Fill and Sign the California 4 H Youth Development Program Annual Project Report Ucanr Form

Supplemental Form: OWNERSHIP AND BENEFICIAL INTEREST DISCLOSURE PETITIONER: CORPORATE OFFICERS OR PARTNERS Applicants for an entitlement that will be in possession and the responsibility of more than one individual, such as a co-owner, joint venture, partnerships, corporations, company, or other similar form of ownership, are required to disclose a full and complete list of the name and address of each principal. (use additional paper if necessary) Name Title or Office(if any) Address PROPERTY OWNER: CORPORATE OFFICERS OR PARTNERS The petitioner of a property owned by more than one individual that will benefit from an entitlement is required to disclose a full and complete list of the name and address of each partner, officer, or co-owner. The other owner interest to be reported is co-owner, joint venture, partnership, corporation, company, or other similar form of ownership. (use additional paper if necessary) Name Accepted by: Disclosure (Rev 01/02) Title or Office(if any) Date Address Attach this sheet to your application form Application for Case Number Supplemental Form: ADDITIONAL PETITIONERS ADDITIONAL PETITIONERS: Applicants for an entitlement involving more than one property description and owned by more than one individual are required to provide the name, legal description of property owned, and signature of each petitioner. Persons signatory to this application supplement are deemed to be petitioners (use additional paper if necessary) We, the undersigned, hereby apply for:________________________________________________________________ Signature 1. Name (printed or typed) Legal description of property owned within petition area 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. Accepted by: Petitioners (Rev 01/02) Date Attach this sheet to your application form Application for Case Number