proposed use of site (Project for which this form is filed): __ >)_1_¥=.....,....--t~~-1'\A.-~_l,7~--- Project Description \ o 916 10. Site size: ______ ___._ ____________________ _ 11. 12: 13. 14. P-1(O) Proposed Building square footage: ____ &s-_o __ F_t_2 ____________ _ Number of floors of construction: ___ ....:\=------------------- Amount of off-street parking provided: ___ 3, _______________ _ Associated projects: _______ N_li_A-_______________ _ Page 2 of 4 Revised 07/10 15. If residential, include the number of units and schedule of unit sizes: 16. 17. 18. 19. P-1(0) If commercial, indicate the type, whether neighborhood, city or regionally oriented, square footage of sales area, and loading facilities: If industrial, indicate type, estimated employment per shift, and loading facilities: If institutional, indicate the major function, estimated employment per shift, estimated occupancy, loading facilities, and community benefits to be derived from the project: If the project involves a variance, conditional use or rezoning applications, state this and indicate clearly why the application is required: Page 3 of 4 Revised 07/10 Are the following items applicable to the project or its effects? Discuss all items checked yes (attach additional sheets as necessary). Yes ~ 20. Change in existing features of any bays, tidelands, beaches, or hills, or substantial □ alteration of ground contours. 21. Change in scenic views or vistas from existing residential areas or public lands or □ ~ roads. 22. Change in pattern, scale or character of general area of project. □ cg' 23. Significant amounts of solid waste or litter. □ cg/ 24. Change in dust, ash, smoke, fumes or odors in vicinity. □ DJ' 25. Change in ocean, bay, lake, stream or ground water quality or quantity, or □ [J/ alteration of existing drainage patterns. 26. Substantial change in existing noise or vibration levels in the vicinity. □ IY 27. Site on filled land or on slope of 10 percent or more. □ ~ 28. Use of disposal of potentially hazardous materials, such as toxic substances, □ EJ flammables or explosives. 29. Substantial change in demand for municipal services (police, fire, water, sewage, □ ~ etc.). 30. Substantially increase fossil fuel consumption (electricity, oil, natural gas, etc.). □ ~ 31. Relationship to a larger project or series of projects. □ [Y Environmental Setting Attach sheets that include a response to the following questions: 32. Describe the project site as it exists before the project, including information on topography, soil stability, plants and animals, and any cultural, historical or scenic aspects. Describe any existing structures on the site, and the use of the structures. Attach photographs of the site. Snapshots or Polaroid photos will be accepted. 33. Describe the surrounding properties, including information on plants and animals and any cultural, historical or scenic aspects. Indicate the type of land use (residential, commercial, etc.), intensity of land use (one-family, apartment houses, shops, department stores, etc.), and scale of development (height, frontage, set-back, rear yard, etc.). Attach photographs of the vicinity. Snapshots or polaroid photos will be accepted. Certification I hereby certify that the statements furnished above and in the attached exhibits present the data and information required for this initial evaluation to the best of my ability, and that the fa~ts, statepents, and information presented are true and correct to the best of my knowledge and belief. ~ Date: t O / I ~) 2--o Signature: --p~y __________ _ For: J::>v-c. I½,.,. Wehskr" P-1(0) Page 4 of 4 Revised 07/10 ( City of Carlsbad MINOR COASTAL DEVELOPMENT PERMIT/ SINGLE FAMILY RESIDENCE APPLICATION Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.gov P-6 A proposed project requiring application submittal must be submitted by appointment*. Please contact the appointment specialist at (760) 602-2723 to schedule an appointment. *SAME DAY APPOINTMENTS ARE NOT AVAILABLE All joint application exhibits, i.e. Tentative Map and Planned Development Site Plan should be prepared at the same scale. (Use a scale no smaller than 1" = 40' .) I. GENERAL BACKGROUND A. Estimated Cost of Development: Development costing $60,000 or more does not qualify as a Minor Coastal Development Permit. The City Planner shall make the final determination regarding a project's cost of development. The primary basis for determining cost of development will be the application of dollar costs per square foot for different types of residential construction. These costs are set by the International Conference of Building Officials (ICBO) and are applied throughout San Diego County. Please complete the following information to assist in the determination of this project's cost of development (Contractor proposals may also be submitted for consideration by the City Planner). Please refer to the current fee schedule for the appropriate $/square foot fee rate. ⇒ New ~sidential Square Footage: 5 O square feet x $ /sq. ft. = $ ⇒ Residential Addition Square Footage: 6 0 square feet x $ /sq. ft.=$ ⇒ Any Gar~e Square Footage: 0 square feet x $ /sq. ft. = $ ⇒ Resident~ Conversion Square Footage: L) square feet x $ /sq. ft.=$ ⇒ Please contact the City of Carlsbad Building Division for current fee rate for Non- Residential uses (i.e. Retail/Store; Restaurants; Office; and Manufacturing/Warehouse uses.) (J r-"\. ______ square feet x $ __ /sq. ft.= $ ___ u _______ _ COST OF DEVELOPMENT ESTIMATE: $ ___________ _ B. Do you wish to apply for: 1. A Minor Coastal Development Permit (Under $60,000 cost estimate) D 2. A Coastal Development Permit ($60,000 or more cost estimate) D C. Street address of proposed devetopment tu ~ J..e,. \-t-..,..,,... , J.t-tG__ P-6 Page 1 of 7 Revised 08/19 ..... D. Assessor's Parcel Number of proposed development 2 I '-1 -3 -b 6 -0 b -oo E. Development Description: Briefly describe project: A 3,r-0 .f I-2... de d-A: C-~ ) ..._ LC,< , s "''? d "''" , , ~j ,,., , . b 7 \j Y\ -t: ..-b ,t 'l' F. Describe the present land uses (i.e. vacant land, single family homes, apartments, offices, etc.) that surround the proposed development to the: North: $~ {L South: <,;. ~ -(2.... East: ~ f West: ~ (2- G. Is project located within a 100-year flood plain? □Yes 0 II. PRESENT USE OF PROPERTY is0'es D No A. Are there existing structures on the property? If yes, please describe. B. Will any existing structure be removed/demolished? D Yes If yes to either question, describe the extent of the demolition or removal, including the relocation site, if applicable (also show on plans). 111. LOT COVERAGE P-6 A. Existing and Proposed Building Coverage Landscaped Area Hardscape Area Unimproved Area (Left Natural) Existing Proposed Total L l ' 2-sq. ft. 6 s Osq. ft. 3 o 1 2. sq. ft. "6 l S--'-{ sq. ft. -&50 sq. ft. 11> olj: sq. ft. 6 o o sq. ft. 0 sq. ft. bO D sq. ft. ___ sq.ft. ___ sq.ft. ___ sq.ft. 2-7.6 ·'lo 's tlt£eto 6(;,q % c;. 5" % ___ % Page 2 of 7 Revised 08/19 P-6 B. Parking: r '" Number of existing spaces Number of new spaces proposed l c; f"'c.<. I.Jc.fij-<>, .'k_ Existing/Proposed TOT AL: ~ Number of total spaces required -~3 ____ _ Number of covered spaces 2. Number of uncovered spaces ___ \'------- Number of standard spaces 3 Number of compact spaces 3 . / Is tandem parking existing? D Yes# __ [YNo Is tandem parking proposed? QYes #__l__ D No C. Grade Alteration: °'° Is any grading proposed? D Yes If yes, please complete the following: 1. Amount of cut __________________ cu. yds. 2. Amount of fill cu. yds. 3. Maximum height of fill slope feet Maximum height of cut slope _____________ feet 4. 5. Amount of import or export cu. yds. 6. Location of borrow or disposal site _______________ _ Page 3 of 7 Revised 08/19 City of Carlsbad Climate Action Plan Consistency Checklist STEP 1: LAND USE CONSISTENCY The first step in determining CAP consistency for discretionary development is to assess the project's consistency with the growth projections used in the development of the CAP. This section allows the city to determine a project's consistency with the land use assumptions used in the CAP. Projects found not to be consistent with the CAP's land use assumptions and that are projected to emit at or above the CAP screening threshold of 900 metric tons of CO2 equivalent (MTC02e) GHG will be subject to a project-specific analysis of GHG emissions' impact on the environment in accordance with the requirements of the California Environmental Quality Act (CEQA). This may result in GHG-reducing mitigation measures applied as a condition of project approval in addition to compliance with the CAP ordinance requirements identified in Step 2 of this checklist. Checklist Item (Check the appropriate box and provide an explanation and supporting documentation for your answer) A. Is the proposed project consistent with the existing General Plan land use and specific/master plan or zoning designations? OR, If the proposed project is not consistent with the existing land use plan and zoning designations, does the project include a land use plan and/or specific plan, master plan or zoning designation amendment that would result in an equivalent or less GHG-intensive project when compared to the existing designations? Yes No □ If "Yes", proceed to Step 2 of the checklist. For the second option under Question A above, provide estimated project-related GHG emissions under both existing and proposed designation(s) for comparison. GHG emissions must be estimated in accordance with the City of Carlsbad Guidance to Demonstrating Consistency with the Climate Action Plan. If "No", proceed to Question B. B. The CAP established a screening threshold of 900 MTC02e/year for new development projects to assist in determining consistency with the CAP. The types and sizes of typical projects listed below have been determined to correspond to the CAP screening threshold. Will the proposed land use change result in the construction of less than any one of the following? Single-Family Housing: 50 dwelling units • Multi-Family Housing: 70 dwelling units • Office: 35,000 square feet Retail Store: 11,000 square feet Grocery Store: 6,300 square feet • Other: If the proposed project is not one of the above types, provide a project-specific GHG emissions analysis to determine whether it is below the 900 MTC02e/year screening threshold. If "Yes", proceed to Step 2 of the checklist. □ □ If "No", the project's GHG impact is potentially significant and must be analyzed in accordance with CEQA. Applicant must prepare a Self-developed GHG emissions reduction program in accordance with the City of Carlsbad Guidance to Demonstrating Consistency with the Climate Action Plan to demonstrate how it would offset the increase in emissions over the existing designations. The project must incorporate each of the applicable measures identified in Step 2 to mitigate cumulative GHG emissions impacts unless the decision maker finds that a measure is infeasible in accordance with California Environmental Quality Act Guidelines Section 15091. Mitigation in lieu of or in addition to the measures in Step 2 may be required, depending on the results of the project-specific GHG impact analysis. Proceed and complete a project-specific Self-developed GHG emissions reduction program and Step 2 of the Checklist. P-30 Page 2 of7 Revised 02/20 City of Carlsbad Climate Action Plan Consistency Checklist STEP 2: CAP ORDINANCE COMPLIANCE REQUIREMENTS Completion of this checklist will document a project's compliance with CAP ordinances, and in turn, demonstrate consistency with the applicable measures and actions of the CAP. The compliance requirements in this Step 2 apply to development projects that require a building permit. All other development projects shall implement all emissions-related mitigation measures from the General Plan Update EIR. Project No./Name: Property Address/APN: Applicant Name/Co.: Applicant Address: Contact Phone: Contact information of person completing this checklist (if different than above): Name: Company name/address: Contact Phone: h,!\I\ (> (u (_ Contact Email : j o 11'1 "'-fh.c-,,-, ~~ ~ ""o'Jl'<:S, .• >u-} ts~c_1,.. ___ ~_s '~#:~~~-,~'--~~" -~o , ~5 ::. ~ k tf'l , 0 1 ) Use the table below to determine which sections of the Ordinance Compliance checklist are applicable to your project. If your project includes alterations or additions to an existing building, please contact the Carlsbad Building Division for assistance in estimating building permit valuation, by phone at 760-602-2719 or by email at building@carlsbadca.gov. □ Alterations: □ BPV 2: $60,000 □ BPV 2: $60,000 □ Electrical service panel upgrade □ BPV 2: $200,000 □ New construction □ Alterations: P-30 lA lA and 4A 4A lA and 4A Page 3 of7 All residential alterations 1-2 family dwellings and townhouses with attached garages only Multi-family dwellings only where interior finishes are removed and significant site work and upgrades to structural and mechanical, electrical, and/or plumbing systems are proposed Revised 02/20 City of Carlsbad Climate Action Plan Consistency Checklist □ BPV ~ $200,000 or additions ~ 1B, 5 1,000 square feet □ BPV ~ $1,000,000 1B, 2B and 5 Building alterations of~ 75% existing gross floor area □ ~ 2,000 sq. ft. new roof addition 2B and 5 1B also applies if BPV ~ $200,000 Please refer to Carlsbad Ordinance No. CS-347 and the California Green Building Standards Code (CALGreen) for more information when completing this section. A. Residential addition or alteration ~ $60,000 building permit valuation. See Ord. CS-347, Section 8. Year Built Single-family Requirements □ Before 1978 Select one: □ Duct sealing □ Attic insulation □ Cool roof □ 1978 and later Select one: □ Lighting package □ Water heating package □ Between 1978 and 1990 'f/ 1991 and later B. 0 Nonresidential* new construction or alterations~ $200,000 building permit valuation, or additions ~ 1,000 square feet. See CALGreen Appendix AS, Discussion AS.2, as amended in CS-347, Section 3. A5.203.1.1.1 □ Outdoor lighting: .90 Allowed Outdoor Lighting Power A5.203.l.l.2 □ Restaurant service water heating (comply with California Energy Code Section 140.5, as amended) A5.203.l.2.l Choose one as applicable: D .95 Energy budget D .90 Energy budget A5.211.l.** □ On-site renewable energy A5.211.3** □ Green power (if offered by local utility provider, 50% minimum renewable sources) A5.212.1 D Elevators and escalators A5.213.1 □ Steel framing P-30 Page 4 of 7 □ N/A ________ _ □ Exception: Home energy score~ 7 (attach certification) Multi-family Requirements □ Attic insulation Select one: □ Attic insulation □ Duct Sealing Select one: □ Cool roof □ Lighting package □ Water heating package □ N/A _________ _ □ N/A □ N/A □ N/A □ N/A □ N/A □ N/A Revised 02/20 City of Carlsbad Climate Action Plan Consistency Checklist □ N/A * Includes hotels/motels and high-rise residential buildings ** For alterations ~ $1,000,000 BPV and affecting > 75% existing gross floor area, or alterations that add 2,000 square feet of new roof addition: comply with California Energy Code section 120.10 instead. A. D Residential new construction (for building permit applications submitted after 1/1/20). Refer to 2019 California Energy Code section 150.l(c) 14 for requirements. Note: if project includes installation of an electric heat pump water heater pursuant to Carlsbad ordinance CS-348, increase system size by .3kWdc if PV offset option is selected. Floor Plan ID (use additional CFA #d.u. Calculated kWdc* sheets if necessary) Total System Size: kWdc = (CFAx.572) / 1,000 + {1.15 x #d.u.) *Formula calculation where CFA = conditional floor area, #du = number of dwellings per plan type If proposed system size is less than calculated size, please explain. Exception □ □ □ □ kWdc B. 0 Nonresidential new construction or alterations :!$1,000,000 BPV and affecting i!75% existing floor area, or addition that increases roof area by i!2,000 square feet. Please refer to Carlsbad Ordinance CS-347, Section 6 when completing this section. Choose one of the following methods: D Gross Floor Area (GFA) Method GFA: □ If< 10,000s.f. Enter: 5 kW de Min. System Size: □ If:::: 10,000s.f. calculate: 15 kWdc x (GFA/10,000) ** ___ kWdc **Round building size factor to nearest tenth, and round system size to nearest whole _number. D Time-Dependent Valuation Method Annual TDV Energy use:*** x .80= Min. system size: kWdc ---- *** Attach calculation documentation using modeling software approved by the California Energy Commission. P-30 Page 5 of 7 Revised 02/20 City of Carlsbad Climate Action Plan Consistency Checklist A. D Residential and hotel/motel new construction Please refer to Carlsbad Ordinance CS-347 and CS-348 when completing this section. □ For systems serving individual dwelling units choose one: D Heat pump water heater AND compact hot water distribution AND drain water heat recovery (low-rise residential only) D Heat pump water heater AND PV system .3 kWdc larger than required in CA Energy Code Section 120.10 (for high rise residential hotel/motel) or 150.l(c) 14 (for low-rise residential) □ Heat pump water heater meeting Tier 3 or higher NEEA Advanced Water Heating Specification □ Solar water heating system that is either .60 solar savings fraction or 40 s.f. solar collectors □ Exception: D For systems serving multiple dwelling units, install a central water-heating system with all of the following: □ Gas or propane water heating system □ Recirculation system per CS-347 (high-rise residential, hotel/motel) or CS-348 (low-rise residential) □ Solar water heating system that is either: □ .60 solar savings fraction or 40 s.f. solar collectors □ .40 solar savings fraction, plus drain water heat recovery D Exception: B. D Nonresidential new construction Please refer to Carlsbad Ordinance CS-347 when completing this section. □ Water heating system derives at least 40% of its energy from one of the following (attach documentation): □ Solar-thermal □ Photovoltaics □ Recovered energy □ Water heating system is (choose one): □ Heat pump water heater □ Electric resistance water heater(s) □ Solar water heating system with .40 solar savings fraction D Exception: A. ~ Residential New construction and major alterations* Please refer to Carlsbad Ordinance CS-349 when completing this section. D One and two-family residential dwelling or townhouse with attached garage: ji/.one EVSE ready parking space req uired □ Exception : D Multi-family residential · □ Exception · Total Parking Spaces EVSE Spaces Proposed Capable I Ready I Calculations: Total EVSE spaces= .10 x Total parking (rounded up to nearest whole number) EVSE Installed= Total EVSE Spaces x .SO (rounded up to nearest whole number) EVSE other= Total EVSE spaces -EVSE Installed (EVSE other may be "Capable," "Ready" or "Installed.") I I Installed I I Total P-30 Page 6 of 7 Revised 02/20 City of Carlsbad Climate Action Plan Consistency Checklist *Major alterations are: (1) for one and two-family dwellings and townhouses with attached garages, alterations have a building permit valuation~ $60,000 or include an electrical service panel upgrade; (2) for multifamily dwellings (three units or more without attached garages), alterations have a building permit valuation~ $200,000, interior finishes are removed and significant site work and upgrades to structural and mechanical, electrical, and/or plumbing systems are proposed. B. D Nonresidential new construction (includes hotels/motels) □ Exception : Total Parking Spaces EVSE Spaces Proposed Capable I Ready I Installed I Total I I I Calculation: Refer to the table below: Total Number of Parking Spaces provided Number of required EV Spaces Number of required EVSE Installed Spaces □ 0-9 1 1 □ 10-25 2 1 □ 26-50 4 2 □ 51-75 6 3 □ 76-100 9 5 □ 101-150 12 6 □ 151-200 17 9 □ 201 and over 10 percent of total SO percent of Required EV Spaces A. List each proposed nonresidential use and gross floor area (GFA) allocated to each use. B. Employee ADT/1,000 square feet is selected from the City of Carlsbad Employee ADTTable. Use GFA Employee ADT/1,000 S.F. Total Employee ADT Total If total employee ADT is greater than or equal to 110 employee ADT, a TOM plan is required. *NOTE: Notwithstanding the 110 employee ADT threshold above, General Plan Mobility Element Policy 3-P.ll requires new development that adds vehicle traffic to vehicle LOS-exempt street facilities to implement TOM and transportation system management strategies. Please consult with City of Carlsbad Land Development Engineering (LOE) staff to determine whether this policy applies to your project. TOM plan required: Yes D No D LOE Staff Verification: □ _____ (staff initials) P-30 Page 7 of 7 Revised 02/20 G. Fidelity National Title· Fidelity National Title -SD 7565 Mission Valley Road, #100, San Diego, CA 92108 Preliminary Report Fidelity National Title -SD 7565 Mission Valley Road, #100, San Diego, CA 92108 Phone: (619) 725-2112 Fax: (619) 297-2213 Property Address: 917 Orchid Way, Carlsbad, CA Introducing Title Officer: Marlo Macias Email: sdunit4@fnf.com Phone No.: (619) 725-2112 Fax No.: (619) 297-2213 File No.: 00159782-992-SD1-2MM FIDEL.ITV Ill FIRST J!.!-,.!~! LiveLOOK title document delivery system is designed to provide 24/7 real-time access to all information related to a title insurance transaction. Access title reports, exception documents, an easy-to-use summary page, and more, at your fingertips and your convenience. To view your new Fidelity Nationa I Title First Alert powered by Live LOOK report. Click Here < .. Effortless, Efficient, Compliant, and Accessible r • Fidelity National Title Company 7565 Mission Valley Road, #100, San Diego, CA 92108 Phone: (619) 725-2100 • Fax: (619) 297-2213 Issuing Policies of Fidelity National Title Insurance Company Title Officer: Marlo Macias Phone: (619) 725-2112 Fax: (619) 297-2213 Email: sdunit4@fnf.com Webster Realty Group 2445 Brandt Street, Suite 511 San Diego, CA 92101 ATTN: Jonathan Webster YOUR REF: PROPERTY: 917 Orchid Way, Carlsbad, CA PRELIMINARY REPORT ORDER NO.: 00159782-992-SD1-2MM LOAN NO.: In response to the application for a policy of title insurance referenced herein, Fidelity National Title Company hereby reports that it is prepared to issue, or cause to be issued, as of the date hereof, a policy or policies of title insurance describing the land and the estate or interest therein hereinafter set forth, insuring against loss which may be sustained by reason of any defect, lien or encumbrance not shown or referred to as an exception herein or not excluded from coverage pursuant to the printed Schedules, Conditions and Stipulations or Conditions of said policy forms. The printed Exceptions and Exclusions from the coverage and Limitations on Covered Risks of said policy or policies are set forth in Attachment One. The policy to be issued may contain an arbitration clause. When the Amount of Insurance is less than that set forth in the arbitration clause, all arbitrable matters shall be arbitrated at the option of either the Company or the Insured as the exclusive remedy of the parties. Limitations on Covered Risks applicable to the CLTA and ALTA Homeowner's Policies of Title Insurance which establish a Deductible Amount and a Maximum Dollar Limit of Liability for certain coverages are also set forth in Attachment One. Copies of the policy forms should be read. They are available from the office which issued this report. This report (and any supplements or amendments hereto) is issued solely for the purpose of facilitating the issuance of a policy of title insurance and no liability is assumed hereby. If it is desired that liability be assumed prior to the issuance of a policy of title insurance, a Binder or Commitment should be requested. The policy(s) of title insurance to be issued hereunder will be policy(s) of Fidelity National Title Insurance Company, a Florida Corporation. Please read the exceptions shown or ref erred to herein and the exceptions and exclusions set forth in Attachment One of this report carefully. The exceptions and exclusions are meant to provide you with notice of matters which are not covered under the terms of the title insurance policy and should be carefully considered. It is important to note that this preliminary report is not a written representation as to the condition of title and may not list all liens, defects and encumbrances affecting title to the land. Authorized Signature CL TA Preliminary Report Form -Modified (11/17/06) Page 1 e Fidelity National Title Company 7565 Mission Valley Road, #100, San Diego, CA 92108 Phone: (619) 725-2100 • Fax: (619) 297-2213 PRELIMINARY REPORT EFFECTIVE DATE: October 8, 2020 at 7:30 a.m. ORDER NO.: 00159782-992-SD1-2MM The form of policy or policies of title insurance contemplated by this report is: ALT A Homeowners Policy of Title Insurance (12-2-13) ALT A Extended Loan Policy (6-17-06) 1. THE EST A TE OR INTEREST IN THE LAND HEREINAFTER DESCRIBED OR REFERRED TO COVERED BY THIS REPORT IS: AFEE 2. TITLE TO SAID ESTATE OR INTEREST AT THE DATE HEREOF IS VESTED IN: Jeffrey Oren DeChamplain and Carmem Branco DeChamplain, Trustees, of the Jeffrey and Carmem DeChamplain Family Trust, Under Declaration of Trust of dated November 12, 2014 3. THE LAND REFERRED TO IN THIS REPORT IS DESCRIBED AS FOLLOWS: See Exhibit A attached hereto and made a part hereof. CL TA Preliminary Report Form -Modified (11/17/06) Page 2 PRELIMINARY REPORT YOUR REFERENCE: EXHIBIT A LEGAL DESCRIPTION Fidelity National Title Company ORDER NO.: 00159782-992-SD1-2MM THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE CITY OF CARLSBAD, COUNTY OF SAN DIEGO, STATE OF CALIFORNIA, AND IS DESCRIBED AS FOLLOWS: LOT 60 OF CARLSBAD TRACT NO. 79-39, UNIT NO. 2, IN THE CITY OF CARLSBAD, COUNTY OF SAN DIEGO, ST A TE OF CALIFORNIA, ACCORDING TO MAP THEREOF NO. 8404, FILED IN THE OFFICE OF THE COUNTY RECORDER OF SAN DIEGO COUNTY, NOVEMBER 5, 1976. EXCEPT THEREFROM AN UNDIVIDED ONE-HALF INTEREST IN ALL OIL, GAS, PETROLEUM, NAPHTHA AND OTHER HYDROCARBON SUBSTANCES AND MINERALS OF WHATSOEVER KIND OF NATURE IN, UPON OR BENEATH THE SOUTHWEST QUARTER OF THE NORTHEAST QUARTER OF THE NORTHWEST QUARTER OF THE SOUTHEAST QUARTER OF SECTION 28, TOWNSHIP 14 SOUTH, RANGE 4 WEST, SAN BERNARDINO MERIDIAN, ACCORDING TO OFFICIAL PLAT THEREOF, AS RESERVED BY THE FEDERAL BANK OF BERKELEY IN DEED RECORDED JULY 26, 1941, RECORDERS FILE NO. 44001 IN BOOK 1213, PAGE ill OF OFFICIAL RECORDS. APN: 214-366-06-00 Cl TA Preliminary Report Form -Modified (11/17/06) Page 3 PRELIMINARY REPORT YOUR REFERENCE: EXCEPTIONS Fidelity National Title Company ORDER NO.: 00159782-992-SD1-2MM AT THE DATE HEREOF, ITEMS TO BE CONSIDERED AND EXCEPTIONS TO COVERAGE IN ADDITION TO THE PRINTED EXCEPTIONS AND EXCLUSIONS IN SAID POLICY FORM WOULD BE AS FOLLOWS: I. Property taxes, including any personal property taxes and any assessments collected with taxes, are as follows: Code Area: Tax Identification No.: Fiscal Year: I st Installment: 2nd installment: Exemption: Land: Improvements: Personal Property: Bill No.: 09027 214-366-06-00 2020-2021 $4,973.96 Open $4,973.96 Open $7,000.00 $732,895.00 $169,129.00 $0.00 0.00 2. The lien of supplemental or escaped assessments of property taxes, if any, made pursuant to the provisions of Chapter 3.5 (commencing with Section 75) or Part 2, Chapter 3, Articles 3 and 4, respectively, of the Revenue and Taxation Code of the State of California as a result of the transfer of title to the vestee named in Schedule A or as a result of changes in ownership or new construction occurring prior to Date of Policy. Note: If said supplementals (if any) are not posted prior to the date of closing, this company assumes no liability for payment thereof. 3. Covenants, conditions and restrictions but omitting any covenants or restrictions, if any, including but not limited to those based upon race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, familial status, source of income, disability, veteran or military status, genetic information, medical condition, citizenship, primary language, and immigration status, as set forth in applicable state or federal laws, except to the extent that said covenant or restriction is permitted by applicable law, as set forth in the document Recording Date: June 3, 1977 Recording No: 1977-217525, Official Records Said covenants, conditions and restrictions provide that a violation thereof shall not defeat the lien of any mortgage or deed of trust made in good faith and for value. 4. A deed of trust to secure an indebtedness in the amount shown below, Amount: Dated: Trustor/Grantor: Trustee: Beneficiary: Loan No.: Recording Date: Recording No: $650,000.00 December 20, 2016 Jeffrey Oren DeChamplain and Carmem Branco Dechamplain, Trustees, of the Jeffrey and Carmem DeChamplain Family Trust, Under Declaration of Trust of dated November 12, 2014 JPMorgan Chase Bank, N. A. JPMorgan Chase Bank, N. A. 1235303435 December 22, 2016 2016-0701838, Official Records PLEASE REFER TO THE "INFORMATIONAL NOTES" AND "REQUIREMENTS" SECTIONS WHICH FOLLOW FOR INFORMATION NECESSARY TO COMPLETE THIS TRANSACTION. END OF EXCEPTIONS CL TA Preliminary Report Form -Modified (11/17/06) Page4 PRELIMINARY REPORT YOUR REFERENCE: REQUIREMENTS SECTION I _,,; Fidelity National Title Company ORDER NO.: 00159782-992-SD1-2MM 1. In order to complete this report, the Company requires a Statement of Information to be completed by the following party(s), Party(s): All Parties The Company reserves the right to add additional items or make further requirements after review of the requested Statement of Information. NOTE: The Statement of Information is necessary to complete the search and examination of title under this order. Any title search includes matters that are indexed by name only, and having a completed Statement of Information assists the Company in the elimination of certain matters which appear to involve the parties but in fact affect another party with the same or similar name. Be assured that the Statement of Information is essential and will be kept strictly confidential to this file. 2. The Company will require either (a) a complete copy of the trust agreement and any amendments thereto certified by the trustee(s) to be a true and complete copy with respect to the hereinafter named trust, or (b) a Certification, pursuant to California Probate Code Section 18100.5, executed by all of the current trustee(s) of the hereinafter named trust, a form of which is attached. Name of Trust: The Jeffrey and Carmem Dechamplain Family Trust 3. Any invalidity or defect in the title of the vestees in the event that the trust referred to herein is invalid or fails to grant sufficient powers to the trustee(s) or in the event there is a lack of compliance with the terms and provisions of the trust instrument. If title is to be insured in the trustee(s) of a trust, ( or if their act is to be insured), this Company will require a Trust Certification pursuant to California Probate Code Section 18100.5. The Company reserves the right to add additional items or make further requirements after review of the requested documentation. END OF REQUIREMENTS CLTA Preliminary Report Form-Modified (11/17/06) Page 5 PRELIMINARY REPORT YOUR REFERENCE: Fidelity National Title Company ORDER NO.: 00159782-992-SD1-2MM INFORMATIONAL NOTES SECTION 1. Note: The name(s) of the proposed insured(s) furnished with this application for title insurance is/are: Name(s) furnished: TBD If these name(s) are incorrect, incomplete or misspelled, please notify the Company. 2. Notice: Please be aware that due to the conflict between federal and state laws concerning the cultivation, distribution, manufacture or sale of marijuana, the Company is not able to close or insure any transaction involving Land that is associated with these activities. 3. None of the items shown in this report will cause the Company to decline to attach ALT A Endorsement Form 9 to an Extended Coverage Loan Policy, when issued. 4. Note: The Company is not aware of any matters which would cause it to decline to attach CL TA Endorsement Form I I 6 indicating that there is located on said Land a Single Family Dwelling, known as 9 I 7 Orchid Way, Carlsbad, California to an Extended Coverage Loan Policy. 5. Note: The policy of title insurance will include an arbitration provision. The Company or the insured may demand arbitration provision. Arbitrable matters may include, but are not limited to any controversy or claim between the Company and the insured arising out of or relating to this policy, any service of the Company in connection with its issuance or the breach of a policy provision or other obligation. Please ask your escrow or title officer for a sample copy of the policy to be issued if you wish to review the arbitration provisions and any other provisions pertaining to your Title Insurance Coverage. 6. Note: There are NO conveyances affecting said Land recorded within 24 months of the date of this report. 7. Pursuant to Government Code Section 27388.1, as amended and effective as of 1-1-2018, a Documentary Transfer Tax (OTT) Affidavit may be required to be completed and submitted with each document when OTT is being paid or when an exemption is being claimed from paying the tax. If a governmental agency is a party to the document, the form will not be required. OTT Affidavits may be available at a Tax Assessor-County Clerk-Recorder. 8. Unless this company is in receipt of WRITTEN instructions authorizing a particular policy, Fidelity Title will AUTOMA TI CALLY issue the American Land Title Association Homeowner's Policy (02/03/10) for all qualifying residential 1-4 properties/transactions to insure the buyer at the close of escrow. 9. If a county recorder, title insurance company, escrow company, real estate broker, real estate agent or association provides a copy of a declaration, governing document or deed to any person, California law requires that the document provided shall include a statement regarding any unlawful restrictions. Said statement is to be in at least 14-point bold face type and may be stamped on the first page of any document provided or included as a cover page attached to the requested document. Should a party to this transaction request a copy of any document reported herein that fits this category, the statement is to be included in the manner described. 10. NOTE: Amended Civil Code Section 2941, which becomes effective on January 1, 2002, sets the fee for the processing and recordation of the reconveyance of each Deed of Trust being paid off through this transaction at $45.00. The reconveyance fee must be clearly set forth in the Beneficiary's Payoff Demand Statement ("Demand"). In addition, an assignment or authorized release of that fee, from the Beneficiary to the Trustee of record, must be included. An example of the required language is as follows: The Beneficiary identified above hereby assigns, releases or transfers to the Trustee ofrecord, the sum of$45.00, included herein as 'Reconveyance Fees', for the processing and recordation of the Reconveyance of the Deed of Trust securing the indebtedness covered hereby, and the escrow company or title company processing this pay-off is authorized to deduct the Reconveyance Fee from this Demand and forward said fee to the Trustee of record or the successor Trustee under the Trust Deed to be paid off in full. Cl TA Preliminary Report Form -Modified (11/17/06) Page 1 PRELIMINARY REPORT YOUR REFERENCE: INFORMATIONAL NOTES (Continued) Fidelity National Title Company ORDER NO.: 00159782-992-SD1-2MM In the event that the reconveyance fee and the assignment, release or transfer are not included within the demand statement, then Fidelity National Title Insurance Company and its Underwritten Agent may decline to process the reconveyance and will be forced to return all documentation directly to the Beneficiary for compliance with the requirements of the revised statute. 11. Note: Part of the RESP A Rule to simplify and Improve the Process of Obtaining Mortgages and Reduce Consumer Settlement Costs requires the settlement agent to disclose the agent and underwriter split of title premiums, including endorsements as follows: Line 1107 is used to record the amount of the total title insurance premium, including endorsements, that is retained by the title agent. Fidelity National Title Company retains 88% of the total premium and endorsements. Line 1108 used to record the amount of the total title insurance premium, including endorsements, that is retained by the title underwriter. Fidelity National Title Insurance Company retains 12% of the total premium and endorsements. 12. The Company and its policy issuing agents are required by Federal law to collect additional information about certain transactions in specified geographic areas in accordance with the Bank Secrecy Act. If this transaction is required to be reported under a Geographic Targeting Order issued by FinCEN, the Company or its policy issuing agent must be supplied with a completed AL TA Information Collection Form ("ICF") prior to closing the transaction contemplated herein. END OF INFORMATIONAL NOTES Marlo Macias/ms0 Cl TA Preliminary Report Form -Modified (11/17/06) Page2 Inquire before you wire! Wire Fraud Alert This Notice is not intended to provide legal or professional advice. If you have any questions, please consult with a lawyer. All parties to a real estate transaction are targets for wire fraud and many have lost hundreds of thousands of dollars because they simply relied on the wire instructions received via email, without further verification. If funds are to be wired in conjunction with this real estate transaction, we strongly recommend verbal verification of wire instructions through a known, trusted phone number prior to sending funds. In addition, the following non-exclusive self-protection strategies are recommended to minimize exposure to possible wire fraud. • NEVER RELY on emails purporting to change wire instructions. Parties to a transaction rarely change wire instructions in the course of a transaction. • ALWAYS VERIFY wire instructions, specifically the ABA routing number and account number, by calling the party who sent the instructions to you. DO NOT use the phone number provided in the email containing the instructions, use phone numbers you have called before or can otherwise verify. Obtain the phone number of relevant parties to the transaction as soon as an escrow account is opened. DO NOT send an email to verify as the email address may be incorrect or the email may be intercepted by the fraudster. • USE COMPLEX EMAIL PASSWORDS that employ a combination of mixed case, numbers, and symbols. Make your passwords greater than eight (8) characters. Also, change your password often and do NOT reuse the same password for other online accounts. • USE MULTI-FACTOR AUTHENTICATION for email accounts. Your email provider or IT staff may have specific instructions on how to implement this feature. For more information on wire-fraud scams or to report an incident, please refer to the following links: Wire Fraud Alert Federal Bureau of Investigation: http://www.fbi.gov Original Effective Date: 5/11/2017 Current Version Date: 5/11/2017 Internet Crime Complaint Center: http://www.ic3.gov Page 1 WIRE0016 (DSI Rev. 12/07/17) TM and© Fidelity National Financial, Inc. and/or an affiliate. All rights reserved e Fidelity National Title Company 7565 Mission Valley Road, #100, San Diego, CA 92108 Phone: (619) 725-2100 • Fax: (619) 297-2213 Notice of Available Discounts Pursuant to Section 2355.3 in Title 10 of the California Code of Regulations Fidelity National Financial, Inc. and its subsidiaries ("FNF") must deliver a notice of each discount available under our current rate filing along with the delivery of escrow instructions, a preliminary report or commitment. Please be aware that the provision of this notice does not constitute a waiver of the consumer's right to be charged the filed rate. As such, your transaction may not qualify for the below discounts. You are encouraged to discuss the applicability of one or more of the below discounts with a Company representative. These discounts are generally described below; consult the rate manual for a full description of the terms, conditions and requirements for such discount. These discounts only apply to transactions involving services rendered by the FNF Family of Companies. This notice only applies to transactions involving property improved with a one-to-four family residential dwelling. Not all discounts are offered by every FNF Company. The discount will only be applicable to the FNF Company as indicated by the named discount. FNF Underwritten Title Company CTC -Chicago Title company CL TC -Commonwealth Land Title Company FNTC -Fidelity National Title Company of California FNTCCA -Fidelity National Title Company of California TICOR -Ticor Title Company of California L TC -Lawyer's Title Company SL TC -ServiceLink Title Company Available Discounts DISASTER LOANS (CTIC, CL TIC, FNTIC) Underwritten by FNF Underwriters CTIC-Chicago Title Insurance Company CL TIC -Commonwealth Land Title Insurance Company FNTIC -Fidelity National Title Insurance Company FNTIC -Fidelity National Title Insurance Company CTIC-Chicago Title Insurance Company CL TIC -Commonwealth Land Title Insurance Company CTIC-Chicago Title Insurance Company The charge for a Lender's Policy (Standard or Extended coverage) covering the financing or refinancing by an owner of reccrd, within twenty-four (24) months of the date of a declaration of a disaster area by the government of the United States or the State of California on any land located in said area, which was partially or totally destroyed in the disaster, will be fifty percent (50%) of the appropriate title insurance rate. CHURCHES OR CHARITABLE NON-PROFIT ORGANIZATIONS (CTIC, FNTIC) On properties used as a church or for charitable purposes within the scope of the normal activities of such entities, provided said charge is normally the church's obligation the charge for an owner's policy shall be fifty percent (50%) to seventy percent (70%) of the appropriate title insurance rate, depending on the type of coverage selected. The charge for a lender's policy shall be forty (40%) to fifty percent (50%) of the appropriate title insurance rate, depending on the type of coverage selected. Notice of Available Discounts (Rev. 01-15-20) MISC0164 (OSI Rev. 03/12/20) Last Saved: October 14, 2020 by MS0 Escrow No.: 00159782-992-SD1-2MM ,..... \. FIDELITY NATIONAL FINANCIAL, INC. PRIVACY NOTICE Effective April 9, 2020 Fidelity National Financial, Inc. and its majority-owned subsidiary companies (collectively, "FNF," "our," or "we") respect and are committed to protecting your privacy. This Privacy Notice explains how we collect, use, and protect personal information, when and to whom we disclose such information, and the choices you have about the use and disclosure of that information. A limited number of FNF subsidiaries have their own privacy notices. If a subsidiary has its own privacy notice, the privacy notice will be available on the subsidiary's website and this Privacy Notice does not apply. Collection of Personal Information FNF may collect the following categories of Personal Information: • contact information (e.g., name, address, phone number, email address); • demographic information (e.g., date of birth, gender, marital status); • identity information (e.g. Social Security Number, driver's license, passport, or other government ID number); • financial account information (e.g. loan or bank account information); and • other personal information necessary to provide products or services to you. We may collect Personal Information about you from: • information we receive from you or your agent; • information about your transactions with FNF, our affiliates, or others; and • information we receive from consumer reporting agencies and/or governmental entities, either directly from these entities or through others. Collection of Browsing Information FNF automatically collects the following types of Browsing Information when you access an FNF website, online service, or application (each an "FNF Website") from your Internet browser, computer, and/or device: • Internet Protocol (IP) address and operating system; • browser version, language, and type; • domain name system requests; and • browsing history on the FNF Website, such as date and time of your visit to the FNF Website and visits to the pages within the FNF Website. Like most websites, our servers automatically log each visitor to the FNF Website and may collect the Browsing Information described above. We use Browsing Information for system administration, troubleshooting, fraud investigation, and to improve our websites. Browsing Information generally does not reveal anything personal about you, though if you have created a user account for an FNF Website and are logged into that account, the FNF Website may be able to link certain browsing activity to your user account. Other Online Specifics Cookies. When you visit an FNF Website, a "cookie" may be sent to your computer. A cookie is a small piece of data that is sent to your Internet browser from a web server and stored on your computer's hard drive. Information gathered using cookies helps us improve your user experience. For example, a cookie can help the website load properly or can customize the display page based on your browser type and user preferences. You can choose whether or not to accept cookies by changing your Internet browser settings. Be aware that doing so may impair or limit some functionality of the FNF Website. Web Beacons. We use web beacons to determine when and how many times a page has been viewed. This information is used to improve our websites. Do Not Track. Currently our FNF Websites do not respond to "Do Not Track" features enabled through your browser. Links to Other Sites. FNF Websites may contain links to unaffiliated third-party websites. FNF is not responsible for the privacy practices or content of those websites. We recommend that you read the privacy policy of every website you visit. Use of Personal Information FNF uses Personal Information for three main purposes: • To provide products and services to you or in connection with a transaction involving you. • To improve our products and services. • To communicate with you about our, our affiliates', and others' products and services,jointly or independently. When Information Is Disclosed We may disclose your Personal Information and Browsing Information in the following circumstances: • to enable us to detect or prevent criminal activity, fraud, material misrepresentation, or nondisclosure; • to nonaffiliated service providers who provide or perform services or functions on our behalf and who agree to use the information only to provide such services or functions; • to nonaffiliated third party service providers with whom we perform joint marketing, pursuant to an agreement with them to jointly market financial products or services to you; FNF Privacy Statement (Eff. April 9, 2020) MISC0219 (DSI Rev. 04/10/20) Copyright© 2020. Fidelity National Financial, Inc. All Rights Reserved Page 1 Order No. 00159782-992-SD1-2MM • to law enforcement or authorities in connection with an investigation, or in response to a subpoena or court order; or • in the good-faith belief that such disclosure is necessary to comply with legal process or applicable laws, or to protect the rights, property, or safety of FNF, its customers, or the public. The law does not require your prior authorization and does not allow you to restrict the disclosures described above. Additionally, we may disclose your information to third parties for whom you have given us authorization or consent to make such disclosure. We do not otherwise share your Personal Information or Browsing Information with nonaffiliated third parties, except as required or permitted by law. We may share your Personal Information with affiliates (other companies owned by FNF) to directly market to you. Please see "Choices with Your Information" to learn how to restrict that sharing. We reserve the right to transfer your Personal Information, Browsing Information, and any other information, in connection with the sale or other disposition of all or part of the FNF business and/or assets, or in the event of bankruptcy, reorganization, insolvency, receivership, or an assignment for the benefit of creditors. By submitting Personal Information and/or Browsing Information to FNF, you expressly agree and consent to the use and/or transfer of the foregoing information in connection with any of the above described proceedings. Security of Your Information We maintain physical, electronic, and procedural safeguards to protect your Personal Information. Choices With Your Information If you do not want FNF to share your information among our affiliates to directly market to you, you may send an "opt out" request by email, phone, or physical mail as directed at the end of this Privacy Notice. We do not share your Personal Information with nonaffiliates for their use to direct market to you without your consent. Whether you submit Personal Information or Browsing Information to FNF is entirely up to you. If you decide not to submit Personal Information or Browsing Information, FNF may not be able to provide certain services or products to you. For California Residents: We will not share your Personal Information or Browsing Information with nonaffiliated third parties, except as permitted by California law. For additional information about your California privacy rights, please visit the "California Privacy" link on our website (https://fof.com/pages/californiapri\ acy .aspx) or call (888) 413-1748. For Nevada Residents: You may be placed on our internal Do Not Call List by calling (888) 934-3354 or by contacting us via the information set forth at the end of this Privacy Notice. Nevada law requires that we also provide you with the following contact information: Bureau of Consumer Protection, Office of the Nevada Attorney General, 555 E. Washington St., Suite 3900, Las Vegas, NV 89101; Phone number: (702) 486-3132; email: BCPINFO@ag.state.nv.us. For Oregon Residents: We will not share your Personal Information or Browsing Information with nonaffiliated third parties for marketing purposes, except after you have been informed by us of such sharing and had an opportunity to indicate that you do not want a disclosure made for marketing purposes. For Vermont Residents: We will not disclose information about your creditworthiness to our affiliates and will not disclose your personal information, financial information, credit report, or health information to nonaffiliated third parties to market to you, other than as permitted by Vermont law, unless you authorize us to make those disclosures. Information From Children The FNF Websites are not intended or designed to attract persons under the age of eighteen (18). We do not collect Personal Information from any person that we know to be under the age of thirteen ( 13) without permission from a parent or guardian. International Users FNF's headquarters is located within the United States. If you reside outside the United States and choose to provide Personal Information or Browsing Information to us, please note that we may transfer that information outside of your country of residence. By providing FNF with your Personal Information and/or Browsing Information, you consent to our collection, transfer, and use of such information in accordance with this Privacy Notice. FNF Website Services for Mortgage Loans Certain FNF companies provide services to mortgage loan servicers, including hosting websites that collect customer information on behalf of mortgage loan servicers (the "Service Websites"). The Service Websites may contain links to both this Privacy Notice and the mortgage loan servicer or lender's privacy notice. The sections of this Privacy Notice titled When Information is Disclosed, Choices with Your Information, and Accessing and Correcting Information do not apply to the Service Websites. The mortgage loan servicer or lender's privacy notice governs use, disclosure, and access to your Personal Information. FNF does not share Personal Information collected through the Service Websites, except as required or authorized by contract with the mortgage loan servicer or lender, or as required by law or in the good-faith belief that such disclosure is necessary: to comply with a legal process or applicable law, to enforce this Privacy Notice, or to protect the rights, property, or safety ofFNF or the public. Your Consent To This Privacy Notice; Notice Changes; Use of Comments or Feedback By submitting Personal Information and/or Browsing Information to FNF, you consent to the collection and use of the information in accordance with this Privacy Notice. We may change this Privacy Notice at any time. The Privacy Notice's effective date will show the last date changes were made. If you provide information to us following any change of the Privacy Notice, that signifies your assent to and acceptance of the changes to the Privacy Notice. We may use comments or feedback that you submit to us in any manner without notice or compensation to you. FNF Privacy Statement (Eff. April 9, 2020) MISC0219 (OSI Rev. 04/10/20) Copyright© 2020. Fidelity National Financial, Inc. All Rights Reserved Page 2 Order No. 00159782-992-SD1-2MM .... Accessing and Correcting Information; Contact Us If you have questions, would like to correct your Personal Information, or want to opt-out of information sharing for affiliate marketing, send your requests to privacyril'fnf.com, by phone to (888) 934-3354, or by mail to: FNF Privacy Statement (Eff. April 9, 2020) MISC0219 (DSI Rev. 04/10/20) Fidelity National Financial, Inc. 601 Riverside Avenue Jacksonville, Florida 32204 Attn: Chief Privacy Officer Copyright© 2020. Fidelity National Financial, Inc. All Rights Reserved Page 3 Order No. 00159782-992-SD1-2MM ATTACHMENT ONE (Revised 05-06-16) CALIFORNIA LAND TITLE ASSOCIATION STANDARD COVERAGE POLICY-1990 EXCLUSIONS FROM COVERAGE The following matters are expressly excluded from the coverage of this policy and the Company will not pay loss or damage, costs, attorneys' fees or expenses which arise by reason of: 1. (a) Any law, ordinance or governmental regulation (including but not limited to building or zoning laws, ordinances, or regulations) restricting, regulating, prohibiting or relating (i) the occupancy, use, or enjoyment of the land; (ii) the character, dimensions or location of any improvement now or hereafter erected on the land; (iii) a separation in ownership or a change in the dimensions or area of the land or any parcel of which the land is or was a part; or (iv) environmental protection, or the effect of any violation of these laws. ordinances or governmental regulations, except to the extent that a notice of the enforcement thereof or a notice of a defect, lien, or encumbrance resulting from a violation or alleged violation affecting the land has been recorded in the public records at Date of Policy. (b) Any governmental police power not excluded by (a) above, except to the extent that a notice of the exercise thereof or notice of a defect, lien or encumbrance resulting from a violation or alleged violation affecting the land has been recorded in the public records at Date of Policy. 2. Rights of eminent domain unless notice of the exercise thereof has been recorded in the public records at Date of Policy, but not excluding from coverage any taking which has occurred prior to Date of Policy which would be binding on the rights ofa purchaser for value without knowledge. 3. Defects, liens, encumbrances, adverse claims or other matters: (a) whether or not recorded in the public records at Date of Policy, but created, suffered, assumed or agreed to by the insured claimant; (b) not known to the Company, not recorded in the public records at Date of Policy, but known to the insured claimant and not disclosed in writing to the Company by the insured claimant prior to the date the insured claimant became an insured under this policy; ( c) resulting in no loss or damage to the insured claimant; ( d) attaching or created subsequent to Date of Policy; or ( e) resulting in loss or damage which would not have been sustained if the insured claimant had paid value for the insured mortgage or for the estate or interest insured by this policy. 4. Unenforceability of the lien of the insured mortgage because of the inability or failure of the insured at Date of Policy, or the inability or failure of any subsequent owner of the indebtedness, to comply with the applicable doing business laws of the state in which the land is situated. 5. Invalidity or unenforceability of the lien of the insured mortgage, or claim thereof, which arises out of the transaction evidenced by the insured mortgage and is based upon usury or any consumer credit protection or truth in lending law. 6. Any claim, which arises out of the transaction vesting in the insured the estate of interest insured by this policy or the transaction creating the interest of the insured lender, by reason of the operation offederal bankruptcy, state insolvency or similar creditors' rights laws. EXCEPTIONS FROM COVERAGE-SCHEDULE B, PART I This policy does not insure against loss or damage (and the Company will not pay costs, attorneys' fees or expenses) which arise by reason of: I Taxes or assessments which are not shown as existing liens by the records of any taxing authority that levies taxes or assessments on real property or by the public records. Proceedings by a public agency which may result in taxes or assessments, or notices of such proceedings, whether or not shown by the records of such agency or by the public records. 2. Any facts, rights, interests, or claims which are not shown by the public records but which could be ascertained by an inspection of the land or which may be asserted by persons in possession thereof. 3. Easements, liens or encumbrances, or claims thereof, not shown by the public records. 4. Discrepancies, conflicts in boundary lines, shortage in area, encroachments, or any other facts which a correct survey would disclose, and which are not shown by the public records. 5. (a) Unpatented mining claims; (b) reservations or exceptions in patents or in Acts authorizing the issuance thereof; (c) water rights, claims or title to water. whether or not the matters excepted under (a), (b) or (c) are shown by the public records. 6. Any lien or right to a lien for services, labor or material not shown by the public records. CLTA HOMEOWNER'S POLICY OF TITLE INSURANCE (12-02-13) ALT A HOMEOWNER'S POLICY OF TITLE INSURANCE EXCLUSIONS In addition to the Exceptions in Schedule B, You are not insured against loss, costs, attorneys' fees, and expenses resulting from 1. Governmental police power, and the existence or violation of those portions of any law or government regulation concerning: a. building; b. zoning; c. land use; d. improvements on the Land; e. land division; and f. environmental protection. This Exclusion does not limit the coverage described in Covered Risk 8.a., 14, 15, 16, 18, 19, 20, 23 or 27. 2. The failure of Your existing structures, or any part of them, to be constructed in accordance with applicable building codes. This Exclusion does not limit the coverage described in Covered Risk 14 or 15. 3. The right to take the Land by condemning it. This Exclusion does not limit the coverage described in Covered Risk 17. 4. Risks: a. that are created, allowed, or agreed to by You, whether or not they are recorded in the Public Records; b. that are Known to You at the Policy Date, but not to Us, unless they are recorded in the Public Records at the Policy Date; Attachment One -CA (Rev. 05-06-16) Page 1 © California Land Title Association. All rights reserved. The use of this Form is restricted to CL TA subscribers in good standing as of the date of use. All other uses are prohibited. Reprinted under license or express permission from the California Land Title Association. ,. .. c. that result in no loss to You; or d. that first occur after the Policy Date -this does not limit the coverage described in Covered Risk 7, 8.e., 25, 26, 27 or 28. 5. Failure to pay value for Your Title. 6. Lack of a right: a. to any land outside the area specifically described and referred to in paragraph 3 of Schedule A; and b. in streets, alleys, or waterways that touch the Land. This Exclusion does not limit the coverage described in Covered Risk 11 or 21. 7. The transfer of the Title to You is invalid as a preferential transfer or as a fraudulent transfer or conveyance under federal bankruptcy, state insolvency, or similar creditors' rights laws. 8. Contamination, explosion, fire, flooding, vibration, fracturing, earthquake, or subsidence. 9. Negligence by a person or an Entity exercising a right to extract or develop minerals, water, or any other substances. LIMITATIONS ON COVERED RISKS Your insurance for the following Covered Risks is limited on the Owner's Coverage Statement as follows: • For Covered Risk 16, I 8, 19, and 21 Your Deductible Amount and Our Maximum Dollar Limit of Liability shown in Schedule A. The deductible amounts and maximum dollar limits shown on Schedule A are as follows: Covered Risk 16: Covered Risk I 8: Covered Risk 19: Covered Risk 21 Your Deductible Amount 1.00% of Policy Amount Shown in Schedule A or $2,500.00 (whichever is less) 1.00% of Policy Amount Shown in Schedule A or $5,000.00 ( whichever is less) 1.00% of Policy Amount Shown in Schedule A or $5,000.00 ( whichever is less) 1.00% of Policy Amount Shown in Schedule A or $2,500.00 (whichever is less) 2006 ALTA LOAN POLICY (06-17-06) EXCLUSIONS FROM COVERAGE Our Maximum Dollar Limit of Liability $ 10,000.00 $25,000.00 $25,000.00 $5,000.00 The following matters are expressly excluded from the coverage of this policy, and the Company will not pay loss or damage, costs, attorneys' fees, or expenses that arise by reason of: I. (a) Any law, ordinance, permit, or governmental regulation (including those relating to building and zoning) restricting, regulating, prohibiting, or relating to (i) the occupancy, use, or enjoyment of the Land; (ii) the character, dimensions, or location of any improvement erected on the Land; ( iii) the subdivision ofland; or (iv) environmental protection; or the effect of any violation of these laws, ordinances, or governmental regulations. This Exclusion l(a) does not modify or limit the coverage provided under Covered Risk 5. (b) Any governmental police power. This Exclusion l(b) does not modify or limit the coverage provided under Covered Risk 6. 2. Rights of eminent domain. This Exclusion does not modify or limit the coverage provided under Covered Risk 7 or 8. 3. Defects, liens, encumbrances, adverse claims, or other matters (a) created, suffered, assumed, or agreed to by the Insured Claimant; (b) not Known to the Company, not recorded in the Public Records at Date of Policy, but Known to the Insured Claimant and not disclosed in writing to the Company by the Insured Claimant prior to the date the Insured Claimant became an Insured under this policy; ( c) resulting in no loss or damage to the Insured Claimant; ( d) attaching or created subsequent to Date of Policy (however, this does not modify or limit the coverage provided under Covered Risk I I, 13 or 14 ); or (e) resulting in loss or damage that would not have been sustained if the Insured Claimant had paid value for the Insured Mortgage. 4. Unenforceability of the lien of the Insured Mortgage because of the inability or failure of an Insured to comply with applicable doing-business laws of the state where the Land is situated. 5. Invalidity or unenforceability in whole or in part of the lien of the Insured Mortgage that arises out of the transaction evidenced by the Insured Mortgage and is based upon usury or any consumer credit protection or truth-in-lending law 6. Any claim, by reason of the operation of federal bankruptcy, state insolvency, or similar creditors' rights laws, that the transaction creating the lien of the Insured Mortgage, is (a) a fraudulent conveyance or fraudulent transfer, or (b) a preferential transfer for any reason not stated in Covered Risk 13(b) of this policy. 7. Any lien on the Title for real estate taxes or assessments imposed by governmental authority and created or attaching between Date of Policy and the date of recording of the Insured Mortgage in the Public Records. This Exclusion does not modify or limit the coverage provided under Covered Risk l l(b). The above policy form may be issued to afford either Standard Coverage or Extended Coverage. In addition to the above Exclusions from Coverage, the Exceptions from Coverage in a Standard Coverage policy will also include the following Exceptions from Coverage EXCEPTIONS FROM COVERAGE {Except as provided in Schedule B-Part II,{ t{or T}his policy does not insure against loss or damage, and the Company will not pay costs, attorneys' fees or expenses, that arise by reason of: {PART I {The above policy form may be issued to afford either Standard Coverage or Extended Coverage. In addition to the above Exclusions from Coverage, the Exceptions from Coverage in a Standard Coverage policy will also include the following Exceptions from Coverage: Attachment One -CA (Rev. 05-06-16) Page 2 © California Land Title Association. All rights reserved. The use of this Form is restricted to CL TA subscribers in good standing as of the date of use. All other uses are prohibited. Reprinted under license or express permission from the California Land Title Association. (a) Taxes or assessments that are not shown as existing liens by the records of any taxing authority that levies taxes or assessments on real property or by the Public Records; (b) proceedings by a public agency that may result in taxes or assessments, or notices of such proceedings, whether or not shown by the records of such agency or by the Public Records. 2. Any facts, rights, interests, or claims that are not shown by the Public Records but that could be ascertained by an inspection of the Land or that may be asserted by persons in possession of the Land. 3. Easements, liens or encumbrances, or claims thereof, not shown by the Public Records. 4. Any encroachment, encumbrance, violation, variation, or adverse circumstance affecting the Title that would be disclosed by an accurate and complete land survey of the Land and not shown by the Pub I ic Records. 5. (a) Unpatented mining claims; (b) reservations or exceptions in patents or in Acts authorizing the issuance thereof; (c) water rights, claims or title to water, whether or not the matters excepted under (a), (b ), or ( c) are shown by the Public Records. 6. Any lien or right to a lien for services, labor or material not shown by the Public Records.} PART II In addition to the matters set forth in Part I of this Schedule, the Title is subject to the following matters, and the Company insures against loss or damage sustained in the event that they are not subordinate to the lien of the Insured Mortgage } 2006 ALTA OWNER'S POLICY (06-17-06) EXCLUSIONS FROM COVERAGE The following matters are expressly excluded from the coverage of this policy, and the Company will not pay loss or damage, costs, attorneys' fees, or expenses that arise by reason of: I (a) Any law, ordinance, permit, or governmental regulation (including those relating to building and zoning) restricting, regulating, prohibiting, or relating to (i) the occupancy, use, or enjoyment of the Land; (ii) the character, dimensions, or location of any improvement erected on the Land; (iii) the subdivision ofland; or (iv) environmental protection; or the effect of any violation of these laws, ordinances, or governmental regulations. This Exclusion l(a) does not modify or limit the coverage provided under Covered Risk 5. (b) Any governmental police power. This Exclusion I (b) does not modify or limit the coverage provided under Covered Risk 6. 2. Rights of eminent domain. This Exclusion does not modify or limit the coverage provided under Covered Risk 7 or 8. 3. Defects, liens, encumbrances, adverse claims, or other matters ( a) created, suffered, assumed, or agreed to by the Insured Claimant; (b) not Known to the Company, not recorded in the Public Records at Date of Policy, but Known to the Insured Claimant and not disclosed in writing to the Company by the Insured Claimant prior to the date the Insured Claimant became an Insured under this policy; (c) resulting in no loss or damage to the Insured Claimant; (d) attaching or created subsequent to Date of Policy (however, this does not modify or limit the coverage provided under Covered Risk 9 and IO); or (e) resulting in loss or damage that would not have been sustained if the Insured Claimant had paid value for the Title. 4. Any claim, by reason of the operation of federal bankruptcy, state insolvency, or similar creditors' rights laws, that the transaction vesting the Title as shown in Schedule A, is (a) a fraudulent conveyance or fraudulent transfer; or (b) a preferential transfer for any reason not stated in Covered Risk 9 of this pol icy. 5. Any lien on the Title for real estate taxes or assessments imposed by governmental authority and created or attaching between Date of Policy and the date of recording of the deed or other instrument of transfer in the Public Records that vests Title as shown in Schedule A. The above policy form may be issued to afford either Standard Coverage or Extended Coverage. In addition to the above Exclusions from Coverage, the Exceptions from Coverage in a Standard Coverage policy will also include the following Exceptions from Coverage EXCEPTIONS FROM COVERAGE This policy does not insure against loss or damage, and the Company will not pay costs, attorneys' fees or expenses, that arise by reason of: { The above policy form may be issued to afford either Standard Coverage or Extended Coverage. In addition to the above Exclusions from Coverage, the Exceptions from Coverage in a Standard Coverage policy will also include the following Exceptions from Coverage: I (a) Taxes or assessments that are not shown as existing liens by the records of any taxing authority that levies taxes or assessments on real property or by the Public Records; (b) proceedings by a public agency that may result in taxes or assessments, or notices of such proceedings, whether or not shown by the records of such agency or by the Public Records. 2. Any facts, rights, interests, or claims that are not shown in the Public Records but that could be ascertained by an inspection of the Land or that may be asserted by persons in possession of the Land. 3. Easements, liens or encumbrances, or claims thereof, not shown by the Public Records. 4. Any encroachment, encumbrance, violation, variation, or adverse circumstance affecting the Title that would be disclosed by an accurate and complete land survey of the Land and that are not shown by the Public Records. 5. (a) Unpatented mining claims; (b) reservations or exceptions in patents or in Acts authorizing the issuance thereof; (c) water rights, claims or title to water, whether or not the matters excepted under (a), (b), or (c) are shown by the Public Records. 6. Any lien or right to a lien for services, labor or material not shown by the Public Records. } 7. {Variable exceptions such as taxes, easements, CC&R's, etc. shown here.} Attachment One -CA (Rev. 05-06-16) Page 3 © California Land Title Association. All rights reserved. The use of this Form is restricted to CL TA subscribers in good standing as of the date of use. All other uses are prohibited. Reprinted under license or express permission from the California Land Title Association. ALTA EXPANDED COVERAGE RESIDENTIAL LOAN POLICY -ASSESSMENTS PRIORITY (04-02-15) EXCLUSIONS FROM COVERAGE The following matters are expressly excluded from the coverage of this policy and the Company will not pay loss or damage, costs, attorneys' fees or expenses which arise by reason of: I. (a) Any law, ordinance, permit, or governmental regulation (including those relating to building and zoning) restricting, regulating, prohibiting, or relating to ( i) the occupancy, use, or enjoyment of the Land; ( ii) the character, dimensions, or location of any improvement erected on the Land; (iii) the subdivision ofland; or (iv) environmental protection; or the effect of any violation of these laws, ordinances, or governmental regulations. This Exclusion l(a) does not modify or limit the coverage provided under Covered Risk 5, 6, 13( c ), 13( d), 14 or 16. (b) Any governmental police power. This Exclusion l(b) does not modify or limit the coverage provided under Covered Risk 5, 6, l 3(c), 13(d), 14 or 16. 2. Rights of eminent domain. This Exclusion does not modify or limit the coverage provided under Covered Risk 7 or 8. 3. Defects, liens, encumbrances, adverse claims, or other matters (a) created, suffered, assumed, or agreed to by the Insured Claimant; (b) not Known to the Company, not recorded in the Public Records at Date of Policy, but Known to the Insured Claimant and not disclosed in writing to the Company by the Insured Claimant prior to the date the Insured Claimant became an Insured under this policy; ( c) resulting in no loss or damage to the Insured Claimant; (d) attaching or created subsequent to Date of Policy (however, this does not modify or limit the coverage provided under Covered Risk I I, 16, 17, 18, 19, 20, 21, 22, 23, 24, 27 or 28); or (e) resulting in loss or damage that would not have been sustained if the Insured Claimant had paid value for the Insured Mortgage. 4. Unenforceability of the lien of the Insured Mortgage because of the inability or failure of an Insured to comply with applicable doing-business laws of the state where the Land is situated. 5. Invalidity or unenforceability in whole or in part of the lien of the Insured Mortgage that arises out of the transaction evidenced by the Insured Mortgage and is based upon usury, or any consumer credit protection or truth-in-lending law. This Exclusion does not modify or limit the coverage provided in Covered Risk 26. 6. Any claim of invalidity, unenforceability or lack of priority of the lien of the Insured Mortgage as to Advances or modifications made after the Insured has Knowledge that the vestee shown in Schedule A is no longer the owner of the estate or interest covered by this policy. This Exclusion does not modify or limit the coverage provided in Covered Risk 11. 7. Any lien on the Title for real estate taxes or assessments imposed by governmental authority and created or attaching subsequent to Date of Policy. This Exclusion does not modify or limit the coverage provided in Covered Risk l l(b) or 25. 8. The failure of the residential structure, or any portion of it, to have been constructed before, on or after Date of Policy in accordance with applicable building codes. This Exclusion does not modify or limit the coverage provided in Covered Risk 5 or 6. 9. Any claim, by reason of the operation of federal bankruptcy, state insolvency, or similar creditors' rights laws, that the transaction creating the lien of the Insured Mortgage, is ( a) a fraudulent conveyance or fraudulent transfer, or (b) a preferential transfer for any reason not stated in Covered Risk 27(b) of this policy. I 0. Contamination, explosion, fire, flooding, vibration, fracturing, earthquake, or subsidence. 11. Negligence by a person or an Entity exercising a right to extract or develop minerals, water, or any other substances. Attachment One -CA (Rev. 05-06-16) Page4 © California Land Title Association. All rights reserved. The use of this Form is restricted to CL TA subscribers in good standing as of the date of use. All other uses are prohibited. Reprinted under license or express permission from the California Land Title Association. § 0.. ~ SHT I .. 111o•s,'c ,,. .. " H .0.1 n~, 38 37 40 39 ': ~@ e @ ~ @~ ~ ' ~ " " " PRIMROSE \.. "·" 7Z I~ ,,., TllS WP w,s ~-Fa> ,ss,s,11;,.1 IURlSfi IN.I. IO Ull'lllY ~ ~ ~ 11-E ACCl,Rl,CY CJ TIE [)\JA 9(N'H. .\Si.~Drs PAIULS IMT tOT llMU 'flIH tOCAL ~ ~ fU.[)t{; ~'£ES NO'S.J'C ,,,,, 36 ~ @ ,.,. ,,.o, WAY : ~ SHT 2 ,. . ~ >-:~ • I ~ .. " 0 3.77 AC. 70 214-36 SHT20f2 --=>, z 1"•100' 1/,, d -,_y--·3 -,.,·<~ CHANGES I ll 01D NEW Tl CUT ,..,,, ,,~,, "'" ,,,,31 ~ .. -.. 2/JU l•s~.1~ l~•t5 17 Z:Z5& ... ~ ,,.,, w= !J\%7' ~ SHT I MAP 10815 CARLSBAD TRACT NO. 83-2 POR REM PARCEL MAP 8405 -CARLSBAD TRACT NO. 73-39 UNIT NO. 2 MAP 8404-CARLSBAD TRACT NO. 73-39 UNIT NO. I 8 Fidelity National Title Company 7565 Mission Valley Road, #100, San Diego, CA 92108 Phone: (619) 725-2100 • Fax: (619) 297-2213 STATEMENT OF INFORMATION CONFIDENTIAL INFORMATION FOR YOUR PROTECTION Escrow No.: 00159782-992-SD1-2MM Title No.: Completion of this statement expedites your application for title insurance, as it assists in establishing identity, eliminating matters affecting persons with similar names and avoiding the use of fraudulent or forged documents. Complete all blanks (please print) or indicate "none" or "NIA". If more space is needed for any item(s), use the reverse side of the form. Each party (and spouse/domestic partner, ifapplicable) to the transaction should personally sign this form. First Name Home Phone: Cell Phone: Social Security No.: NAME AND PERSONAL INFORMATION Middle/Maiden Name (if none, indicate) Business Phone: Fax: Last Name Driver's License No .. Date of Birth: ---------- Birthplace: ___________ _ Email: List any other name you have used or been known by State of residence: I have lived continuously in the U.S.A. since Are you currently married? Date and place of marriage: Spouse: First Name Home Phone: Cell Phone: Social Security No .. IF YES, COMPLETE THE FOLLOWING INFORMATION: Middle/Maiden Name (if none, indicate) Business Phone: Fax: Last Name ------------------ Driver's License No.: Date of Birth: ---------- Birthplace: Email: ------------- List any other name you have used or been known by: State of residence: Are you currently a registered domestic partner? Domestic Partner: First Name Home Phone: Cell Phone: Social Security No.: I have lived continuously in the U.S.A. since IF YES, COMPLETE THE FOLLOWING INFORMATION: Middle/Maiden Name (if none, indicate) Business Phone: Last Name Fax: _________________ _ Driver's License No .. Date of Birth: ---------- Birthplace: Email: ------------- List any other name you have used or been known by: State ofresidence: Child Name: Child Name: Number & Street Number & Street Finn or Business Name Finn or Business Name Statement of Information MISC0008 (OSI Rev. 03/26/20) I have lived continuously in the U.S.A. since Date of Birth: CHILDREN Child Name: Date of Birth: Child Name: (if more space is required, use reverse side offonn) RESIDENCES (LAST to YEARS) City City (if more space is required, use reverse side of form) OCCUPATIONS/BUSINESSES (LAST to YEARS) Address Address (if more space is required, use reverse side offonn) Page 1 Date of Birth: Date of Birth: From (date) to (date) From (date) to (date) From (date) to (date) From (date) to (date) Last Saved: 10/14/2020 2:30 PM by MS0 Order No.: 00159782-992-SD1-2MM SPOUSE'S/DOMESTIC PARTNER'S OCCUPATIONS/BUSINESSES (LAST 10 YEARS) Finn or Business Name Address From (date) to (date) Finn or Business Name Address From (date) to (date) (if more space is required, use reverse side of form) PRIOR MARRIAGE(S) Any prior marriages for either spouse? Prior spouse's (Party A) name: IF YES, COMPLETE THE FOLLOWING INFORMATION: __________________ Prior Spouse of Party A: Marriage ended by: □ Death □ Divorce Date of Death/Divorce Prior spouse's (Party B) name: __________________ Prior Spouse of Party B: Marriage ended by: □ Death □ Divorce Date of Death/Divorce ( if more space is required, use reverse side of form) PRIOR DOMESTIC PARTNERSHIP(S) Any prior domestic partnerships for either person? IF YES, COMPLETE THE FOLLOWING INFORMATION: Prior partner's name: ______________________ Prior Partner: Partnership ended by: □ Death □ Dissolution □ Nullification □ Termination Date of Death/Dissolution/etc.: Prior partner's name: Prior Partner: --------------------- Partnership ended by: □ Death □ Dissolution □ Nullification □ Termination Date of Death/Dissolution/etc .. (if more space is required, use reverse side of form) INFORMATION ABOUT THE PROPERTY Buyer intends to reside on the property in this transaction: □ Yes □ No OWNER TO COMPLETE THE FOLLOWING ITEMS Street Address of Property in this transaction: The land is □ unimproved; or improved with a structure of the following type: □ A Single or 1-4 Family □ Condo Unit Improvements, remodeling or repairs to this property have been made within the past six (6) months: □ Yes □ No If yes, have all costs for labor and materials arising in connection therewith been paid in full? □ Yes □ No Any current loans on property? IF YES, COMPLETE THE FOLLOWING INFORMATION: Lender: Loan Amount: Loan Account No .. ---------------------------- Lender: ________________ Lo an Amount: Lo an Account No. ------------ The undersigned declare, under penalty of perjury, that the foregoing is true and correct IN WITNESS WHEREOF, the undersigned have executed this document on the date(s) set forth below. Signature Print Name Signature Print Name Date Date (NOTE: IF APPLICABLE, BOTH SPOUSES/DOMESTIC PARTNERS MUST SIGN.) THANK YOU. □ Other Statement of Information MISC0008 (OSI Rev. 03/26/20) Page 2 Last Saved: 10/14/2020 2:30 PM by MS0 Order No.: 00159782-992-SD1-2MM RECORDING REQUESTED BY Fidelity National Title Company WHEN RECORDED MAIL TO: =addressee= ORDER NO.: 00159782-992-2MM SPACE ABOVE THIS LINE FOR RECORDER'S USE CERTIFICATION OF TRUST California Probate Code Section 18100.5 The undersigned declare(s) under penalty of perjury under the laws of the State of California that the following is true and correct: I . The Trust known as executed on ___________ , is a valid and existing trust. 2. The name(s) of the settlor(s) of the Trust is (are): __________________________ _ 3. The name(s) of the currently acting trustee(s) is (are): ________________________ _ 4. The trustee(s) of the Trust have the following powers (initial applicable line(s)): ___ Power to acquire additional property. ___ Power to sell and execute deeds. ___ Power to encumber, and execute deeds of trust. Other: --- 5. The Trust is ( check one): ___ Revocable Irrevocable --- The name of the person who may revoke the Trust is: ________________________ _ 6. The number of trustees who must sign documents in order to exercise the powers of the Trust is (are): _______ _ whose name(s) is (are): 7. Title to Trust assets is to be taken as follows: ---------------------------- 8. The Trust has not been revoked, modified or amended in any manner which would cause the representations contained herein to be incorrect. 9. I (we) am (are) all of the currently acting trustees. IO. I (we) understand that I (we) may be required to provide copies of excerpts from the original Trust documents which designate the trustees and confer the power to act in the pending transaction. Dated: ---------------- TRST0003 (OSI Rev. 11/05/14) Order No.: 00159782-992-2MM TRST0003 (Rev. 02/07/2012) (Acknowledgement must be attached) , .... CERTIFICATE OF ACKNOWLEDGEMENT OF NOTARY PUBLIC A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA COUNTY OF } ss: On __________________________________________ before me, a Notary Public, personally appeared---------------------------------- who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies) and that by his/her/their signature(s )on the instrument the person(s ), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature _________________ _ CERTIFICATE OF ACKNOWLEDGEMENT OF NOTARY PUBLIC A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. ST A TE OF CALIFORNIA COUNTY OF } ss: On __________________________________________ before me, a Notary Public, personally appeared---------------------------------- who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies) and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature _________________ _ RECORDING REQUESTED BY Fidelity National Title Company WHEN RECORDED MAIL TO: =addressee= ORDER NO.: 00159782-992-2MM SPACE ABOVE THIS LINE FOR RECORDER'S USE CERTIFICATION OF TRUST California Probate Code Section 18100.5 The undersigned declare(s) under penalty of perjury under the laws of the State of California that the following is true and correct: I. The Trust known as executed on ___________ , is a valid and existing trust. 2. The name(s) of the settlor(s) of the Trust is (are): __________________________ _ 3. The name(s) of the currently acting trustee(s) is (are): ________________________ _ 4. The trustee(s) of the Trust have the following powers (initial applicable line(s)): ___ Power to acquire additional property. Power to sell and execute deeds. --- ___ Power to encumber, and execute deeds of trust. Other: --- 5. The Trust is (check one): ___ Revocable Irrevocable --- The name of the person who may revoke the Trust is: ________________________ _ 6. The number of trustees who must sign documents in order to exercise the powers of the Trust is (are): _______ _ whose name(s) is (are): ----------------------------------- 7. Title to Trust assets is to be taken as follows: ___________________________ _ 8. The Trust has not been revoked, modified or amended in any manner which would cause the representations contained herein to be incorrect. 9. I (we) am (are) all of the currently acting trustees. 10. I (we) understand that I (we) may be required to provide copies of excerpts from the original Trust documents which designate the trustees and confer the power to act in the pending transaction. Dated: _______________ _ TRST0003 (DSI Rev. 11/05/14) Order No.: 00159782-992-2MM TRST0003 (Rev. 02/07/2012) (Acknowledgement must be attached) CERTIFICATE OF ACKNOWLEDGEMENT OF NOTARY PUBLIC A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. ST A TE OF CALIFORNIA COUNTY OF □ ss: On __________________________________________ before me, a Notary Public, personally appeared---------------------------------- who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies) and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalfofwhich the person(s) acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature _________________ _ CERTIFICATE OF ACKNOWLEDGEMENT OF NOTARY PUBLIC A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. ST A TE OF CALIFORNIA COUNTY OF □ ss: On __________________________________________ before me, a Notary Public, personally appeared---------------------------------- who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies) and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature _________________ _ e Fidelity National Title Company 7565 Mission Valley Road, #100, San Diego, CA 92108 Phone: (619) 725-2100 • Fax: (619) 297-2213 CREDIT LINE / EQUITY LINE OF CREDIT CLOSURE REQUEST Date: To: Attention: Payoff Dept. Reference: Account/Loan # ----------------------------------Property Address: 917 Orchid Way, Carlsbad, CA 92011 To Whom It May Concern: Please accept this letter as a request to close/freeze the above-referenced credit line or equity line of credit as of this date. 1/W e agree not to request any advances on this account on or after the date of this letter. You will be receiving payment in full from the proceeds of our escrow transaction. Upon receipt of payoff, please send your Reconveyance or Release of Lien to: Fidelity National Title Company 7565 Mission Valley Road, #100 San Diego, CA 92 I 08 Attn: Marlo Macias Ref: 00159782-992-2MM Sincerely, (All borrowers must sign) REQOOOOI (Rev. 12/5/2012) ALTA Information Collection Form Page 8 of 4 Under 31 U.S.C. § 5326(a), the Treasury Department's Financial Crimes Enforcement Network (FinCEN) issued a Geographic Targeting Order to title insurance companies requiring the collection of beneficial ownership information for certain real estate transactions. Please complete the below questionnaire. This Company will rely on the answers provided to meet its reporting obligations. Who is completing this form? Name Position/Title Company/Law Firm Postal Address (Headquarters City State Zip Phone Email Fax Transactional Information Property Address (If Multiple properties see NOTE below): City State Zip County Date of Settlement Total purchase price (if multiple properties see NOTE below) Type of Transaction: D Residential (1-4 family) D Commercial I Bank Financing: □ Yes Purchase type: D Natural Person D Corporation □ LLC D Partnership NOTE: if more than one property is purchased, list each address and purchase price as an addendum. Purchase Funds Information Total Amount paid by below instruments: $ Which type of Monetary Instruments were used ( Use check boxes below) D U.S. Currency (Paper money & coin) D Foreign Currency Country: D Cashier's check(s) D Money order(s) D Certified check(s) D Personal or Business check(s) D Wire or other funds transfer(s) D Virtual Currency D Other □No AL TA Information Collection Form (12/20/18) UFRM0004 (DSI Rev. 1/2/19) Last Saved: 6/28/2017 2:56 AM by MS0 Order No.: 00159782-992-SD1-2MM ALTA Information Collection Form Page 9 of4 Individual Primarily Representing Purchaser (Define as the individual authorized by the entity to enter into legally binding contracts). Attach Legible copy of government issued identification (i.e., passport, driver's license, etc.) Type of ID Issuing State or Country Last Name First Name - Gov't ID Number M.I. Date of Birth I Occupation Individual Taxpayer ID# (if none write NA) % of ownership Address City State Zip Purchasing Entity Name & Address Name of Purchaser Taxpayer ID Number or EIN (/fnone write NIA) Doing Business Name (DBA) (if none write NIA) Address City State Zip Complete the information below if the real estate purchase is being made by a corporation, LLC, partnership, other legal entity. (Do not report trusts.) For Corporations, LLCs, Partnerships and Other Entities provide the information for: • Each BENEFICIAL OWNER defined as an individual who, directly or indirectly, owns 25% or more of the equity interests of the Purchaser. • If a legal entity or a series of legal entities own the equity interests of the Purchaser, provide information for each BENEFICIAL OWNER, of each legal entity in the series oflegal entities. (Note: It is NOT necessary to complete the address fields if the information is on a legible copy of the government issued ID submitted to the title company.) AL TA Information Collection Form (12/20/18) UFRM0004 (OSI Rev. 1/2/19) Last Saved: 6/28/2017 2:56 AM by MS0 Order No.: 00159782-992-SD1-2MM ALTA Information Collection Form Page 10 of 4 Attach Legible copy of government issued identification (i.e., passport, driver's license, etc.) Type of ID I Issuing State or Country Last Name First Name Gov't ID Number Date of Birth Occupation Individual Taxpayer ID# (,{none write NA) Address I City I State Attach Legible copy of government issued identification (i.e., passport, driver's license, etc.) Type of ID I Issuing State or Country I Gov't ID Number Last Name First Name Date of Birth Occupation Individual Taxpayer ID# (,{none wnte NA) Address City State Attach Legible copy of government issued identification (i.e., passport, driver's license, etc.) Type of ID Issuing State or Country Gov't ID Number Last Name I FirstName Date of Birth I Occupation I Individual Taxpayer ID# (if none write NA) Address I City I State Attach Legible copy of government issued identification (i.e., passport, driver's license, etc.) Type of ID Issuing State or Country Gov't ID Number Last Name First Name Date of Birth Occupation I Individual Taxpayer ID# (if none write NA) Address I City I State Attach Legible copy of government issued identification (i.e., passport, driver's license, etc.) M.I. % of ownership Zip M.I. % of ownership Zip M.I. % of ownership Zip M.I. % of ownership Zip AL TA Information Collection Form (12/20/18) UFRM0004 (DSI Rev. 1/2/19) Last Saved: 6/28/2017 2:56 AM by MS0 Order No.: 00159782-992-SD1-2MM ,,,...._ ALTA Information Collection Form Page 11 of 4 Type of ID Issuing State or Country Gov't ID Number Last Name First Name M.I. Date of Birth I Occupation I Individual Taxpayer ID# (if none write NA) % of ownership Address City State Zip I declare that to the best of my knowledge, the information I have furnished is true, correct and complete. I understand that this Title Company will rely on this information for the purposes of completing any reports made pursuant to an obligation under 31 U.S.C. § 5326(a), Signature: Type or Print Name: ALTA Information Collection Form (12/20/18) UFRM0004 (OSI Rev. 1/2/19) Date: Title: Last Saved: 6/28/2017 2:56 AM by MS0 Order No.: 00159782-992-SD1-2MM