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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: f) 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, orhave experienced a loss of income due to the economic or health Impacts of Compavirus and <br />who have been unable to maintain their rent payments under their lease agreements. Insufficlent or <br />missing documentation may cause a delay in processing or, In some cases, a denial of the application. <br />Additional documentation maybe requested during the review of your application. i hereby atest that the <br />Impacted Tenants listed below will be released from any remaining obligation for any rent arrears owed <br />(2N) following payment by the City of Santa Ana (84%). <br />Property Name:: Artists Village Apartments <br />Property Address: 300 West 2nd Street Santa Ana CA 92701 <br />Tax ID for Payment: 27-0350167 <br />Full Name of Tenant <br />(as stated on the Lease) <br />_ <br />Address of Tenant's Rental Unit <br />Total amount <br />of ReniArrears <br />Owed <br />Domini ue Morris <br />300 W 2nd Street Apt. 156 <br />$ 9Q,250.00 <br />Daniel Cornellous <br />300 W 2nd Street Apt. 215 <br />$ a ,495.00 <br />Alexander Lopez <br />300 W 2nd Street Apt. 234 <br />$ 9,310.00 <br />Ashley Schroeder <br />300 W 2nd Street A 1 236 <br />$ 1;212,00 <br />Donia Salem <br />300 W 2nd Street Apt. 237 <br />$ 17,375.00 <br />Fermin Yanez <br />300 W 2nd Street Apt. 239 <br />$ 't3,553,00 <br />Mony Sary <br />300 W 2nd Street Apt. 285 <br />$ 1,865.00 <br />Faustino Aragon <br />300 W 2nd Street Apt. 290 <br />$ 4,816.00 <br />Loraine Ferrara <br />300 W 2nd Street Apt, 315 <br />$ 1,795.OU <br />Sarah Killion <br />300 W 211d Street Apt. 360 <br />$ 7,380.00 <br />Russell Kawaguchi <br />300 W 211d Street Apt. 386 <br />$ 1,902,20 <br />Amrita Shergill <br />300 W 2nd Street Apt. 390 <br />$ 2,371,40 <br />Kristen Klein <br />300 W 2nd Street Apt. 394 <br />$ 0,419.00 <br />Lisa Freeman <br />300 W 2nd Street Apt. 405 <br />$ .1,023,50 <br />Patricia Schack <br />300 W 2nd Street Apt. 409 <br />$ ;1,163.50 <br />Total Amount of Assistance <br />Requested <br />$ <br />"Aad additional pages it 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 Paged 3 <br />Application <br />