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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: 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 file 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 />(20%) following payment by the City of Santa Ana (80%), <br />** <br />Property Name: Lyon Manor Apartments <br />Property Address: 224 S. Lyon Street, Santa Ana, CA 92701 <br />Tax ID for Payment: 27-3201526 <br />Full Name of Tenant <br />(as stated on the Lease) <br />p <br />Maria Arredondo v <br />^� <br />Address of Tenant's Rental Unit <br />__ <br />224S. Lyon Street Unit 6, Santa Ana, CA 92701 <br />Total Amount <br />of Rent Arrears <br />Owed <br />$ 1,450 <br />Jose Antonio Zuarez <br />224 S. Lyon Street Unit 11, Santa Ana, CA 92701 <br />$ 12,155 <br />Diana Guttierrez <br />224 S. Lyon Street Unit 16, Santa Ana, CA 92701 <br />$4,800 <br />Christine Perez <br />224 S. Lyon Street Unit 17, Santa Ana, CA 92701 <br />$ 1,600 <br />Ramon Angel <br />224 S. Lyon Street Unit 19, Santa Ana, CA 92701 <br />$ 1,880 <br />Lucia Ortiz <br />224 S. Lyon Street Unit 20, Santa Ana, CA 92701 <br />$ <br />$ 4 <br />Total Amount of Assistance <br />Requested <br />$ 23,158 <br />'Add additional pages it necessary. It 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 />