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City of Santa Ana <br />PROTEST FORM FOR 2013 DOWNTOWN SANTA ANA BUSINESS <br />IMPROVEMENT DISTRICT ASSESSMENT <br />Sergio Levenzon, MD Business License #: 173265 <br />Main Street Prenatal Medical C Assessment Type: Variable Flat Rate <br />520 N Main St #100 Business Type: Physicians & Surgeons <br />Santa Ana, CA 92701 Bid Rate: 1.0 x Business License Tax <br />Business Location: 520 N Main St Unitg 100 <br />NOTE: The person submitting this protest must be the owner of the business referenced above. <br />Please complete and submit this form to the Clerk of the Council during or prior to the public hearing <br />scheduled for July 1, 2013. <br />The Public Hearing will be held at 5:45pm at: <br />City Council Chamber <br />22 Civic Center Plaza <br />Santa Ana, California ►2702 <br />This form can be mailed to the Clerk of the Council at: 20 Civic Center Plaza, 8t" Floor, Santa Ana <br />CA 92702; however, it must be received prior to the date of the hearing in order for the protest to be <br />considered. <br />AI <br />I am protesting the assessment in its entirety. <br />El I am protesting the following specific types of improvement or activities: <br />Print Name <br />Signature <br />Title <br />Date <br />