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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 Me for all tenants on the Impacted Tenants List that <br />demonstrate that the tenant has been impacted by Coronavirus and have lost fobs, 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 maybe 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 (80916). <br />Property Name; Santa Clara Apartments <br />Property Address: 2010 E. Santa Clara Ave #1 Santa Ana Ca 92705 <br />Tax ID for Payment: 4ti-0� 540122 <br />Full Name of Tenant <br />(as stated on the Lease) <br />Oscar Nieto <br />Address of Tenant's Rental Unit <br />2010 E. Santa Clara Ave #4 <br />Total Amount <br />of Rent Arrears <br />Owed <br />$ 3820.00 <br />Octavio Cruz <br />1950 E. Santa Clara Ave #20 <br />$ <br />$ 8945,00 <br />$ <br />$ <br />$ <br />'Add additional pages ifnecessa <br />Total Amount of Assistance <br />Reguested <br />if <br />$ �� atJ <br />t <br />accept payment on behalf of all of heYou "aV0 roerties and you are unable <br />m, please i st each property separately and provideothe <br />name of the property at the top of each list. <br />Coronavirus <br />Application <br />Fund for landlords <br />