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Impacted Tenants List (Exhibit A) w <br />This List wilt become Exhibit A of the Gant Agreement that you will enter into with the City of Santa Ana. <br />Households with a dousing 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 your have: 1) a signed copy of the <br />Lease Agreement verifying occupancy for all tenants on the Impacted Tenants List for whom yQpu 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 fast jobs, had their Jork hours <br />reduced, or have experienced a loss of Income due to the economic or health Impacts of Core avirus and <br />who have been unable to maintain their rent payments under their lease agreements. lnsuffici nt or <br />missing documentation may cause a delay In processing or, in some cases; a denial of the ap lieatton. <br />Additional documentation may be requested during the review of your application, 1 hereby at�st that tha <br />Impacted Tenants listed below will be released from any remaining obligation for any rent arra rs awed <br />(20%) following payment by the City of Santa Ana (80%). <br />Property Name: <br />Property Address: <br />Tax ID for Payment: <br />Full Name of Tenant <br />{as stated on the Lease) <br />� <br />Address of Tenantsi Rental Unit <br />Total mount <br />of RentjArrrears <br />Flor Medina <br />Jenny Sanchez <br />2701 McFadden Ave Apt 1 <br />2701 McFadden Ave Apt 27 <br />$ 1 ,960.00 <br />$ . ,6 0 <br />Victor A uliar Quezada <br />2701 McFadden Ave Apt 33 <br />$ • ,805,00 <br />Mercedes Torres <br />2701 McFadden Ave Apt 39 <br />$ 2,800,00 <br />Julio Morelos Guerrero <br />2701 McFadden Ave Apt 43 <br />$,383.50 <br />Enrique Rivera <br />2701 McFadden Ave Apt 44 <br />$ 5.00 <br />Olga paniagua <br />Jose TrejoLacarias <br />2701 McFadden Ave Apt 46 <br />2701 McFadden Ave Apt 68 <br />$ 1,250,00 <br />$ 4,8�0 <br />Felipa Diego Nicolas <br />2701 McFadden Ave Apt 71 <br />$ ,595.00 <br />Yessica Silva <br />2701 McFadden Ave Apt 77 <br />$ 4,845.00 <br />Jilberto Cuevas Martinez <br />2701 McFadden Ave Apt 82 <br />$ $,760.00 <br />Julio Gomez <br />2701 McFadden Ave Apt 86 <br />$ 6,400.00 <br />Lucia Bautista <br />2701 McFadden Ave Apt 88 <br />$ �,776.00 <br />Benigno Lazaro <br />2701 McFaAve Apt 90 <br />'dden <br />$ ,443,00 <br />Javier Jaramilio mm <br />2701 McFadden Ave Apt 109 <br />$ tt,000.00 <br />,- <br />Total Amount of Assistance <br />Rectuested <br />$ 4,573.50 <br />`Add additional pages if necessary. if you have multiple properties and you are unabt to <br />accept payment on behalf of all of them, please list each property separately and pro lde the <br />name of the property at the top of each list. I <br />Coronavirus Emergency Rental Relief Fund for Landlords <br />Application <br />