Restrictive Covenant Modification

RECORDING REQUESTED BY AND WHEN RECORDED MAIL DOCUMENT TO: NAME STREET ADDRESS CITY, STATE & ZIP CODE SPACE ABOVE THIS LINE FOR RECORDER'S USE ONLY RESTRICTIVE COVENANT MODIFICATION (RACIAL OR OTHERWISE UNLAWFULLY RESTRICTIVE COVENANT MODIFICATION) I (we) an ownership interest of record in the property located at is covered by the document described below. The following referenced document contains a restriction based on race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, familial status, source of income, or disability as defined in subdivision (p) of Section 12955 that violated state and federal fair housing laws and that restriction is void. Pursuant to Section 12956.2 of the Government Code, this document is being recorded solely for the purpose of eliminating that restrictive covenant as shown on page(s) of the document recorded on (Date) in book and page , or instrument number of the official records of the County of San Bernardino. The document referenced above was originally indexed in the following manner and this document shall be indexed in like manner pursuant to Section 12956.2 (e): have (Address) that The effective date of the terms and conditions of this modification document shall be the same as the effective date of the original document referenced above. Signature: Printed Name: Approved as to form: San Bernardino County Counsel By: Deputy County Counsel Signature: Printed Name: Date A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF _________________________________ COUNTY OF _______________________________ On ___________________________________ before me, _____________________________________________________________ _, (Date) (Name and title of the officer) personally appeared _______________________________________________________ _ , who proved to me on the basis of (Name of person signing) satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged 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 of officer Rev.0 1/01/15 (Seal) American LegalNet, Inc. www.FormsWorkFlow.com