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FULL PACKET_09-06-2016
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FULL PACKET_09-06-2016
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10/14/2016 3:26:17 PM
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9/27/2016 4:31:01 PM
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EXHIBIT C <br />FIRPTA CERTIFICATE <br />TRANSFEROR'S CERTIFICATE OF NON -FOREIGN STATUS <br />To inform the Our Lady of Guadalupe Church (Delhi) ("Transferee"), that withholding of tax <br />under Section 1445 of the Internal Revenue Code of 1986, as amended ("Code") will not be required <br />upon the transfer of certain real property to the Transferee by the Housing Authority of the City of <br />Santa Ana (the, "Transferor"), the undersigned hereby certifies the following: <br />1. The Transferor is not a foreign person or citizen, foreign corporation, foreign <br />partnership, foreign trust, or foreign estate (as those terms are defined in the Code and the Income <br />Tax Regulations promulgated thereunder); <br />2. The Transferor's social security number or U.S. employer identification number is as <br />follows: <br />The Transferor's home or office address is: <br />The Transferor understands that this certification may be disclosed to the Internal Revenue <br />Service by the Transferee and that any false statement contained herein could be punished by fine, <br />imprisonment or both. Under penalty of perjury, I declare that I have examined this certification and <br />to the best of my knowledge and belief it is true, correct and complete, and I further declare that I <br />have authority to sign this document. <br />Housing Authority of the City of Santa Ana <br />4-30 <br />
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