RECORDING INFORMATION

Recording requested by:

FOR USE OF COUNTY
RECORDER

After recording return to:

Indexing instructions.
This notice must be
indexed as follows:

Grantor and grantee
index—each claimant
is a grantor.

NOTICE OF INTENT TO PRESERVE INTEREST

This notice is intended to preserve an interest in real property from extinguishment pursuant to Title 5 (commencing with Section 880.020) of Part 2 of Division 2 of the Civil Code (Marketable Record Title).

Claimant

Name:

Mailing address:
(must be given for each claimant)

Interest

Character (e.g., power of
termination):

Record location of document
creating or evidencing
interest in claimant:

Real Property

Legal description (may be same
as in recorded document
creating or evidencing
interest in claimant):

I assert under penalty of perjury that this notice is not recorded for the purpose of slandering title to real property and I am informed and believe that the information contained in this notice is true. If this notice is made on behalf of a claimant, I assert under penalty of perjury that I am authorized to act on behalf of the claimant.

Signed:

(claimant)

(person acting on behalf

of claimant)

Date:

Certificate of acknowledgment required.