Laserfiche WebLink
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: 1) 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 Coronavirus 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 may be requested during the review of your application. I hereby attest that the <br />Impacted Tenants listed below will be released from any remaining obligation for any rent arrears owed <br />(205/6) following payment by the City of Santa Ana (80%). <br />** The information below may be submitted In a separate spreadsheet attached to your application <br />Please include the minimum information below and name it Exhibit A— Property Name ** <br />Property Name: Hidalgo Apartments <br />Property Address: 1812 W. 4TH ST, SANTA ANA, CA 92703 <br />Tax ID for Payment: 278258 <br />Full Name of Tenant <br />(as stated on the Lease) <br />Address of Tenant's Rental Unit <br />Total Amount <br />of Rent Arrears <br />Owed <br />Reyna Guadalupe Salas <br />1810 W. 4TH ST, Santa Ana CA 92705 <br />$ 6000 <br />Ralph Frisbee <br />1812 W. 4TH ST, Santa Ana, CA 92703 <br />$ 6000 <br />Carlos Franco <br />1812 1I2 W. 4TH ST, Santa Ana, CA 9270 <br />$ 4800 <br />$ <br />$ <br />$ <br />$ <br />*Add <br />Total Amount of Assistance <br />Requested <br />$ 16,800 <br />Add additional pages tf 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 Page 13 <br />Application <br />