ATTACHMENT B
Disclosure Pursuant to the
City of Pasadena Taxpayer Protection Amendment
Pasadena City Charter, Article XVII
Contractor/Organization hereby discloses its trustees, directors, partners, officers, and those with more than 1 0% equity, participation, or revenue interest in Contractor/Organization, as follows:
(If printing, please print legibly. Use additional sheets as necessary.)
1. Contractor/Organization Name:
^^s
2. Type of Entity:eof Entity:
a non-government '^nonprofit 501(c)j<3)^ (4), or (6)
3. Name(s) of trustees, directors, partners, officers ofContractor/Organization:
^} I /. ^ / ^'
r?o^ i^ii^'n , c^
J^AA /y}r/^i^i/, <T^^s^&^t- ' //
4. Names of those with more than a 10% equity, participation or revenue interest in Contractor/Organization:
/
//
f
V
Prepared by:
Title:
^/oL m^^i
T
^/c^Ln-g^-
Phone:/-^-?^^3"^
Date:3-r-^
Rev.07.10.2007