FREE RECORDING REQUESTED	)

PURSUANT TO GOVERNMENT	)

CODE	SECTION 27383

RECORDING REQUESTED BY	[Appendix E]

AND WHEN RECORDED MAIL TO:

California Department of Developmental Services

c/o Director of the Department

MS 2-13

P.O. Box 944202

Sacramento, CA 94244-2020

REQUEST FOR NOTICE

UNDER SECTION 2924b CIVIL CODE

APN: ____________

In accordance with Section 2924b, Civil Code, request is hereby made that a copy of any notice of default and a copy of any notice of sale under the deed of trust (or mortgage) recorded on ____________, _____, for (property street address)_________________________ in Book _______ page _____ records of _____________________ County, (or filed for record with recorder’s serial number __________, _____________________ County) California, executed by ____________________ as trustor (or mortgagor) in which ____________________ is named as beneficiary (or mortgagee) and ____________________ as trustee be mailed to:

California Department of Developmental Services

c/o Director of the Department

MS 2-13

P.O. Box 944202

Sacramento, CA 94244-2020

NOTICE: A copy of any notice of default and of any notice of sale will be sent to the address contained in this recorded request. If your address changes, a new request must be recorded.

Signature______________________________________________

[Regional Center should sign here]

Dated:_______________________________________________

ACKNOWLEDGEMENTS

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 California	)

)

County of _______________	)

On __________________________ before me, _____________________________, a Notary Public, 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 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	(Seal)