Attachment A
Public Integrity Disclosure
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PUBLIC INTEGRITY DISCLOSURE
APPLICANT DISCLOSURE FORM
1. Name of Entity
2. Address of Entity (Principal Place of Business)
3. Local or California Address (if different than #2)
4. State where Entity is Registered with Secretary of State If other
than California, is the Entity also registered in California? Yes No
5. Type of Entity
Corporation Limited Liability Company Partnership Trust Other (please specify)
6. Officers, Directors, Membe rs, Managers, Tru stees, Other F iduciaries (please specify) Note: If any response is not a natural person, please iden tify all off icers, directors, members, managers and other fiduciaries for the member, manager, trust, or other entity
________________________ Officer Director Member Manager [name] General Partner Limited Partner
Other _____________ ______________
_______________________________ Officer Director Member Manager [name] General Partner Limited Partner
Other __________________________
________________________________
Officer Director Member Manager
[name] General Partner Limited Partner
Othe r __________________________
TSG Enterprises, Inc. dba The Solis Group
3452 E Foothill Blvd, Ste 200, Pasadena, CA 91107
See above
California
X
Elvira Elizabeth Diez Solis X
Andrew Solis-Castillo X
Item 1L - Page 6
7. O wners/Investors with a 5% beneficial interest in the Applicant Entity or a related entity
EXAMPLE
JANE DOE
[name of owner/investor]
50% , A BC COM
PANY, Inc.
[percentage of beneficial interest in entity and
name of entity]
A.
[name of owner/investor] [percentage of beneficial interest in entity and name of entity]
B.
[name of owne r/investor] [percentage of beneficial interest in entity and name of entity]
C.
[name of owner/inve stor] [p ercentage of beneficial interest in entity and name of entity]
D.
[name of owner/investor] [p ercentage of beneficial interest in entity and name of entity]
E.
[name of owner/investor] [percentage of benef icial interest i n entity and name of entity]
I D ECLARE UNDER PENALTY OF PERJURY UNDER T HE LAWS OF T HE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT.
Signature of Disclosing Party, Printed Name, Title Date Elvira Elizabeth Diez Solis
100%, TSG Enterprises, Inc. dba
The Solis Group
Elvira Elizabeth Diez Solis,
CEO
February 3, 2023
Item 1L - Page 7
City of
Palm Springs, CA.
Busine ss
Disclosure Supplementary Instructions
In an effor
t to ensure we capture the required business entity information in accordance with the attached instructions, we provide you these supplementary i nstructions to clearly identif y th e required information, and the format the information should be provided.
If you, as the applicant, are a business entity (i.e. a corporation or limited liability company), and it is also comprised of other business e ntities as i ts members or having a financial interest, all other such bu siness entities must also be disclosed, including those e ntities other business entities, if any.
Ult imat el
y, th e City’s disclosure document (at tached) requires a listing identif ying a ll n atural persons having any financial interest over 5% of the business entities (and any other bus iness entities comprising your business entity).
As an exam
ple, Applicant is: Acme Brothers, Inc., a California corporation, whose officers are:
John Doe, Jill Doe, and Jay Doe, which i s ow ned 50% by Acme Brot hers, LLC, a Cal ifornia limited liabilit y comp any, and John Doe (25% inte rest) and Jill Doe (25% i nterest). Acme Brothers, LLC, is managed by Acme Brothers 2, Inc ., a California corporation, whose officers are: George Doe, Bill Doe, and Jane Doe, which is owned 100% by Ac me Brothers 2, LLC, a California limited liability comp any, w hich is ma naged by George Doe, with G eorge Doe and Jane Doe having 50% interest each.
The ful
l business entity disclosure in this example would resemble the following:
1. Acme Brothers, Inc., a California corporation
a. Officers: John Doe, Jill Doe, and Jay Doe
b. Ownership:
i. 50% Acme Brot
hers, LLC, a California limited liability company
ii. 25% John Doe
iii. 25% Jill Doe
2. Acme Brothers, LLC, a California limited liability company a. Managers: Acme Brothers 2, Inc., a California corporation b. Ownership: 100% Acme Brothers 2, Inc., a California corporation
3. Acme Brothers 2, Inc., a California corporation
a. Officers: George Doe, Bill Doe, and Jane Doe
b. Ownership: 100% Acme Brothers 2, LLC, a California limited liability company
4. Acme Brothers 2, LLC, a California limited liability company a. Managers: George Doe
b. Ownership:
i. 50%
Item 1L - Page 8