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EXHIBIT 3 <br />Santa Ana <br />indicating the residential unit address, monthly rent amount, who the <br />tenant is and who the landlord is satisfies both requirements to identify <br />where the applicant resides and their rental payment amount. A hand- <br />written or typed written statement is preferred in the absence of a signed <br />lease. <br />(ii) I hat 1 or more individuals within the household has* <br />(11) qualified for unemployment benefits or <br />(III) experienced a reduction in household income, incurred significant costs, <br />or experienced other financial hardship due, directly or indirectly to the <br />novel coronavirus disease (COVID-19) outbreak, to which the applicant <br />shall attest in writing. <br />(iii) That 1 or more individuals within the household can demonstrate a risk of <br />experiencing homelessness or housing instability, which may include— <br />(1) a past due utility or rent notice or eviction notice, <br />(11) written attestation of unsafe or unhealthy living conditions; <br />(111) written attestation that the household is at risk of homelessness; <br />(IV) written attestation of doubling or tripling up with other households, or <br />(V) a rent ledger from the landlord documenting an accumulation of rental <br />arrears. <br />(iv) The household has a household income that is not more than 80 percent of the <br />area median income for the household: <br />Family Size <br />Maximum Family <br />Income 80% AMI <br />Family Size <br />Maximum Family <br />Income 80% AMI <br />1 <br />$75 300 <br />5 <br />$116 200 <br />2 <br />$86,050 <br />6 <br />$124,800 <br />3 <br />$96,800 <br />7 <br />$133,400 <br />4 <br />$107,550 <br />8 <br />$142,000 <br />In reviewing applications for financial assistance, the City has a preference for households with <br />incomes less than 50% of the area median income. <br />While we do require identification for all members of your household, we will not ask <br />about your citizenship status. We will ask about your race and ethnicity on the <br />application as part of the Department of Housing and Urban Development's (HUD) and <br />Department of Treasury data collection purposes. It may even help Santa Ana get more <br />federal and/or state funds to help our residents. Your race or ethnicity does not impact <br />your eligibility for rental assistance. <br />Households residing in temporary housing such as motels or homeless shelters are not <br />eligible. <br />cor l o nci 9— 79 7/6/2 1 6 <br />Prograrr� dNerilnes as of June 1, 2021 <br />