LLA 1990-109CITY OF LA QUINTA
PLANNING i DEVELOT DEPARTMENT
78-105 CALLS ESTADO '
LA QUINTA, CALIFORNIA 92253
APPLICATION FOR LOT LINE. ADJUSTMENT
u
OFFICE
USE ONLY i
u
nZoning: G,/:z
LLA No. 90
a Related Cases:
N"
Reviewed By:
up Reviewed
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APPLICANT
Name: O)a , D if LT rd KI
Address: Q-1 rd
9:1�7.3
(City) (State) '(Zip)
PROPERTY OWNERS
Daytime
Phone: . k.
Owner "A" "A" Name: DAJ O) CE7i a:;4 (L,v A-)
Address: r,,-l-jGS
J-;4 C9 ,n7iZ (° ✓� �J?� i '� Phone:
(City) (State) (Zip)
Owner "B" Name:
Address: rj _t-
G.��i Phone:
(City) (State) (Zip)
Owner "C" Name:
Address:
Phone:
(City) (State) (Zip)
PROPERTY DATA
Property A: Assessor's Parcel Number: %b i -14 Z— �n �
Street Address (if any):
Property B:
Property C:
Assessor's Parcel Number: 'L42—
Street Address (if any):
Assessor's Parcel Number:
Street Address (if any):
REASON FOR REQUEST:�„i ct n n
E
E
I/We hereby certify that: 1) I am/We are the record owner(s) of
all parcels proposed for merger by this Application; (2) I/we have
knowledge of and consent to the filing of this Application; and,
3) The information submitted in connection with this Application
is true and correct.
Owner "A":
Name Date
Owner "s":
e Date
Owner "C":
Representative
Signature:
(Attach Letter(s) of Authorization)
Date
Date
MR /FOPMT.T,A . 001
-ois -74,R- I g-
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77
EXHIBIT er25I°JLw'i
L1-A CASE NO. d`/-4 «'� �� —cn' 6 (-9
�ocf Unit No, 5
®
0
RECORDING REQUESTED BY
Recording requested by
UNIGN LAND TITLE COMPANY
AND WHEN RECORDED MAIL T0:
SSlI
,IuM
,1%b
Name
MR. AND MRS. , DAVID CETINA
Street
51-2&5' Cane '4v;Nro
! i•.1s:;..'t:;
Cddrity gss
LA QUINTA, CA 92253
i'"""`---'--.._.__�'iA
State
.. •_
... «..
MAIL TAX STATEMENTS TO:
F 7
Name
Street
Address
City a SAME
State
L J
SPACE ABOVE THIS LINE FOR RECORDER'S USE
The undersigned grantor(s) declare(s): Title Company as an accomodation only. It has
Documentary transfer tax is $ not been examined as to its execution or as to its
( ) computed on full value of property conveyed, or affect upon the titles
( ) computed on full value less value of liens and encumbrances remaining at time of sale.
( ) Unincorporated area: (XX ) City of I A QU I NIA , and
BRUC'E Y BCAI ART JRATAND'L���r'M6 CATHCA� e YusrbancVan wife as joint tenants, aS
to an undivided 1/3 interest; JAMES YOUNG CATHCART, a married man as his sole and sep
here byG�ff5tjytbas to an undivided 1/3 interest; JOE G. CAFFERY AND KIM MARIE CAFFERY,
DAVID CETINA AND ALMA CETINA, husband and wife, as joint tenants
the following described real property in the
County of RIVERSIDE , State of California:
THE NORTHERLY FIVE (5) FEET OF LOT 176 OF DESERT CLUB ESTATES UNIT #5, AS PER MAP
RECORDED IN BOOK 21 PAGES 61 AND 62 OF MAPS, RECORDS OF SAID COUNTY.
THIS DEED REFLECTS LOT LINE ADJUST14ENT #90.109 AS APPROVED BY THE CITY OF LA QUINTA.
**husband and wife as joint tenants, as to an undivided 1/3 interest.
Dated: MAY 312 1990
STATE OF CALIFORNIA SS.
COUNTY OF RIVERSIDE
On 5TH OF JUNE 1990
before me, a Notary Public
in and for said State, personally appeared BRIT .E YOUNG .A HC.
&TQRA MnON CATHCART C TAMES YOUNG CATHCART
& JOE G. CAFFERY & KIM MARIE CAFFERY
(known to mi
(xaveRXvcroxXmxt�xXffiN9c0�eag8at2bYgkW'ehigej to be the person
whose name ARE subscribed to the
within instrument and acknowledged that THEY
executed the same.
WITNESS my hand and official seal���
_—
KATHERINE A. BEVERS
Name (Typed or Printed)
Title Order No
-----------------
OFFICIAL SEAT.
KATHERINE A REVERS
19 NOTARYPtBUC • CALIFORMII
PoVEA3BECOUNIY
Aq Caw agrM APr010, 1PP2
(This area for official notarial reap
Escrow or Loan No.
UL-4 MAIL TAX STATEMENTS AS DIRECTED ABOVE.
RECORDING REQUESTED BY
j l„
Recording requested by
ANION LAND TITLE VUmrANY
AND WHEN RECORDED MAIL TO:
F
Name
BRUCE YOUNG CATHCART
Street
JAMES YOUNG CATHCART,
et al
Address
City
P.O. BOX 1555
State
L
LA QUINTA, CA 92253
J
MAIL TAX STATEMENTS TO:
r
Name
Street
Address
SAME
City 8
State
L
J
Gra
.IUN 199C.
SPACE ABOVE THIS LINE FOR RECORDER'S USE
Union
not been examined as to its execution or as to its
The undersigned grantor(s) declare(s): effect upon the tide.
Documentary transfer tax is $ -n-
( ) computed on full value of property conveyed, or
( ) computed on full value less value of liens and encumbrances remaining at time of sale.
[ ) Unincorporated area: ( XX) City of LA QUINTA and
BRUCE YOUNG BC HCAI2TDT."O Nbr@cDeiAt MO J��A�i�Mby giuk�an�dc wife as joint tenants,
as to an und(i;viddeedd�1/3 interest; JAMES YOUNG CATHCART, a married man as his sole and
separate property, as to an undivided 1/3 interest; JOE G. CAFFERY AND KIM MARIE
hereby GRAT�IT(S) to CAFFERY,*
BRUCE YOUNG CATHCART, JR., AND LORA MOON CATHCART husband and wife as joint
tenants, as to an undivided 1/3 interest; JAMES YOUNG CATHCART, a married man as his
sole and separate property, as to an undivided 1/3 interest; JOE G. CAFFERY AND KIM
r1ARtlO�O mFE sbri�e�bea�paopar�iyfnt�e Joint tenants, as to an undivided 1/3 interest.
County of RIVERSIDE , State of California:
LOT 176 EXCEPTING THEREFROM THE NORTHERLY FIVE (5) FEET OF DESERT CLUB ESTATES
TRACT #5, AS PER MAP RECORDED IN BOOK 21 PAGES 61 AND 62 OF MAPS, RECORDS OF SAID
COUNTY.
THIS DEED REFLECTS LOT LINE ADJUSTMENT # % -109 AS APPROVED BY THE CITY OF LA QUINT
**husband and wife as joint tenants, as to an undivided 1/3 interest.
STATE OF CALIFORNIA y SS.
COUNTY OF RIVERSIDE )
On 5TH OF JUNE 1990
before me, a Notary Public
in and for said State, personally appeared
BRUCE YOUNG CATHCART & LORA MOON CATHCART &
JAMES YOUNG CATHCART & JOE G. CAFFERY & KIM
MARIE CAFFERY (known to me) tm
x6t:d$xscaaac:oxxkecBatiaxafsatEc6aa�x}ateckLgxec) to be the person
whose name ARE subscribed to the
within instrument and acknowledged that THEY
executed the same.
WITNESS my hand and official
A. BEVERS
Name (Typed or Printed)
Title Order No
----------------
KATNWK A. BEVERS
100WNWM-CMEOMA
11110 R0011m1Y
19AVCOM111110MAP11111,111111111
(Thin area for official lateral seat)
Escrow or Loan No.
uL-4 MAIL TAX STATEMENTS AS DIRECTED ABOVE.
I Ell
RECORDING REQUESTED BY
LZA- to 9
Recording requested by
UNION LAND TITLE COMPANY
AND WHEN RECORDED MAIL TO:
A
Name
MR. AND
MRS. DAVID CETINA
Street
51- 265
Calle Quinto
Cddraaa
LA QUINTA,
CA 92253
State
L
J
MAIL TAX STATEMENTS TO:
r
Name
Same
street
Address
SAME
city,
State
L
,J
Gra
Rc
tr , S� t.tir�•
Y
SPACE ABOVE THIS LINE FOR RECORDER'S USE
The undersigned grantor(s) declare(s):
Documentary transfer tax is $
( ) computed on full value of property conveyed, or
( ) computed on full value less value of liens and encumbrances remaining at time of sale.
( ) Unincorporated area: ( XX) City of I A QI I TNTA and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
DAVID CETINA AND ALMA CETINA
hereby GRANT(S) to
DAVID CETINA AND ALMA CETINA, husband and wife as joint tenants
the following described real property in the This Instrument filed for record by onion L9tt1
Title Company as an accomodation only. It has
County of RIVERSIDE State of California: not been examined as to its execution or as to its
effect upon the title.
LOT 177 AND THE NORTHERLY FIVE (5) FEET OF LOT 176 OF DESERT CLUB ESTATES UNIT #5,
AS SHOWN BY MAP ON FILE IN BOOK 21, PAGES 61 AND 62 OF MAPS, RECORDS OF SAID
COUNTY.
This Deed Reflects Lot Line Adjustment 11 20-4c,9 as Apprgved by the City of
Dated: MAY 31, 1990
STATE OF CALINRNIA
COUNTY 9F ) Ile r' S l e SS.
On /(J_ iU�6; 199n
before me, a Notary Public
in and for said State personally appeared
ID�ii r271711 y .
/9/zt:a- Ce4/n1l
,(known to me)(or
proved to me on the basis of satisfactory evidence) to be the person
whose name subscribed to the
within instrument and acknowledged that
executed the same.
WITNESS my a/nndandofficial seal.
Signature 1& 'LAv & i/7zL)A-d L,OL)/C-17 S., be�Ierla r-d
Name (Typed or Printedl
Title Order No
I
1 ,
(This area for official notarial seal)
Escrow or Loan No.
nL-4 MAIL TAX STATEMENTS AS DIRECTED ABOVE.
IRECORDING REQUESTED BY
v
AND WHEN RECORDED MAIL TO:
r
HMT. MR. AND MRS. DAVID CETINA
$1eB1
e0,e95 57- 265 Calle Qninto
A
c"' LLA QUINTA, CA 92253
Sian,
MAIL TAX STATEMENTS TO'.
r
Name
Ades, Same
C."ae, SAME
Sin.
LI SPACE ABOVE THIS LINE FOR RECORDER'S USE
Grant Dee AP„.
The undersigned grantorls) declare(s):
Documentary transfer tax is $
( computed on full value of property conveyed, or
( ) computed on full value less value of liens and encumbrances remaining at time of sale.
( J Unincorporated area:( XX)City of IA QUINIA ,and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
DAVID CETINA AND ALMA CETINA
hereby GRANT(S) to
DAVID CETINA AND ALMA CETINA, husband and wife as joint tenants
the following described real property in the
County of RIVERSIDE , State of California:
LOT 177 AND THE NORTHERLY FIVE (5) FEET OF LOT 176 OF DESERT CLUB ESTATES UNIT #5,
AS SHOWN BY MAP ON FILE IN BOOK 21, PAGES 61 AND 62 OF MAPS, RECORDS OF SAID
COUNTY.
This Deed Reflects Lot Line Adjustment # 20-6:�9 as Approved by the City of LaQuint
Dated: MAY 31, 1990
DAVID CETINA
STATE OF CALIPgRNIA �������
COUNTYOF K 'eC3 CL �ss. ,,j ALMA CETIN
On �li�n/e /990 1
before me, a Notary Public
in and for said State personally appeared
�f lIC
Jf/n%A
(known to me) (or
proved to me on the basis of satisfactory evideneel to be the person
whose name subscribed to the
within inst Dement and acknowledged that
executed the same.
WITNESS my Nnd and official seal.
Signature �
Neme (typed o, 1-1l nl
�4 1 #A zIa
o
oTie d.ee W, ollinel a a —I —1)
Title Order No. Escrow or Loan No.
UL-It MAIL TAX STATEMENTS AS DIRECTED ABOVE.
M
RECORDING REQUESTED BY
AND WHEN RECORDED MAIL TO:
r
Name
BRUCE
YOUNG CATHCART
SIVU
JAMES
YOUNG CATHCART,
et al
�ilyA
P.O.
BOX 1555
sti'e
L
LA QUINTA,
CA 92253
J
r
MAIL TAX TO:
�
NimB
street
AEe,Oe
SAME
City a
st.t.
L
J
Gra
SVACE ABOVE THIS LINE FOR RECORDER'S USE
The undersigned grantor(s) declare(s):
Documentary transfer tax is $ -n-
( ) computed on full value of property conveyed. or
( ) computed on full value less value of liens and encumbrances remaining at time of sale.
[ )Unincorporated area:( XX)Cityof I A QIITNTA ,and
t?UG� Yah��B� r�?d '"� O, t �6nl VV r, 55 ,y R`uktan�dPI-wi fe as joint tenants,
as to an undivided 03 interest; JAMES YOUNG CATHCART, a married man as his sole and
separate DroDerty, as to an undivided 1/3 interest; JOE G. CAFFERY AND KIM MARIE
hereby GRANT(5)to CAFFERY,*
BRUCE YOUNG CATHCART, JR., AND LORA MOON CATHCART husband and wife as joint
tenants, as to an undivided 1/3 interest; JAMES YOUNG CATHCART, a married man as his
soleandse&aratte property, as to an undivided 1/3 interest; JOE G. CAFFERY AND KIM
heRflon wAngEdesd,, eu� ana ande i .at�ie Joint tenants, as to an undivided 1/3 interest.
County of RIVERSIDE State of California:
LOT 176 EXCEPTING THEREFROM THE NORTHERLY FIVE (5) FEET OF DESERT CLUB ESTATES
TRACT #5, AS PER MAP RECORDED IN BOOK 21 PAGES 61 AND 62 OF MAPS, RECORDS
OF SAID
COUNTY.
THIS DEED REFLECTS LOT LINE ADJUSTMENT ll iO-(09 AS APPROVED BY THE CITY
OF LA QUINT
**husband and wife as joint tenants, as to an undivided 1/3 interest.
Dated:— MAY 31 1990
CATH ART
VAMOON
STATE OF CALIFORNIA 11courvry
H
oeRIVERSIDEss.�
On 5TH OF JUNE 1990��-
3 RT
before me, a Notary Public
�
in and for said State, personally appeared
BRUCE YOUNG CATHCART & LORA MOON CATHCART']
-&JOE
JAMES YOUNG CATHCART & JOE GCAFFERY & KIM '
MARIE CAFFERY (known to me) Kit
pxaxffiBlmaKnxxkBESagsnfaatM�AerBclaYaael to he the person KIM"MARIE GA FERY �-
-Whose name ARE subscribed to the
Within instrument and acknowledged that THEY
executed the same.
RATlEPoNE IL REVERS
WITNESS Iny hand and official seal 1111MUff"Auc-ampaiiiNIA
Signor --lip 60MAo410.19v2
KATHERINE A. BEVERS
I... rrVed ur Frmlee) jbT..... I., en;-1 nLun.I... 11
Title Order No. Escrow or Loan No.
CL-4 MAIL TAX STATEMENTS AS DIRECTED ABOVE.
RECORDING REQUESTED BY
AND WHEN RECORDED MAIL T0:
I
Name
MR. AND MRS. DAVID CETINA
suds,
51 -2/aS CA/lE 4✓i,v ro
Address
cd a
LA QUINTA, CA 92253
State
L
J
as —
r
MAIL TAX STATEMENTS TO'.
St .at
Adress
city e
SAME
L
J
Gra
SPACE ABOVE THIS LINE FOR RECORDER'S USE
The undersigned grantor(s) declare(s):
Documentary transfer tax is $
( ) computed on full value of property conveyed, or
( ) computed on full value less value of liens and encumbrances remaining at time of sale.
( ) Unincorporated area: ( gg ) City of , and
BKUI;tVY�BI:A1 Hl;ARI JRA AND'Lu �tPM0o0N CATH�AR ebl�usTno(rlan wit as joint tenants, as
to an undivided 1/3 interest; JAMES YOUNG CATHCART, a married man as his sole and sep
heeeby Gi�'"('tbas to an undivided 1/3 interest; JOE G. CAFFERY AND KIM MARIE CAFFERY,
DAVID CETINA AND ALMA CETINA, husband and wife, as joint tenants
the following described real property in the
County of RIVERSIDE . State of California:
THE NORTHERLY FIVE (5) FEET OF LOT 176 OF DESERT CLUB ESTATES UNIT /i5, AS PER MAP
RECORDED IN BOOK 21 PAGES 61 AND 62 OF MAPS, RECORDS OF SAID COUNTY.
THIS DEED REFLECTS LOT LINE ADJUSTMENT it'90.10 9 AS APPROVED BY THE CITY OF LA QUINTA.
**husband and wife as joint tenants, as to an undivided 1/3 interest.
Dated: MAY 31 1990
STATE OF CALIFORNIA
-
5s.
COUNTYOF RIVERSIDE
On 5TH OF JUNE 1990
before me.
a Notary Public
in and forsaid State, personally appeared
RRUCF- YOTIN]C CATHC
T
& JOE G. CAFFERY & KIM MARIE CAFFERY
(known to mel*tik
P¢ace]tRatmEa[witAaRnvlsmlkSxttuycTS to be the person
whose name ARE
subscribed to the
within instrument and acknowledged that
THEY
executed the same.
WITNESS my hand and official seal.-
SignO
KATHERINE A.
FEVERS
Name ITvodd o. Pnmedl
BTnTC��bUNG-CATTfCAkT
2�1
or
OFPICJAL SEAT.
KATRERINE A BEVERS
NDTARVggp-CAIiORfM
RNHMOELgMY
AR�fns EV��ApY tat 199t
tTMt area for o2nJ nouren seal]
Title Order No. Escrow or Loan No.
UL-4 MAIL TAR STATEMENTS AS DIRECTED ABOVE.
RDING REOUESTED BY
AHD WMEN RECORDED MAIL THIS OEE. NLE66
.END
WISE SHOWN BELOW, MAIL TAX sTATEM EiNVTo TO:
O NwYE
M...... Mr. and Mrs. David Cetina
err. 51-505 Avenida Martinez
6*in LLa Quints, CA 92253
Title Order No. 1690876
Escrow No. 7-3594
J
Ito,�M
�
1
Q D
V VLO
E
W m4uD
m i
I
-�> � r
ul a s
w
tt
p
SPACE ABOVE THIS
LINE FOR RECORDER'S USE r
GRANT DEED
The undersigned declares that the documentary transfer tax is $_.._.... .9.35_...... _._. _ _ and is
Ey computed on the full value of the interest or property conveyed, or is
❑ computed on the full value less the value of liens or encumbrances remaining, thereon at the time of sale. The land,
tenements or realty is located in
❑ unincorporated area ® city of ......... La Qudnta -
-.__ ...............____....._.__.._............ ____.....__... and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
1 GRETHE A. BUCRHOJ, a widow Said THORA E. GERSBOLL, a widow
pp� hereby GRANT(S) to
('p DAVID CETINA and ALMA CETINA, husband and wife, as joint tenants
V`
�T the following described real property in the city of La Quinta
county of Riverside ,state of California:
Lot 177 of Desert Club Tract, Unit No. 5, as shown by map on file in Book
21, Pages E1 anA A2 of Maps, Pecords of Riverside County, California
Dated —October 1fi, 19M5
GRETHE A. BUCEHOJ
THORA E. GERSBOLL
f
STATE OF CALIFORNIA
/'
COUNTY OF �f:./ {L� �nnSS.
/'r`
—
On this the day of
19�7before me the undersigned, a
Notary Public in and for said County and State, personally appeared
FOR NOTARY SEAL OR STAMP
. personally known
to me or proved to me on the basis of satisfactory evidence to be the
Bib l' l Z ' 1 701 de .015S I"NW! IF
person whose names IeEeuD6eribetl t0 the within instrument
11M90] 00310 IRS /
NI 30Uf01Yd10NlNd
and acknowledged that laic executed the same.
NBOdRrDOITBnd Adrl.ON�I.
Parrel No -._ .... ....... I
)IA 11, TAX STATEMENTS TO
CAL-1 (Rev.8 82)
IF NO LART1 O )HOV;N, MAIL 1.SDIRECTED AB(NF.
verl Addre ( n S Slele
FRANK C. SEELEY
RIVERSIDE COUNTY ASSESSOR
COUNTY ADMINISTRATIVE CENTER
4080 Lemon Street
Riverside, CA 92501-3659
Telephone (714) 787-6331
CATHCART7 BRUCE YOUNG Date Notice Mailed: 03-01-89
CATHCART? LORA MOON Supplemental Assessment No..050501545-9
CATHCART? JAMES YOUNG Assessment No:
CAFFERYr JOE G 769142006-5
Street Address or Leg, I Description:
P 0 BOX 1555 51275 CALLE QUITO
LA QUINTA9 CA 92253 LA QUINTA CA 92253
NOTICE OF SUPPLEMENTAL ASSESSMENT
One or more Supplemental Assessments have been enrolled for the property identified above. The cal-ulition of the amount is shown
in Section 1 below. l he supplemental assessment is caused by one of the following events as indicated -
Owners i
Ownership Date
New Construction
11-23-88 Recorder's 344179
No.
New Full Taxable Value
TOTAL 639000
Land 151000
Structures 48 000
Value o New Construction
Completion Date TOTAL
Land
Structures
The supplemental assessment is made in accordance with Article XIIIA of the California Constitutior that requires reappraisal of
property upon change in ownership or completion of new construction. Important information concerning roe Supplemental Assessment,
exemptions, your right to file an Application for Valuation Change, and refunds to which you may be entitled in the event of a negative
supplemental assessment, is located on the back.
The Amount of the Supplemental Assessment is the difference between the New Full Taxable Value of the sum of: 1) the Full Taxable
Value on the Roll and 2) the total of Prior Supplemental Assessment(s) which have occurred during the same assessment year.
A special property tax bill, or refund, based on the amounts of the Supplemental Asseimments noted below,
will be mailed to the name and address noted at the top of this form. Please read the reverse side for other
important supplemental assessment information.
1. Calculation of Supplemental Assessment(s)
First Supplemental Assessment
Fiscal Year 1988-89
Second Supplemental Assessment
Fiscal Year
NEW FULL TAXABLE VALUE
63*000
Less: Full Taxable Value on Roll
66 000
Less: Amount of Prior Supplemental(;)
AMOUNT OF SUPPLEMENTAL ASSESSMENT
-3 r 300
2. Exemptions:
Current Roll
Roll Being Prepared
Amount
Type
F112-7391Hemsee 10/811 PROPERTY IN CALIFORNIA IS ASSESSED AT 100% OF FULL (TAXABLEI VALUE
— THIS IS NOT A TAX BILL —
�cl,arty LOT 176 MB 021/061 DESE CLUB TR UNIT 5
Hats
®till
Number
0533972
Assessment Number
769142008-5
I" Rate Area
Pmcrtl Number
i,rro,s 5T275 CALLE QUITO LA QUINTA
92253
20-016
JjQ1§_z.QQB-5_
.essen CATHCART, BRUCE YOUNG JR
& LORA MOON & C
ETAL
t.and
$ 15,000
,w er evir,d by Tadn A moles (see item Ks on reverse _
G�NERAL PU-OP
Rate
Amount
Suucwres
48,000
1.00000
630.00
Fixtures
UNIFIED SCHOOL DEBT SV
.00971
6.11
1toes e.vines
COMMUNITY COLLEGE DEBT SV
.00142
COroS Past Vel le
COACHELLA VAL WATER DEBT SERV
.04980
.89
31.37
Personal Property
CVWD IMP DIST 1 DEBT SV
A
25.20
CITY OF LA QUINTA LDS & LTG
A
12.00
CITY OF LA QUINTA WASTE DISP
A
83.40
FullVnlno
$ 63,000
Lass Fxornpoons
Net Val io
9 63,000
lax Rau• per ? u value
9 06.0.93—
Taxes
Other Assess,n 'Its
668.38
120.60
`91 9%ZM9
TOTAL AMOI,NT DUE
s 788.98
CATHCART, BRUCE YOUNG
JR & LORA MOON
& C ETAL
1 st ins al lnient Receipt
2nd lnstallmem. Receipt
P 0 BOX 1555
394.49
3949,Al?w
LA QUINTA, CA
92253
Add Io^r,
penalty
ponallSEE
$10 enoi
REVERSE SIDE FOR
IAX FIRFAIII I VFAR AM'
I ItARFR
after
tler
attvi
IMPORTANT INFORMATION
lSee Item 45 on re",
12110/fig
04110l96
5626-2456000 4476404
_�
394.49
a 394.49