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, TO BE COMPLETED BY ASSIGNOR(S) A.K.A. SELLER(S) CERTIFICATION: Pursuant to A.R.S. Title 37 and the Rules of the Arizona State Land Department, A.A.C. Title 12, Chapter 5, you must complete the following information pertinent to you and sign the certification. NOTE: Applicant must complete item #1. 1. Is this application made in the name of: (Applicant must check one) Individual(s) Husband & Wife Corpo ration Ltd. Liability Co. Partnership Ltd. Partnership Estate Trust Joint Venture ' Municipality _XPolitical Subdivision Other (specify) 2. INDIVIDUAL(s) OR HUSBAND & WIFE: Complete the following for each applicant: NAME AGE MARITAL STATUS 3. CORPORATION: Complete the following: N //3' (A) Do you have authority from the Arizona Corporation Commission to transact business in the State of Arizona? Yes No (B) Is the corporation presently in good standing with the Arizona Corporation Commission? Yes No (C) In what state are you incorporated? (D) Is the legal corporate name and Arizona business address the same as stated in this application? Yes No If no, state the Legal Corporate Name: Address: (Street or Box Number) (City) (State) (Zip) LIMITED LIABILITY COMPANY: Complete the following: N IA (A) If an hut-of-state limited liability company: Have you filed for a Certificate of Registration with the Arizona Corporation Commission? Yes No (B) If an Arizona limited liability company: Have you filed Articles of Organization with the Arizona Corporation Commission? Yes No (C) Are you authorized by the Arizona Corporation Commission to transact business in Arizona? Yes No 5. PARTNERSHIP OR JOINT VENTURE: Complete the following for each authorized partner or principal: NAME ADDRESS AGE MARITAL STATUS N /Pc 6. LIMII ED PARTNERSHIP: Is this limited partnership on file with the Arizona Secretary of State? YeS No Complete the following for the authorized general partner(s) only: GENERAL PARTNER(S) NAME BUSINESS ADDRESS iPc 7. ESTATE: Complete the following and attach a copy of the court or estate do cument(s): Name of the court appointed administrator or personal representative: List the type and date of issuance of the court or Estate document: (Type of Document) (Date issued) TRUST: (A) Complete the following pursuant to A.R.S. § 33-409, for each beneficiary of the Trust: NAME ADDRESS AGE MARITAL STATUS NV:\ or (B) Identify the Trust document by title, document number, and county where document is recorded: 9. I ITEREBY CERTIFY, UNDER PENALTY OF PERJURY, THAT THE INFORMATION AND STATEMENTS CONTAINED HEREIN, TOGETHER WITH ALL EXHIBITS AND ATTACHMENTS ARE TRUE, CORRECT AND COMPLETE AND THAT INVE HAVE AUTHORITY TO SIGN TECIS DOCUMENT. SIGNATURE(S) phut( subd (Namekif Corpor nership, etc.) Signature of Assignor (Individual, Trustee, Personal Representative, etc Signature Title Signature of Assignor (Individual, Trustee, Personal Representative, etc) (Signatures must be notarized on page 4) 6100-05199 (Rev. 08/20166v) Assign 3 ASSIGNOR(S) A.K.A. SELLER(S) NOTARY ACKNOWLEDGMENT STATE OF ARIZONA ) ss. County of On this day of , 20 before me, a Notary Public within and for said County, personally appeared and known to me to be the person(s) described in and who executed the same as free act and deed. (h is/h er/their) IN WITNESS WHEREOF, I hereunto set my hand and official seal. My Commission Expires: Notary Public STATE OF ARIZONA ) ss. County of On this day of , 20 before me, a Notary Public within and for said County, personally appeared and known to me to be the person(s) described in and who executed the same as free act and deed. (h is/h er/their) IN WITNESS WHEREOF, I hereunto set my hand and official seal. My Commission Expires: Notary Public 6100-05/94 (Rev. 08/2016dw) Assigh 4 TO DE COMPLETED BY ASSIGNEE(S) A,K,A, BUYER(S) . CERTIFICATION: Pursuant to A.R.S. Title 37 and the Rules of the Arizona State Land Department, A, A.C. Tide 12, Chapter 5, you must complete the following Information pertinent to you and sign the certification, NOTE: Applicant must complete item Mt 1, Is this application made In the name oft (Applicant must check one) Individual(s) Husband & Wife Corporation Ltd, Liability Co. Partnership Lid. Partnership Estnte Trust - Joint Venture • Marticipality Political Subdivision Other (specify) 2. INDIVIDUAL(s) OR HUSBAND & WIFE: Complete the following for each applicant: NAME AGE MARITAL STATUS 3, CORPORATION; Complete the following: (A) Do you hive authority from the Arizona Corporation Commission to transact business in the State of Arizona? Yes ND (B) Is the corporation presently in good standing with the Arizona Corporation Commission? Yes No (C) In what state are you incorporated? (D) Is the legal corporate name mid Arizona business address the same as stated in this application? Yes No If no, state the Legal Corporate Name: Address: (Street 01' Box Number) (City) (State) MP) 4. LIMITED LIABILITY COMPANY; Complete Me Mowing: (A) Han out-of-state limited liability company: Have you filed for a Cfrtificate of Registration with the Arizona Corporation Commission? Yes No (II) II' an Arizona limited liability company: Have you flied Articles of Organization with the Arizona Corporation Commission? Yes No (C) Are you authorized by the Arizona Corporation Commission to transact business In Arizona? Yes No 5, PARTNERSHIP OR JOINT VENTURE: Complete the following for each authorized partner or principal; NAME ADDRESS AGE MARITAL STATUS 6. LIMITED PARTNERSHIP; Is this limited partnership on file with the Arizona Secretary of State? Yes No Complete the following for the authorized anent partner(s) only: GENERAL PARTNER(S) NAME BUSINESS ADDRESS 7, ESTATE: Complete the following and attach a copv of the court or estate document(s): Name of the court appointed administrator or personal representative; List the type and date of Issuance of the con ii 01 Estate document: (Type of Document) (Date issued) 8. TRUST; (A) Complete the folloiving pursuant to A.R.S. § 33-404, for each beneficiary of lice Trust: NAME ADDRESS AGE MARITAL STATUS or (B) Identity the Trust document by title, document number, and county where document is recorded: 9, I HEREBY CERTIFY, UNDER PENALTY OF PERJURY, THAT THE INFORMATION AND STATEMENTS CONTAINED HEREIN, TOGETHER WITH ALL EXHIBIrl ATTACHMENTS ARE TRUE, CORRECT AND COMPLETE AND THAT !AVE HAVE AUTHORITY TO SIGN THIS DOCUMENT, SIGNATURE(S) ignature of Assignee (Individual, Trustee, Personal Representative, etc) iguature o sa goes n vii int , rustee, CI'S() 111, preset] tat ve, etc (Signatures must be notarized on page 6) 6100-05/94 (Rev. 08/2016dw) Assign 5 EXHIBIT "A" DESCRIPTION ROAD RIGHT OF WAY INSTRUMENT 19870578338 MARICOPA COUNTY RECORDS Three parcels of land lying In Section Thirty-six (36), Township Five (5) North, Range Two (2) West of the Gila and Salt River Base and Meridian, Maricopa County Arizona. Parcel No. 1: The East fifty-five (65) feet of said Section 36. Parcel No. 2: The South fifty-five (55) feet of the West 246 feet of the East 300 feet of the Southeast one-quarter of the Southeast one-quarter (SE 14 of SE %) of said Section 36. Parcel No. 3: The North 100 feet of the South 166 feet of the West 100 feet of the East 165 feet of the Southeast one-quarter of the Southeast one-quarter (SE 1/4 of SE 1/4) of said Section 36 described as follows: BEGINNING at the Southeast Corner of said Section 36; Thence along the south line of said Southeast one-quarter South 89 045123" West 300.00 feet; Thence departing said line North 00°0451" East 65.00 feet; Thence North 89 045123" East 146.00 feet; Thence North 00 004151" East 100.00 feet; Thence North 89°45'23" East 100.00 feet; Thence North 00 004151" East 2267.69 feet to the East-West midsection line of said Section 36; Thence North 00 00245" East 2639.06 feet to the north line of the Northeast one-quarter of said Section 36; Thence along said line South 89°41'47" East 55.00 feet to the Northeast Corner of said Section 36; Thence along the east line of said Northeast one-quarter South 00 002 145" West 2639.08 feet to the East One-quarter Corner of said Section 36; Thence along the East line of the Southeast one-quarter of said Section 36 South 00°04'51" West 2422.15 feet to the POINT OF BEGINNING. Containing 301,855 square feet, or 6.9296 acres, more or less. Attached is EXHIBIT "B" and by this reference is made a part hereof. End of description PATTON ROAD EXHIBIT "B" L6 NE COR NORTH LINE SECTION 36 SEC 36 T5N, R2W LINE TABLE LINE BEARING LENGTH Li S89° 45'23"W 300.00' L2 NOO° 04'51"E 55.00' SCALE: 1".300' L3 N89° 45'23"E 145.00' 14 N00° 04'51"E 100.00' !!!!!en 0 100 200 300 L5 N89° 45'23"E 100.00' L6 S89° 41 147"E 55.00' E 1/4 COR EAST-WEST MIDSECTION LINE SECTION 36 SEC 36 T3N, R2W LEGEND z KB POINT OF BEGINNING M.C.R. MARICOPA COUNTY RECORDER AREA: 301,855 SO. FT. OR 6.9296 ACRES r-4 — SUBJECT PARCEL LINE (NI BASIS OF BEARINGS Maricopo County Low Distortion Projection Linear unit: International foot Geodetic Datum: NAD 1983 Projection type: Lambert Conformal Conic (single parallel) Latitude of origin: 33°15 100"N Central meridian: 112°15'00" W False northing: 1,500,000.000 if t False Easting: 2,500,000.000 if t Standard parallel scale: 1.000045 (exact) POB SOUTH LINE SECTION 36 L21 Le SE COR JOMAX ROAD Ll SEC 36 T5N, R2W ROAD RIGHT OF WAY CITY OF SURPRISE INSTRUMENT 19870578338 M.C.R. SURPRISE LAND SURVEY DEPARTMENT AR$ZONA PROJECT # 18025 DRAWN BY RCD DATE 10-29-18 SHEET 1 OF 1 1 J5N ' I R 2 IN R 2 VVr 1`.77=-- 503 51 021C CITY OF SURPRISE REQUESTING ASSIGNMENT OF THIS AREA FROM MCDOT ASLD ROW P/I\RCELL111 -50 521 01: kl R2IN . 4 503 . 019D . . . o ma ic=4 R DESERT: OASIS:ofisuFF -xdsE A.'Jomax 1 - iri aril] i NI-17.7r. =.198c. WiRower Rdr i11111 DESERT OASIS PARCEL OF'SURPRISEi B5 SURPRISE • T4N 6664)7: