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Fidelity National Title Company <br />39650 Liberty Street, #120 • Fremont, CA 94538 <br />(510) 651-8900 • FAX (510) 651-1531 <br />FIRPTA CERTIFICATE Date: December 19, 2001 <br />Escrow No.: 427175-M"0 <br />This form is provided so that the buyer and/or seller in this transaction can certify compliance with the <br />Foreign Investment in Real Property Tax Act to the escrow agent and/or buyer. Transferee must retain <br />a copy of this document until after the fifth taxable year following the transfer. <br />I. Transactions on Persona/ Residence not exceeding $300, 000.00. <br />I/We hereby certify that: <br />(a) the amount realized for the property in this transaction does not exceed $300,000.00; and <br />(b) buyer(s) is/are acquiring said property for use as a residence. <br />Date: <br />City of San Leandro, A Municipal <br />Corporation <br />H. Individual Seller's Certification (IRS reg. 1. 14452T, et seq.). <br />Section 1445 of the Internal Revenue Code provides that a transferee (buyer) of a U.S. Real <br />Property interest must withhold tax if the transferor (seller) is a foreign person. To inform the <br />transferee (buyer) and escrow agent that withholding of tax is not required upon my disposition of <br />a U.S. Real Property Interest, I Anna Koo, as Trustee of the Anna Koo Family Trust, U D T (Under <br />Declaration of Trust) dated June 15, 2001 hereby certify the following: <br />1. For the purposes of U.S. Income Taxation, I am not a non-resident alien; <br />2. My U.S. taxpayer identifying number (Social Security Number) is: <br />3 <br />My home address is: <br />and <br />I understand tha+ this certification may be disclosed to the Internal Revenue Service by the transferee <br />and that any false statement I have made herein could be punished by fine, imprisonment, or both. <br />Date: <br />Anna Koo, as Trustee of the Anna Koo Family Trust, U D T (Under Declaration of Trust) dated June 15, <br />2001 <br />By: <br />Anna Koo, Trustee <br />FIRPTA-1007 (Rev. 11/96) <br />