Fill and Sign the Real Estate Rights Form

NOTICE OF REVOCATION OF CONSENT TO USE LAND PLEASE TAKE NOTICE THAT the undersigned record owner of the real property located in _______________ County, California more specifically described as ______________ _____________________ [legal description] ("real property"), hereby rev okes [either: If Prior Notice of Consent Recorded] the Notice of Consent to Use Land that was executed by the undersigned on ____________ and recorded in the Office of the County Recorder of _________________ __ County, California on ______, at Book ____, Page _____ [or: If prior notice not recorded] any and all consent previously granted to use of said real property, including but not limited to revocation of any right of the public or any person to m ake any use whatsoever of the above described land or any portion thereof (other than any use expressly allowed by a written or recorded map, agreement, deed, or dedication). The undersigned is the record holder [agent for the record holder] of title to sa id real property. Dated: _____________________________ ___________________________________ Signature ACKNOWLEDGMENT State of California County of On before me, (here insert name and title of the officer), personally appeared , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledg ed to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (Seal)