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Impacted Tenants List (Exhibit A) <br />This List will become Exhibit A of the Grant Agreement that you will enter into with the City of Santa Ana. <br />Households with a Housing Choice Voucher, also known as Section 8, or those who receive other <br />government rental assistance are not eligible. Tenants that you plan to evict are not eligible. It is your <br />decision to include which tenants qualify on this list Please ensure you have: i) a signed copy of the <br />Lease Agreement verifying occupancy for all tenants on the Impacted Tenants List for whom you are <br />seeking assistance; 2) documentation on rile for all tenants on the Impacted Tenants List that <br />demonstrate that the tenant has been impacted by Coronavirus and have lost jobs, had their work hours <br />reduced, or have experienced a loss of income due to the economic or health impacts of Comnavirus and <br />who have been unable to maintain their rent payments under their lease agreements. Insufficient or <br />missing documentation may cause a delay in processing or, in some cases, a denial of the application. <br />Additional documentation maybe requested during the review of your application. l hereby attest that the <br />Impacted Tenants listed below will be released from any remaining obligation for any rent arrears owed <br />(20%) following payment by the City of Santa Ana (80%). <br />Las Castles de Halladay, Ponderosa Patens <br />Property Name: French Court\(alas. Spwgeon Anna Apartments <br />Property Address: <br />Tax ID for Payment: 45-3950379 <br />Full Name of Tenant <br />(as stated on the Lease) Address of Tenant's Rental Unit <br />rA <br />Total Amount <br />of Rent Arrears <br />Owed <br />Garin Lucero and Yobani Moran <br />115 S. Halladay #8, Santa Ana, CA 92701 <br />$ 2,850.00 <br />Carmen Rojas <br />820 N. Spurgeon #4, Santa Ana, CA 92701 <br />$ 5.125.00 <br />Rosa Avila and Raul Serrano_ <br />13892 Ponderosa St. #6, Santa Ana, CA 92705 <br />13892 Ponderosa St. #14, Santa Ana, CA 92705 <br />$ 4,210.88 <br />$ 1,675.00 <br />Maria Vizcana and Esteban Sanchez <br />Juan Carlos Sanchez and Rine Callejas <br />208 Oak SL, Santa Ana, CA 92701 <br />$ 2,290.00 <br />Rigoberto Reyes and Daisy Ba9adares <br />424 E. Pine St. #1, Santa Ana, CA 92701 <br />$ 2,595.41 <br />LLft Mrs, rasa ChmFa, am aa,onceaoar. <br />424 E. Pine St. 416, Santa Ana, CA 92701 <br />$ 4,815.00 <br />Juan Slive and Maria Martinez -Ramirez <br />315 E. Washington Ave. #3B, Santa Ana, CA 92701 <br />$ 2,750.00 <br />Douglas Smith <br />315 E. Washington Ave. #3F, Santa Ana, CA 92701 <br />$ 6,750.00 <br />$ <br />$ <br />$ <br />$ <br />$ <br />i <br />Total Amount of Assistancei3,061.29 <br />Re nested <br />Aaa aaamonai pages it necessary. If you have multiple properties and you are unable to <br />accept payment on behalf of all of them, please list each property separately and provide the <br />name of the property at the top of each list. <br />Coronavirus Emergency Rental Relief Fund for Landlords <br />Application <br />Page 13 <br />113-115 S. Halladay St. Sella Ana, CA 92701 <br />13892 Ponderosa St. Santa Ana, CA 92705 <br />208-210 Oak St Santa Ana, CA 92701 <br />424 E. Pine St. Santa Ana, CA 92701 <br />315 E. Washington Ave. Santa Ana, CA 92701 <br />2701 <br />