AR 3 ATTACHMENT B District 3_Redacted — Pasadena City Council, April 19, 2023

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CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THE
PASADENA RENTAL HOUSING BOARlD; 93FORM RHB-001 1^w^
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The information contained on this form will be used by the City Council to fill vacancies on thePasadena Rental Housing Board. Please answer all questions. You are invited to attach additionalpages, a copy of your resume, or submit supplemental information which you feel may assist theCity Council in its evaluation of your application. Applications will be purged from the City's filesJanuary 31 of each year. If you have not been appointed to the Rental Housing Board and stilldesire to be considered for appointment, please resubmit an updated application, or advise Citystaff in writing that the initial form is still current and can be used for an additional year.

Applicant Name:

Home Address:

Mailing Address:

Email Address:

Business Phone:

Home Phone:
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REDACTEDREDACTED
Date Available to Start:

Cell Phone:

Board Seat Type: Indicate the type of Board seat in which you wish to fill (mark one or more):

REDACTED
Alternate At-large Member (1 seat, open to any Pasadena resident without respect to tenancy or Council District)
Community Service - List boards, commissions, committees, and organizations on which youare currently serving or have served, offices held and in what city. ^ gg 7z^>^^r//7S ^^e^^c^ 0--^ C^fgz6)^ ^tY fiuc^/o, ^ ___^ C^^r^i-vf^ C^/^^^i/ ^-/.T ^^-/^^ - <Je£ esS^Z/^i 7 L
Employment - Title and duties, current and past (acceptable to attach resume as an alternative).
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Education - Include professional or vocational licenses or certificates. ~z_ lj^^ ^^fc^^C.

1. Have you ever worked for the City of Pasadena? (If yes, please YES j | NO list dates/department)

2. Are you related to any employee, appointed or elected official of the City of Pasadena? (If yes, please indicate name and relationship)
YES NO

3. Are you aware that financial disclosure is required annually? (e.g., sources of income, loans and gifts, investments, interests in real property)

4. Rules of law and ethics prohibit members from participating in and voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest which may develop from your occupation, or economic holdings, in relation to your responsibilities as a member of the Rental Housing Board? (If yes, please indicate any potential conflicts)
YES
YES
NOD
NO

5. Do you,or your extended family1 members, have a material YES interest in rental property in the County of Los Angeles within the last three years?

6. Do you reside at a property owned or managed by a member of YES the City Council, or any member of the City Council's extended family, or in which any member of the City Council, or member of the City Council's extended family, has any ownership stake in said property?

7. Have there been, or are there now, any personal or business YES circumstances which might reflect adversely on the propriety of your serving as a member of the Pasadena Rental Housing Board?

8. Are you aware of the time commitment necessary to fulfill the YES obligations of the Pasadena Rental Housing Board?
D NO
NO
NO
NOD
Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Charter Section 1803(g)).

9. Are you aware that you may serve no more than eight
consecutive years as a member of the Pasadena Rental
Housing Board?
YESNOD
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11. How would you add value to the Pasadena Rental Housing Board?^ ^ / / ^<-z
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12. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
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13. How would you help to achieve these objectives and goals? ^
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I,0^)^//a^^^> (printed name), declare under penalty of perjury under the law of] th^ State of California that the information reported in this Form RHB-001 is true, accurate, and complete.

Signed this Z2^ day of /^O^cM 20^3.

H
Signed:

Printed Name:<-^<^<-y7
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0 Lean Arellano
Pasadena Rental Housing Board
10) My current professional training has me engaging in landlord tenant law by enforcing the Rent Stabilization Ordinance (RSO) for the City of Los Angeles as a Housing Investigator assigned to the Investigations and Enforcement section of the RENT Division for the Los Angeles Housing Department (LAHD). My duties require me to investigate and enforce the rent control laws forthe city of Los Angeles. Specifically, these duties include issuing violations of the RSO for illegal evictions, illegal rent increases, removal of housing services, properties failing to pay RSO rent registry fees, properties failing to post Rent Control Notices on properties, and reviewing Los Angeles Police Department and Los Angeles Fire Department reports as they relate to habitability violations and evictions that involve rent controlled units. My duties also include reviewing and analyzing contracts, legal documents, case law, eviction notices, leases, and Unlawful Detainers.
11) From my high school days and throughout my college career I have always had an interest in public service, so much so that I continuously served on the student governing bodies of the schools I attended. For instance, I was a student elected senator at Bakersfield College then a student governing board memberatthe University of California Davis (UCD). Later, as a private citizen I would go on to co- found and chair for five years, a community cultural arts center in the city of Los Angeles by the name of CorazonDel Pueblo. This background and experience in service would add value to the Pasadena Rental Housing Board because my knowledge and skills of civic engagement, specifically, in coalition building and my experience in cross organizing with different city departments will help to assure the goals and objectives of the Pasadena Rental Housing Board are met. My experience would also add value to the Pasadena Housing Board by ensuring it has a board member with the knowledge and skill set to understand and manage the challenges of implementing and enforcing rent control laws. 12) In my view, the primary objectives and goals of the Pasadena Rental Housing Board are to administer and enforce the provisions of Measure H. Specifically, these duties require that the Board implement and engineerthe framework that will govern rent increases, written notices as they relate to rent controlled units, establish and maintain a rental registry for rental units that have been identified and establish rules related to rent control and enforce the charter amendments of Article XVIII. 13) I believe the goals of the Pasadena Rental Housing Board can only be met by a body where each of its members holds the ideals of civil service and teamwork to the highest esteem. These are two core values I hold and that is why I commit to help achieve the goals of Measure (H) by applying my knowledge and experience as a Housing Investigator, who currently enforces the rent control laws for the City of Los Angeles. I will also bring with me my many years of experience in civil sen/ice, executing a vision, a strong work ethic and dedication in order to meet the goals and objectives of the Board. I am excited to be considered to be a part of something new, innovative and community focused that is beneficial to the greatercommunity of Pasadena as a whole. ff".

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CITY OF PASADENA
Residency Verification - MANDATORY
All applicants must provide proof of residency in a City Council district under section 1811 (b) of The Pasadena Fair and Equitable Housing Charter Amendment (Measure H). Proof of residency may be established by either of the following:

1. If you are a registered voter, please complete and sign the following declaration and the City Clerk will verify your signature on file with the Los Angeles County Registrar of Voters.

I am a resi
I reside at
CA sy^/
;asadena
rM^<.^:~i•^<.M

REDACTEC REDACTED
(zip coae).0
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(street), Pasadena,
Signed:

Printed Name: ^-^^y7 ALfr^//£€^*^
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2. If you are not a registered voter, please provide clear, readable two forms of proof of residency acceptable to the Department of Motor Vehicles (DMV) for a REAL ID, listed below (Cat. Code Regs. tit. 13, § 17.00 and § 15.01 (d)).

Please provide clear, readable copies of two (2) documents from the following list and attach to this application:
h-lome utility bill or cellular phone bill
Records from any state or national bank, state or federal savings association, trust company, industrial loan company, state orfedeYal credit union, or any institution or entity that has issued a credit card
Insurance documents, including medical, dental, vision, life, home, rental or vehicle
Medical documents
A document issued by a U.S. government agency, meaning an entity, office, or authority governing over a country, state, county, city, municipality, district, agency, department, or any other political subdivision of a country or state Mortgage bill
Employment documents
Tax return (either Internal Revenue Sen/ice (IRS) or California Franchise Tax Board (FTB)
Rental or lease agreement with the signature of the owner/landlord and the tenant/resident
School documents issued by a public or private primary, secondary, or post- secondary institution, college, or university that includes the applicant's date of birth. If using a foreign school document, it must be sealed by the school and include a photograph of the applicant at the age the record was issued. •
•
•
•
•
•
Change of Address Confirmation by the U.S. Postal Service Property tax bill or statement
Letter attesting that the applicant resides in Pasadena from a homeless shelter. shelter for abused women, non-profit entity, faith-based organization, employer or government agency within the United States
Deed or title to residential real property
Voter registration confirmation letter or postcard issued by the California Secretary of State or the Los Angeles County Registrar of Voters Proof of payment of resident tuition at a public institution of higher education in California
An original copy of an approved Claim for Homeowners' Property Tax Exemption (BOE-266) form filed with the Los Angeles County Assessor Court documents that list the applicant as a resident of Pasadena California Certificate of Vehicle or Vessel Titles or registration (i.e., a title to, or a DMV registration for, a boat, truck or car)
A DMV No Fee Identification Card Eligibility Verification (DL 933) form, completed and signed
If your name does not appear on any residency documents, you may present a birth certificate, marriage license, or domestic partner registration certificate to trace your relationship to the person whose name does appear on the residency documentation.

If the residency document reflects a name that differs from the tracing document due to a name change (for example, marriage, divorce, or court order), name change documentation is required.

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CITY OF PASADENA
Supplement to Statement of Economic
Interest (FPPC Form 700)
(Form RHB-002)
All applicants must complete a Statement of Economic Interest (FPPC Form 700) and "Economic Interests Affidavit" attesting to the information reported in applicant's Form 700.

Instructions: The Pasadena Fair and Equitable Housing Charter Amendment (Measure H) prohibits Tenant Board and Alternate Tenant Board members from having "Material Interests in Rental Property" (defined below) at the time of their appointment and during their service. All applicants for all Board seats (both Tenant and At-Large) must report their own and their Extended Family's interests and dealings in rental properties in Los Angeles County in the three (3) years before submitting an application. The City is adopting the Fair Political Practices Commission's Form 700 for this purpose, but Measure H requires information about interests in rental property in Los Angeles County for three years, not the one year the FPPC Form otherwise uses. Under City Charter Section 1811(b), these documents are public records; they will not be confidential.

Measure H's Definitions;
Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Section 1803(g)).

Material Interest in Rental Property: an individual has a Material Interest in Rental Property if they, or any member of their Extended Family, own, manage, or have a 5% or greater ownership stake in Rental Units in the county of Los Angeles, or if they or any member of their Extended Family owned, managed, or had a 5% or greater ownership stake in Rental Units injhe county of Los Angeles in the past three (3) years (Section 1803(i)).

Rental Unit: any building, structure, or part thereof, or land appurtenant thereto, or any other rental property rented or offered for rent for residential purposes, whether or not such units possess a valid Certificate of Occupancy for use as rental housing, together with all housing services connected with use or occupancy of such property, such as common areas and recreational facilities held out for use by the Tenant (Section 1803(x)).

Tenant: a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental housing agreement to the use or occupancy of any Rental Unit (Section 1803(aa)).

CITY OF PASADENA
Economic Interests Affidavit - MANDATORY
1,^-<?<^(printed name), declare under penalty of perjury under the law of the State of California that the information provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete.

Signed this ^/^ day of
7 SignedF
, 20 2J .

Printed Name: ^/^^^
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
r£^ec) (printed name), declare under penalty of perjury under the law of the foregoing is true and correct:

1. I am a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental agreement or lease (oral, written, or implied) for the use or occupancy of a rental unit.

2. I am either a) named in a rental housing agreement or lease, or b) have provided proof of a relationship to a person named jj^y^jjg^jvjggg^^^j^g|j|^^|^j^ights of a tenant.

3. I reside at the following address
Pasadena, California <y//ff/ (zip code)
REDACTEd REDACTED(street),
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.

Signed this 2-Z- day of /Wa^C/? _, 20_^J.

Signed:
\
Printed Name:\^s^i /^^//^^
j
1 REDACTED
.eon Arellano
iE^ESSSF^EUGn

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PROFESSIONAL EXPEMENCE
Los Angeles Housing Department (LAHD)
Housing Investigator- Investigations &. Enforcement (RSO) i
Los Angeles, CA
January 2020-Present
Correctly interpreting and applying the LA City Rent Stabilization Ordinance (RSO) and all other applicable state and federal laws. Interviewing landlords, tenants, property management agents and all other relevant parties related to RSO complaints. Mamtaining contact with all necessary government agencies and staff in other City offices, along with tenant and landlord advocacy groups and attorneys with respect to cases that are being investigated. Preparing correspondence and reports describing alleged violations and making determinations ofRSO violations and required corrective action. For cases that warrant referral to the City Attorney's Office, responsible for preparing and updating case file records as needed. Assisting with responses to subpoenas and public records requests as needed.

Los Angeles Dependency Lawyers, Inc.

Senior Litigations Investigator
Monterey Park, CA
March 2009- January 2020
Managed and conducted investigations for cases in the child welfare system where the firm was appointed to represent a parent (client). Worked on a caseload of over a hundred cases a month.

This role included daily interactions with attorneys, clients, court personnel, county social workers and numerous other entities mvolved in the adjudications of the petitions filed in court.

Once information and evidence was gathered, would often have to attend court hearings in order to testify as to the fmdings. As a Senior Investigator, I was also charged with presenting procedures and processes to the newer staff members with respect to submitting requests for investigations. Processing and issuing subpoenas and obtaining medical records in a timely manner as well as conducting forensic interviews of witnesses was also required. Analyzing and compiling evidence in an organized manner to assist attorneys in their presentation of the case.

Additionally, I would have to conduct home inspections, observe visits and prepare written reports.

LANGUAGES
Fluent in Spanish (reading and writing).

EDUCATION
People's College of Law, Los Angeles, CA
First year completed; June 2016
University of California, Davis, Davis, CA
Bachelor of Arts, History, May 2005
Activities: Historic Scholars Society
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CITY OF PASADENA

NOMINATION PETITION -WORKSHEET
Lio^ A^KA^W
(Name of Candidate)
PllHC? ^'^•c^5
(Office and District or Seat)
Total Signatures
Total OK
Date:
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Checked by:
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CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THE

PASADENA RENTAL HOUSING BOARD
FORM RHB-001
The information contained on this form will be used by the City Council to fill vacancies on the Pasadena Rental Housing Board. Please answer all questions. You are invited to attach additional pages, a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Applications will be purged from the City's files January 31 of each year. If you have not been appointed to the Rental Housing Board and still desire to be considered for appointment, please resubmit an updated application, or advise City staff in writing that the initial form is still current and can be used for an additional year.

Applicant Name: ^ C.{ |^4"f'<2j^ffiM211
Home Address:,
Mailing Addres^
Email Address:

Business Phone:

Home Phone:
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REDACTED
REDAC1

REDACTED
.M ^110^

REDACTED
Date Available to Start:

REDACTEDW^lldiiUtHIREDACTED
Board Seat Type: Indicate the type of Board seat in which you wish to fill (mark one or more):

Tenant Member (7 seats, one per Council district, reserved for tenants) Representing City Council District^
At-large Member (4 seats, open to any Pasadena resident without respect to tenancy or Council District)
Alternate Tenant Member (1 seat, reserved for tenants)
Alternate At-large Member (1 seat, open to any Pasadena resident without respect to tenancy or Council District)
Community Service - List boards, commissions, committees, and organizations on which you are currently serving or have served, offices held and in what city. ^x_
^r^v
or have sen/ea,
an-i ^&V ^M.rr^K-lt^ ^yri/in^ ^'\ ^n^,i h/-^r<i5.
^^\^S\OAS oC ri.om^v^t^^S-/ _^
^-.

Employment - Title and duties, current and past (acceptable to attach resume as an alternative).
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Education - Include professional or vocational licenses or certificates.

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1. Have you ever worked for the City of Pasadena? (If yes, please list dates/department), „ , i
ic^o- ^10 ^ -fLih^^ U^'k^. Fipa^ML

YES NOD
fTVgY\6tA^M^ S^A^V i C^^

2. Are you related to any employee, appointed or elected official of YES || NO the City of Pasadena? (If yes, please indicate name and relationship)

3. Are you aware that financial disclosure is required annually? (e.g., sources of income, loans and gifts, investments, interests in real property)

5. Do you,or your extended family1 members, have a material YES | | NO interest in rental property in the County of Los Angeles within the last three years?

6. Do you reside at a property owned or managed by a member of YES || NO the City Council, or any member of the City Council's extended family, or in which any member of the City Council, or member of the City Council's extended family, has any ownership stake in said property?

7. Have there been, or are there now, any personal or business YES || NO circumstances which might reflect adversely on the propriety of your serving as a member of the Pasadena Rental Housing Board?

8. Are you aware of the time commitment necessary to fulfill the YES | | NO obligations of the Pasadena Rental Housing Board?
IExtended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Charter Section 1803(g». "^i

9. Are you aware that you may serve no more than eightconsecutive years as a member of the Pasadena Rental Housing Board?
YESNOD
•a

10. Describe your relevant life experience, professional training, and/or education in thefollowing areas: Housing/Housing Justice^l..andlord Tenant^Relationships/Real Estate:..-i- ,-:^rvi ,,^ •^VU.-vvf:- (^^'6i<-^c'ii H\ ^•^^^^L- ^ ^M^ -f^e- PM^rs^ A^b ^f~/9l)^.o&A^^ ^ipylr:i^^^ ^ V^.<6<^ f ^.?,,<^ ^i.iUit^/• ff^it^L^ . ? H" ' ^T 4 •:a
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11, How would you add, value to the Pasadena Rental Housing Boacd?^'•<- ^^^'^•h ^is/zA'n^. C/4 ^AYA YVW— 'U>';H'^^ \v\ Oj''vnfriU^/^•^U(^\ hj^\~r~.^ •W-\ ^3&^V- fc^v€4l t-v"^-- u^l-V\ U'v. A.^4 i?!syuAjiuv^^ ^ -.^1>CA

12. What do you view are the primary objectives and goals of the Pasadena Rental Housing-Board? ^ ,. , , ^ ^ ^ , ^ . , \ ;1^ ^^^xLLf^Jt. f^k.& /;(A.(3(; Pc-^yi^ll^y^ 'tx-^"' ^0 ^-^^'-^ A^i^^"^TL"f^3- _^_ 'a
1 13. How would you help to achieve these .objectives and goals? ^1 H^MLV^ l"i^v:^+- ^/ft^ fr^J'r J^..i:^x^\^,T
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,^iLlU-l<o1:J;^''>''( 0\U^' (printed name), declare under penalty of perjury under the law ofI, the State of California that the information reported in this Form RHB-001 is true, accurate, andcomplete.

Signed this <i&^h day of W.^'ncafU 20 53
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fc. Signed:

Printed Nam^/^M^ E>1^V^^
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CITY OF PASADENA
Residency Verification - MANDATORY
All applicants must provide proof of residency in a City Council district under section 1811(b) of The Pasadena Fair a nd Equitable Housing Charter Amendment (Measure H). Proof of residency may be established by either of the following:

1. If you are a registered voter, please complete and sign the following declaration and the City Clerk will verify your signature on file with the Los Angeles County Registrar of Voters.

I am a ro^-i^"+ nf nic+rii-+ No.Jena
I reside
CA Alii

REDACTEDREDACTED
(zip coay}"
;/"
Slgned:'1^2^
^. -^^^
(street), Pasadena,

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Printed Name-Wi-v|^^lL-?"<i^O lU-/i
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Please provide clear, readable copies of two (2) documents from the following list and attach to this application:

Home utility bill or cellular phone bill
Records from any state or national bank, state or federal savings association, trust company, industrial loan company, state or federal credit union, or any institution or entity that has issued a credit card
Insurance documents, including medical, dental, vision, life, home, rental or vehicle
Medical documents
A document issued by a U.S. government agency, meaning an entity, office, or authority governing over a country, state, county, city, municipality, district, agency, department, or any other political subdivision of a country or state Mortgage bill
Employment documents
Tax return (either Internal Revenue Service (IRS) or California Franchise Tax Board (FTB)
Rental or lease agreement with the signature of the owner/landlord and the tenant/resident
School documents issued by a public or private primary, secondary, or post- secondary institution, college, or university that includes the applicant's date of birth. If using a foreign school document, it must be sealed by the school and include a photograph of the applicant at the age the record was issued. •
Change of Address Confirmation by the U.S. Postal Service Property tax bill or statement
Letter attesting that the applicant resides in Pasadena from a homeless shelter, shelter for abused women, non-profit entity, faith-based organization, employer or government agency within the United States
• Deed or title to residential real property
Voter registration confirmation letter or postcard issued by the California Secretary of State or the Los Angeles County Registrar of Voters Proof of payment of resident tuition at a public institution of higher education in California
An original copy of an approved Claim for Homeowners' Property Tax Exemption (BOE-266) form filed with the Los Angeles County Assessor Court documents that list the applicant as a resident of Pasadena California Certificate of Vehicle or Vessel Titles or registration (i.e., a title to, or a DMV registration for, a boat, truck or car)
A DMV No Fee Identification Card Eligibility Verification (DL 933) form, completed and signed
If your name does not appear on any residency documents, you may present a birth certificate, marriage license, or domestic partner registration certificate to trace your relationship to the person whose name does appear on the residency documentation.

If the residency document reflects a name that differs from the tracing document due to a name change (for example, marriage, divorce, or court order), name change documentation is required.

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Instructions: The Pasadena Fair and Equitable Housing Charter Amendment (Measure H) prohibits Tenant Board and Alternate Tenant Board members from having "Material Interests in Rental Property" (defined below) at the time of their appointment and during their service. All applicants for all Board seats (both Tenant and At-Large) must report their own and their Extended Family's interests and dealings in rental properties in Los Angeles County in the three f3) years before submitting an application. The City is adopting the Fair Political Practices Commission's Form 700 for this purpose, but Measure H requires information about interests in rental property in Los Angeles County for three years, not the one year the FPPC Form otherwise uses. Under City Charter Section 1811(b), these documents are public records; they will not be confidential.

Measure H's Definitions:

Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Section 1803(g)).

Material Interest in Rental Property: an individual has a Material Interest in Rental Property if they, or any member of their Extended Family, own, manage, or have a 5% or greater ownership stake in Rental Units in the county of Los Angeles, or if they or any member of their Extended Family owned, managed, or had a 5% or greater ownership stake in Rental Units in the county of Los Angeles in the past three (3) years (Section 1803(i)).

Tenant: a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental housing agreement to the use or occupancy of any Rental Unit (Section 1803(aa)).

CITY OF PASADENA
Economic Interests Affidavit - MANDATORY
I, J^iii^U^ j3rC)^n (printedI, '~~ffJ64!(^4//t^ L^t) FO'(/vy^ (printed name), declare under penalty of perjury under the law of the State of California that the information provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete.

Signed this 1^^ day of vf^JbriA/\fi
C") r,
Signed: l"'^^{j^
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Printed Name^/'l i-J Al4L- ^0-t3 l^-
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
.^al&rr^.l^ion(printed name), declare under penalty of perjury under the law of the State of California thaTthe foregoing is true and correct:

1. I am a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental agreement or lease (oral, written, or implied) for the use or occupancy of a rental unit.

2. I am either a) named in a rental housing agreement or lease, or b) have provided proof of a relationship to a person named in^artahMttaBlfiflUfaa^fltitlfiMB^ib^iMifatUfa tenant.

REDACTED 3. I reside at the following address:

Pasadena, California C^ (zipcode)^^"
REDACTED(street),
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.
u
Signed this
Signed:
day of,20
Printed Name:
s
31 •-S1

CITY OF PASADENA

NOMINATION PETITION -WORKSHEET
<KNA I'••(-)'€ P^<?v^^
(Name of Candidate)
P^lA^ P;^.^ 3
(Office and District or Seat)
Total Signatures
Total OK ^
Date: 3 /^^/^V
Checked by: ^S
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CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THE

Applicant Name: T^^^JY^^ ^-v-V-^^^^^
Home Address:

Mailing Address:

Email Address:

Business Phone:

Home Phone:

REDACTEDREDACTED
^^^^

REDACTED

REDACTEDREDACTED
Date Available to Start:

Cell Phone:REDACTED
Board Seat Type: Indicate the type of Board seat in which you wish to fill (mark one or more):

Tenant Member (7 seats, one per Council district, reserved for tenants) Representing City Council District
At-large Member (4 seats, open to any Pasadena resident without respect to tenancy or Council District)
Alternate Tenant Member (1 seat, reserved for tenants)
•^
'7^ Alternate At-large Member (1 seat, open to any Pasadena resident without respect to tenancy or Council District)
Community Service - List boards, commissions, committees, and organizations on which you ^ are currently serving or have served, offices held and in what city. 2-ac'S ^o/o <^/Ty o/:L A.'^^oo^ic. 'la>^^-v-if-, 'FUi\".o^ <^-A4- sr/^fi-f-^ •^, re /y-^f ^7^.7^72./y -o-.:-^ i/r s, •/:?u^, A^'_ '(^rv&jf- ^.fiK^-oftV.i.e' '•^••'•.i^ f-i^- \y»jntM s*-/a-^^n A/IV fl-fl-e/Y vf- /'OYf.^'s^io •^"4-c-^ , /y]/I^A-&&M_ fi-eT-hl-9 '^-»il 1-f^-frl-r^ /»T<.n •$47S^T~y .Ly(»^>-,4->Tn, /^-- S^t^itrt.'^wfiilj^ A-v^l-i i^,. f^is n-t A-^j A-^ar^Q.^-f ^V— JJ <-/ry /t-y-o '='&^^fcw~/'y^', n')»^*<!v-/"L ',?v'j^t ^i^A.y.^v-*, ^i^\l^ ^/, ^frr^iu, yiA^',Employment - Title and duties, current and past (acceptable to attach resume as an alternative).
^•^,7,.^.t-, M<ui.4-i<in^ (^ Itr v^<.^ pya.^l-, i^. P^^i^L^'^, ^oi ^^- s^ ^oyr)-A-^f~ ^^ ^// fZ^'-^T iJI /2-/5A^. ULvnh^J f^t)^-f^-f/j/T=-^^,^- t^i^LfL^ ^ ^£-€^T^ . ^^<ws.(>L<.^ A-/^,/7/r/ A-v-+'A^t-^S 4^ Tt=^4-^r ft^y^j fta-r 4-K/? ^^'Ut4- i^=T^/5w^ ^ <a<!^^-o;^6- ^t'rw- £-^t^>^-> t^"^ ^tt^4t^'itj-f Education - Include professional or vocational licenses or certificates.

P^^M^,^ ^-^ 4?/L^^'72-7'/^ t/i^,^ ^t- Ss^'>-^^ l^'/vLir^^v^ '7s'—77' ^C-S-l-^-l^j ---A^L... ft^-,'^'1 e-S')-/^-/-^ ~~f3>Y^'i^i^^-.

1. Have you ever worked for the City of Pasadena? (If yes, please YES | ° | NO list dates/department)

2. Are you related to any employee, appointed or elected official of the City of Pasadena? (If yes, please indicate name and relationship)
YES NO

3. Are you aware that financial disclosure is required annually? (e.g., sources of income, loans and gifts, investments, interests in real property)

5. Do you,or your extended family1 members, have a material YES | | interest in rental property in the County of Los Angeles within the last three years?

6. Do you reside at a property owned or managed by a member of YES | | the City Council, or any member of the City Council's extended family, or in which any member of the City Council, or member of the City Council's extended family, has any ownership stake in said property?

7. Have there been, or are there now, any personal or business YES | | circumstances which might reflect adversely on the propriety of your serving as a member of the Pasadena Rental Housing Board?

8. Are you aware of the time commitment necessary to fu'fi" the YES l-^\ NO obligations of the Pasadena Rental Housing Board?
NO
D
Extended Family; any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Charter Section 1803(g)).

9. Are you aware that you may serve no more than eight
consecutive years as a member of the Pasadena Rental
Housing Board?
YESNOD

10. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate:
\A/ i 'F^ ov/k-1^0<-< .-e<;v^ I'Fkt (5\/k-vT— 'Z^O t.l.^.t'y^ 0-{- 7-<^~'s—t-/ l-r.f-r-r, L-U^v.'/ t£-:r~ r7t—/3i b-t^ i^— j- t-*r) V>'"iiaL'-f_. (L AU^C^i^i,^, 'h .$.;r- £-^ fi-^ Pft-l-l-Si^ X 1!^^'^ ^ 7^<^/-^^$^.-^ )A.-,.r7+ ^ QftJ^ t^s^r Gp/i^ii^r, .4-7\-r? pO^^e- ^^-T?::W/f~ fc A-z>&-t3~)'->-'on.a-/-i?-' /^ 07-7/ <^^t4--)^-/ Cij^,/) //t—,J rfc.^.-^y-^ -i-o jfaLe&.^ -/^<_ h>^5iNs^5\ £^f~> (?^. r7-ML /^S/A-/-^5''y'--r~^i- •As^'^--^'.-^ /r'tV^ /-rv/tV4^,/[

11. How would you add value to the Pasadena Rental Housing Board? TV<- F^-l\-(2> i^r •jw-U \-a-<^v^.^C,'V jS>«-s_.. Tl-^-. .A-EA.VV)|^,'<, ^^''j;Lt_, i-<A/^7 (^y-, 7 -ITWt^ j&f^AC
^L.,,^ 'oP -U^-^/
A1 -? ^l^J <: />-i^
'•^vv-' \ \^' i •rTJr tU- ^-iit^-e^'l^i-p^v-v\^f~ A-^&^rt^c^; /W/ 'fH^-l '2.'0 /" LU f I'^/L&.^y^ 'r^'^^A-^^n^-if <^> /^••^'((.•CMA . Af^ i^[-fLl-iy-^J ^-z-ru/^T ^ >'/^-,7'/ ^l—r- i 1\j ^-^-^•5 ^<^//-7u^) ^^e?/ /fc-?o<s--t-<^>. i,v^,2C-< /<of^v/i/i<,.? p ^£'{,/^-A.;/^^- /^> ^os,rf \ l^S-ftv^ ^/Y-'r-S-Tl. ^L3 , 7 1 ^ 7

12. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
77t^ Py'1/^c.^w s\o,->L v>^ /^u-- pl^i-i-'V ^^t^-4/ 6^ -ro. /^^ i^_.^uia£:: /\iL t:P;f{S<f /^s, L-/!, t<^' ^C?>-V.^S t>(^ llrC^— f^^-f^.»^ / Dts.pe'^hy^^-^'^ i9^€^ /t^ pl-/}-s^'. ie, vc: /?^^t ^i^<,t), i,^. 3<-i<g/^£7- J~ ^~7 ' :i
Si^r>^>/~. :^s
r I I 1^-t— llt'^s-ry-.s^/ i^ie^pwi r^-f-T^ I iVf f^- / l\f /J L-J'r'z—iS. , id P-v^'^1 fi-ec\f^^, F'^e^ ^-^ Z)<K^./7i^ .^-.Q/IL-^/' ^yWC (^-s/*/5.//,^^7/ X-f-S^. /'/^T~:/^'' ^f^^( ^'^^ ?ypv^c^^ ^'^•'r,fr^^^y^o'&^^^\^£-^ <^^^pL^,^(^->e^ ^•3<^6 r?6 U^- vJu^-\^ oL ^r'v^- is-e/^^-13. How would yoti help to achieve these objectives and goals? ^__^^3^Gg^i-£ Aw€i ^t^iL^i^L^ •^ h-L-'^ ^•^~' ef ^'iu- "'-^1 f-if/ S^fyf., £>f^ <£^-<-^r7cy^ o^ ^ t'6u ^f-f'\cw^^, . '!ty->^u_. p/-fi\^.. 'L^^I—W^-^ /C^-» y, *-^—-/^-4^ •h^'a^ '4 of'iu^' Sim^La^' 'S 4 6^,i ti.it-, * t- /4-w AW 11'^-. '5 ^4? - ^i-v"' ^/<h's M^^~n'>-'a{-S'f 5^fH3-i^ ^Y\ f^^A Ai'v /4~/<s/^/i-/ /sC'L/ffC^^ -'•' .J-l.. . ^-. . ' '._ ., /' o ^_-. ._/5—-^/'~ / ^ :3C^t^LfC.r-^-_ A-W3 •t~'^"-s~ PvySi. ^ — <!> ic K's-^T" Pi^''-^-i-rc-i=f , /
I, V^ i Q+ JY^ L-^ C \^^{)^\^ (printed name), declare under penalty of perjury under the law of the State of California that the information reported in this Form RHB-001 is true, accurate, and complete.383
z-ff.zr':

Signed this v ~> day of ^-E&P^.._, 20 Z? .
v Signed:

Printed Name: VY^-^AW^- ^AA r>^>^
%
V
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.1;
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CITY OF PASADENA
Residency Verification - MANDATORY
All applicants must provide proof of residency in a City Council district under section 1811(b) of The Pasadena Fair and Equitable Housing Charter Amendment (Measure H). Proof of residency may be established by either of the following:

1. If you are a registered voter, please complete and sign the following declaration and the City Clerk will verify your signature on file with the Los Angeles County Registrar of Voters.

I am a residfifl^LQislucL\\f^ of the City of Pasadena
REDACTED! I reside at
CA ^^o^- (zip code).

REDACTED(street), Pasadena,
Signed:

Printed Name: ^>^M^ ^iV^FYW^
&•
II
KS
s
^.

Please provide clear, readable copies of two (2) documents from the following list and attach to this application:
•
•
•
Home utility bill or cellular phone bill
Records from any state or national bank, state or federal savings association, trust company, industrial loan company, state or federal credit union, or any institution or entity that has issued a credit card
Insurance documents, including medical, dental, vision, life, home, rental or vehicle
Medical documents
A document issued by a U.S. government agency, meaning an entity, office, or authority governing over a country, state, county, city, municipality, district, agency, department, or any other political subdivision of a country or state Mortgage bill
Employment documents
Tax return (either Internal Revenue Service (IRS) or California Franchise Tax Board (FTB)
Rental or lease agreement with the signature of the owner/landlord and the tenanVresident
School documents issued by a public or private primary, secondary, or post- secondary institution, college, or university that includes the applicant's date of birth. If using a foreign school document, it must be sealed by the school and include a photograph of the applicant at the age the record was issued.

Change of Address Confirmation by the U.S. Postal Service Property tax bill or statement
Letter attesting that the applicant resides in Pasadena from a homeless shelter, shelter for abused women, non-profit entity, faith-based organization, employer or government agency within the United States
Deed or title to residential real property
Voter registration confirmation letter or postcard issued by the California Secretary of State or the Los Angeles County Registrar of Voters Proof of payment of resident tuition at a public institution of higher education in California
An original copy of an approved Claim for Homeowners' Property Tax Exemption (BOE-266) form filed with the Los Angeles County Assessor Court documents that list the applicant as a resident of Pasadena California Certificate of Vehicle or Vessel Titles or registration (i.e., a title to, or a DMV registration for, a boat, truck or car)
A DMV No Fee Identification Card Eligibility Verification (DL 933) form, completed and signed
If your name does not appear on any residency documents, you may present a birth certificate, marriage license, or domestic partner registration ceri:ificate to trace your relationship to the person whose name does appear on the residency documentation.

If the residency document reflects a name that differs from the tracing document due to a name change (for example, marriage, divorce, or court order), name change documentation is required.

L
RAS--b?SK ^ft
s•s %^ ?0^r^

M easure H's Definitions.

Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Section 1803(g)).

Material Interest in Rental Property: an individual has a Material Interest in Rental Property if they, or any member of their Extended Family, own, manage, or have a 5% or greater ownership stake in Rental Units in the county of Los Angeles, or if they or any member of their Extended Family owned, managed, or had a 5% or greater ownership stake in Rental Units in the county of Los Angeles in the past three (3) years (Section 1803(i)).

Tenant: a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental housing agreement to the use or occupancy of any Rental Unit (Section 1803(aa)).

CITY OF PASADENA
Economic Interests Affidavit - MANDATORY
I ^ (^+A/bz^ ^4./^) (YV\-J (printed name), declare under penalty of perjury under the law of the State of California that the information provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete.

Signed this ^ f day of ^v^,202.^ .
^AA^V^- Signed:

Printed Name: ^^A4ts^- ^M^ rf^
p•^sb?
^'s
*°7*
°Q5 ••»^ ?Qss &rED
I,.

CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
(printed name), declare under penalty of perjury under the law of the State of California that the foregoing is true and correct:

1. I am a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental agreement or lease (oral, written, or implied) for the use or occupancy of a rental unit.

2. I am either a) named in a rental housing agreement or lease, or b) have provided proof of a relationship to a person named in a rental agreement that entitles me the rights of a tenant.

3. I reside at the following address:

Pasadena, California _(zip code)
(street),
^
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.

Signed this \^ day of ^3n/w-
Signed: VU^AA^
,2023 .

Printed Name: \'^i^A^^ ^.IA p-^^v-J
T
u

CITY OF PASADENA

NOMINATION PETITION -WORKSHEET
.M; cL<^< i c^^p ^^^
(Name of Candidate)
PP.'l+^ 1?^^'^ J7
(Office and District or Seat)
Total Signatures
Total OK 2<?
Date: 3/2.3/2.^
/
Checked by: fcs
2^o?
^^
y
s
<D
^'ss ?irE5

CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THE

Applicant Name:

Home Address:

Mailing Address:

Email Address:

Business Phone:

Home Phone:
^5"am^ ^^2^ Co I & 6r6&l^
T
REDACTElRED^
•^
'F?^a^A , C^, ({\\b-^
REDACTED ACTED^s^^a/ ^/ ^/lo^

REDACTED

REDACTED
KtUAUIbU

REDA(REDACTED
uaiy MVdiiauiy lu^iart: 'J./1/.23
/
~GSff^1H^^~REDACTED
Board Seat Type: Indicate the type of Board seat in which you wish to fill (mark one or more):

Tenant Member (7 seats, one per Council district, reserved for tenants) Representing City Council District 3
At-large Member (4 seats, open to any Pasadena resident without respect to tenancy or Council District)
Alternate Tenant Member (1 seat, reserved for tenants)
Alternate At-large Member (1 seat, open to any Pasadena resident without respect to tenancy or Council District)
Community Service - List boards, commissions, committees, and organizations on which you are currently serving or have served, offices held and in what city. (-tM^?3S lot, Al^)^YZ-6Emi/-\ ^.M,v1(.l>|(+y 3'^^') ^Lrfll;<i'.8iS'aA ^l^ly<-: -26lJzi.oLC>^3 / ^lI&iS/^ 9 'I
-tM^?3S Lot, /-^Pl^^LfcB1/jl/-\ ^.Miv^i.lfty ^>^^^/ l^)Vi'Lrfli;<i'. l^is'a.rt r^u^tw-- -^uijs.oLL/.+^t / p^u&ny/ (i^^y<v,^i]^.r4[r^W^ W^f;(^.^Y^<-i]^^M]] ^i^^/w/^^it^Rlf}^' -20ill-,W/ ^. 1%^^, (^ ^ijfl^^^r. (t-kprTA'J'A '^,jtf;^?n(>Tri/L<,(^') /./^^tp ^V't ^j^PC'- P/,1'3-,'^1^, ^.W(l'<^^-

1. Employment - Title and duties, current and past (acceptable to attach resume as an alternative).
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'1
Education - Include professional or vocational licenses or certificates.

P^r^' P'^i^/iiii/i fji^/n( ^[^i -ML ^C^rLy^l 5^^N, ^aLsYA ^[i^'.3f\ b^^p-^ui^ f^ 77?/A/^/ ^Miy7[!^ l^yii.w^ ^A^M^CiS ^^A/'A+l ,/) P^h.^^/iiA A- nJ^^lSf^^/ ^w^ fA
-. /-/ / t -^ ~ , ,< (
6'a sh^- ^J/y /'? ^^y -^, l-e& ^i^w^ d^'^Tl^

1. Have you ever worked for the City of Pasadena? (If yes, please list dates/department)
YES NO

2. Are you related to any employee, appointed or elected official of the City of Pasadena? (If yes, please indicate name and relationship)

YESD NO

3. Are you aware that financial disclosure is required annually? (e.g., sources of income, loans and gifts, investments, interests in real property)

5. Do you,or your extended family1 members, have a material YES j | NO interest in rental property in the County of Los Angeles within the last three years?

6. Do you reside at a property owned or managed by a member of YES | | NO |x'| the City Council, or any member of the City Council's extended family, or in which any member of the City Council, or member of the City Council's extended family, has any ownership stake in said property?

7. Have there been,or are there now, any personal or business YES | | NO circumstances which might reflect adversely on the propriety of your serving as a member of the Pasadena Rental Housing Board?

8. Are you aware of the time commitment necessary to fulfill the YES [^\ NO obligations of the Pasadena Rental Housing Board?
Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Charter Section 1803(g)). ^
r

9. Are you aware that you may serve no more than eight
consecutive years as a member of the Pasadena Rental
Housing Board?
YES@
.'(
NOD

10. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate:
"Irtl ^^.i-f^v! ^/^/lf ^a\if}'\^ic)h-/i ^^f ;/i-^f'r ^,~/j(i»kf t.r^)..^-l ^iil} )',^if;^d ^Jl^&^ K-ft ^.^ ^ {p^.-Pfiir h^i/K, l.i,^,, i^nli-aijf/^ sif'i'j^ ^['iQYpf^i.f^ </•») A ^Yrt ?^.Jo^lr ?itte!-^. ^•^^ n'^cmh(/ urh^^p-.i^ jH'd'.i^ &in} ^,-tu ~Ji/\ /;.<„„•„ ^ ^ W^f^lpti '^twi^,^ <?r^;^ -^r ('^f h^(?,vi^. ^ /! ,-/^,(^^y^ff jj^ ^M.is^ ,>') ,Sff>^i^^^/^^ \'i hf/il ^KA'fw to/tl, »?rt/.;7rt/'h i^'^) /hiMJltll -/^ )i^Mii~i<!t e^-t-{ ,4 (sr.llUt^ •^wLtl-tll. "fi.*/ /7','/y? ?. 'l/'fi^tlt ^f»Ul'i fl'.l/e. f rysvj^! h-> Ry.vl^, "I -^^T-f - Y-y- j—^r^—7»1-^-j-- - - •- -^ "/^^- . - -,--^ . ,-

11. How would you add value to the Pasadena Rental Housing Board? "Irt •A.y^i'B.I +& rt)t/ -frlft'il'l^itll teiih '>iah a:i\D^a<^ ^u)i/?« feuiL 'T/ri/l n^.^.ef. ^iiiiHi.n' ~,i\ThrMPi} i?,/ .Z/^ ^•j,-kriti'M nf,/\nst\ n.^^.ii. "7""'""' """/ '7' ~"t ,""i'7~7) ''~"/ -^-If^'---^-Y"; "'"" ^f ''[ ^-—ji/•••••/• ^•j'"-j ).<\\\A\^ni-i.i\!^ Wsiti^i W^\i^\, MI; A^i?fti»^l h^f-^^.y'^ i^</-Lk/o/-(.')i.^F'b,7^ m^n.^c^^-T •I ^^i,^. ^rr,<s/. in ^n,^;;.^,^ ^/a^'i^\t,.fj ^.flii /"^ft-^'L/T r<?.Sfi[>*-tiOi'\ 'fhhi^ eu/Sf^rt J^/ft f'o /rr^it f>i.^;3iifti.-/t/-f w} i^ sllf -& J&i'r.lV A/c^ly ^ftC^t} f^r--i.fiinr'l/ ^f"lsUu'^ "2nS tJLfi/)^ p^'p^ ^u,''<.f^ Ufti^rt-rt«V;lA^ ^hf) ^.WpfriM'iV . f\\ ^(\ fll_-^il,-</y(!M^-i;Y mrti^i',!lAl)+C-n3(lt'/^-Si./-_<i'Ai'y7/s^(^U( ^••f ,\,ir

12. What do you view are the primary objectives and goals of the Pasadena Rental Housing7 "^""" Board?
1^\>1« ^ prr.Mt^'i /Ci^tf.Qrfy t^Ui+ji I'JyfliA.^) [I-/^C(-L|-,I(; hi'hlVn^ 3/1(1 ('17,-lto &()^m^eirt-ff,^ ^.rh .^ 8i.i •th/ /3iJ r-f^,,',/Y\ '^ftlA a^li(^8,l •Ac <-rY,lk. q &i';>^/ /J' Arfj/s)-:!^, KK-lii/'-fcr All j-wft'i^. •flj^tfflr/) (V^Kl (hW[<\\iA\t(^ -t^ftri'it,^ (/•/•nr^.he./en^wH erf J'f-ai,iai flfptf,nie,/\f{>

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^l-itl i. ?n,S
1,-rr

13. How would you help to achieve these objectives and goals? ff/.Vi.A^Lffdf; pca-i.f.ll ^i'ff<, in Ai-83ni.-;',-7-)i/>/1,fccnr^^i2iAWtYWI'!^An'?')n«!uL-&iUi'iaf.lVk)it^ hi-iuS/na/At'S/Iri^ /'AWlitliAA/'iif inUfli^vlii.^'i.,'1.+k',K I- i"3n (V(tyl Up iA;^ Y's iA -PcArift^ ^ /:'<v\<i(nr|rt)('«j-t ('.•(-' c.p^.f^'.*)''', /'AiVPflii'li^+ft..^ ^A^ (;(Sfl(7i^.,^i'^e. prif^ l^g\^ trs tac/.'/'iA/ ^L >y\+('(» i^ L)6rkiM^ -fi-,(--i))ci1^ /'i^wliM (t r iil/', ^flpiA.\+^y<)!.'7t;?-l'c j/X^^'^y ^•^yj/ult, /^y f?>^Aintb^/:-i\ /Ai/A l,^//^fep»tt rvie-k /-".1-fli'cf ^v\} !i\MMu/i,f3T€ r^A-JfrfiuM!2427^^i).'^M(L'3.«?«t)'fc))/fc/lli All, W»i*«,v.,-t7-f^5l«fl^ -(^ir/^it Ztu) l«l.il ^tp ^^X« ilk§^'u;;tl fc^a^ iw.tV.
•^
I
I
>lf\+('(>) l\ Lltrkiru
c'f'h'5~.-ii-i\u/M ^dfta&c? S/)
I, ^^&b ^L ('T^fil^-(printed name), declare under penalty of perjury under the law of the State of California that the information reported in this Form RHB-001 is true, accurate, and complete.
s
:'s.
.^
;il
Signed this 3.4il day of "Szi\\i^'°f, 2023 .

Signed: ./ 1/v^-
Printed Name: "^'•^w&s ^ C Cr^tly^-
c.
r
FelsmaTyLSO^^,
2823 FEB-3 FH?:5!
James E. C. Creely

CURRICULUM VITAE
-;i .
'v r,James_Edward Cole Creelv Jeff). PhD.

REDACTED
m

REDACTEDREDACTED
EDUCATION HISTORY:

DOCTOR OF PHILOSOPHY IN CLINICAL PSYCHOLOGY June 2016
Fuller Theological Seminaiy, Graduate School of Psychology, Pasadena, CA (APA-Accredited Program)
MASTER OF ARTS IN CHRISTIAN LEADERSHIP June 2016
Fuller Theological Seminary, Graduate School of Theology, Pasadena, CA C.)
MASTER OFARTS IN PSYCHOLOGY June 2012
Fuller Theological Seminary, Graduate School of Psychology, Pasadena, CA (APA-Accredited Program)
BACHELOR OF ARTS IN PSYCHOLOGY May 2010
Lee University, College of Liberal Arts & Sciences, Cleveland, TN Honors: Magna Cum Laude
CLINICAL EXPERIENCE:CA License No. PSY29764—Exp. 12/28/2023 J Creely Psychological Services - Private Practice % Here Counseling LA Licensed Clinical Psychologist August 20 17—Present
520 South Grand Ave, Suite 671, Los Angeles, CA, 90071-2655 c.

APA ACCREDITED POST-DOCTORAL RESIDENCY
Duquesne University - University Counseling and Wellbeing Center Post-Doctoral Resident August 2016—Present
Supervisor: lan Edwards, Ph.D.

APA ACCREDITED INTERNSHIP
University of California, Irvine - Counseling Center
Doctoral Intern August 201 5—July 2016
Supervisor: Carolyn O'Keefe, Psy.D.

February 1,2023 James E. C. Creely

PRE-INTERNSHIP
Azusa Pacific University - Student Counseling Center
Practicum. Augiist 2014—July 2015
Supervisor: Joel Sagawa, Ph.D.

VA Long Beach Healthcare System - GEM Psychology
Clerkship August 2013—July 2014
Supervisor: Lauren Fox-MacMillan, Ph.D.

Vanguard University - University Counseling Center,
Practiciim August 2012—May 2013
Supervisor: Lesley Davis, Psy.D.

Fuller Theological Seminary - Fuller Psychological and Family Services, Clinical Supervisor August 201 3—July 2015
Supervisor: Stephen W. Simpson, Ph.D.

Fuller Theological Seminary - Fuller Psychological and Family Services Practicum September 2011-June 2012
Supervisor: Brett Veltman, Ph.D.

PROFESSIONAL COMPETENCIES & CERTIFICATIONS:

Fair Housing Certification,
Housing Rights Center LA
Undocumented Resident Ally,
SOAR Center: AB540
LGBT Safezone Certification,
UCI LGBT Resource Center
disAbility Ally
UCI Center for Learning and Accessibility
Prolonged Exposure Therapy,
VA Desert Pacific Mental Illness Research and Education Center Proficient in electronic records keeping and other software systems including:

IBM SPSS Statistics for Database Management, SimpIePractice, Therabill, Point and Click, Pages, Numbers, Keynote, and Titanium
RESEARCH & DATA MANAGEMENT:

Travis Research Institute - Fuller Psychological and Family Services TRI RESEARCH FELLOW August 2010-June 2013
Dissertation Title: All Things Through Him who Strengthens Me; Religious Coping, Self-Efficacy, and Post-Traumatic Stress among Teachers in El Salvador Masters Project: Symptom Prevalence following Exposure to Community Violence:

LASC, Posttraumatic Stress, and Self-Efficacy in El Salvador Principal Investigator: Katharine Putman, Ph.D.

February 1,2023James E. C. Creely
TEACHING EXPERIENCE:

Fuller Theological Seminary, Graduate School of Psychology 13 5N Oakland Ave,
Pasadena, CA 91101-1713
Teaching assistant
PC 800: History aiid Systems of Psychology
Course instructor: Stephen W. Simpson, Ph.D.

Teaching assistant
PC 852: General Linear Model: Regression
Course instructor: Seong-Hyeon Kim, Ph.D.

PC 851: General Linear Model: ANOVA
Course instructor: Mari Clements, Ph.D.

Winter 2012
Spring 2012
Fall 2011
Lee University, College of Liberal Arts & Sciences, Department of Social Sciences P.O. Box 3450
Cleveland, TN, 37320-3450
c"'
Teaching assistant
PSYC-310, Child Psychology and Development
Course instructor: Heather Quagliana, Ph.D.

Teaching assistant
PSYC-216, Advanced Research and Statistics
Course instructor: Wendy Steinberg, Ph.D.

Teaching assistant
PSYC-341, Learning and Cognition
Course instructor: John Gulledge, Ph.D.

Teaching assistant
PSYC-215, Introduction to Research and Statistics
Course instructor: John Gulledge, Ph.D.

Fall 2009
Spring 2009
Fall 2009
Spring 2008
PRESENTATIONS:

Creely, J. E. C., Putman, K. M., Penner, K., Rojas-Flores, L., Hen-era, S. M., (2013, June). Symptom prevalence following exposure to community violence in educators: Posttraumatic stress, self-efficacy in El Salvador. Poster presented at the Society for Community Research and Action Biennial Conference, Miami, FL.

Tait, R., Wong, J., Putman, K.. M., Meier, A. M. Wierenga, J., Hess, E., Jacobs, M. A., Creely, J.E.C., & Paiiuell, L. (2011, June). Evaluating training at the Los Angeles police academy:

Field training officers 'perceptions of recruit performance. Poster presented at the Society for Commuuity Research and Action Biennial Conference, Chicago, IL. u.

Creely, J.E.C., Hall, M., Coleman, S.T., (2010, March). A sight unseen: Maladaptive eating behaviors and visual perception of body flaws with eye tracking. Presented at the Blue Ridge Research Conference, Lindsey Wilson College, Columbia, KY.

February 1,2023 James E. C. Creely
PROFESSIONAL AFFILIATIONS:

American Psychological Association,
Sau Gabriel Valley Psychological Association,
California Psychological Association
PSI-CHI National Academic Honors Society,
Director of Student Research Committee,
November 2007 - Januaiy 2016
October 2010 - Januaiy 2013
June 2012 - December 2016
August 2008 - Cuirent
August 2008 - May 2009
SERVICE & ORGANIZATIONAL ENGAGEMENT:

Compass LA, (LGBTQIA Community Support)
Executive Board Member
Momenhim Center for Clinical Excellence
Clinical Director, President of the Board
University of California, Irvine, Counseling Center
Clinical Services Committee Member
OneTable, (LBTQIA Justice and Inclusion)
Leadership Council
Fuller Psychology Graduate Union,
PhD Representative,
Fuller School of Psychology Curriculum Committee,
Student Committee Representative,

REFERENCES
Connor McClenahan, PsyD
Founder and CEO of Here Counseling
B2

REDACTED
Thomas J. Smith, PhD
Assistant Director / Trainiug Coordinator
Duquesne University
>eling and Wellbeing Center

REDACTED
Steven Simpson, Ph.D.

Associate Prof.

Fuller Theological Seminai-y
Graduate School of Psychology
August 2018-June 2022
August 2019-June 2021
August 2015 -June 2016
August 2012-June 2015
August 2010-March 2012
August 2010-May 2011

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CITY OF PASADENA
Residency Verification - MANDATORY
All applicants must provide proof of residency in a City Council district under section 1811(b) of The Pasadena Fair and Equitable Housing Charter Amendment (Measure H). Proof of residency may be established by either of the following:

1. If you are a registered voter, please complete and sign the following declaration and the City Clerk will verify your signature on file with the Los Angeles County Registrar of Voters.

I am a re'si'^p'nt nf nistripf N
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of th^_City of Pasadena
I reside a\
CA qiift^ (ZIPCfil
Signed:
(street), Pasadena,
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Printed N^ime: ^^/.s ;?(; 6<^c^
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Please provide clear, readable copies of two (2) documents from the following list and attach to this application:

Home utility bill or cellular phone bill
Records from any state or national bank, state or federal savings association, trust company, industrial loan company, state or federal credit union, or any institution or entity that has issued a credit card
Insurance documents, including medical, dental, vision, life, home, rental or vehicle
Medical documents
A document issued by a U.S. government agency, meaning an entity, office, or authority governing over a country, state, county, city, municipality, district, agency, department, or any other political subdivision of a country or state Mortgage bill
Employment documents
Tax return (either Internal Revenue Service (IRS) or California Franchise Tax Board (FTB)
Rental or lease agreement with the signature of the owner/landlord and the tenanVresident
School documents issued by a public or private primary, secondary, or post- secondary institution, college, or university that includes the applicant's date of birth. If using a foreign school document, it must be sealed by the school and include a photograph of the applicant at the age the record was issued. •
•
Change of Address Confirmation by the U.S. Postal Service Property tax bill or statement
Letter attesting that the applicant resides in Pasadena from a homeless shelter, shelter for abused women, non-profit entity, faith-based organization, employer or government agency within the United States
Deed or title to residential real property
Voter registration confirmation letter or postcard issued by the California Secretary of State or the Los Angeles County Registrar of Voters Proof of payment of resident tuition at a public institution of higher education in California
An original copy of an approved Claim for Homeowners' Property Tax Exemption (BOE-266) form filed with the Los Angeles County Assessor Court documents that list the applicant as a resident of Pasadena California Certificate of Vehicle or Vessel Titles or registration (i.e., a title to, or a DMV registration for, a boat, truck or car)
A DMV No Fee Identification Card Eligibility Verification (DL 933) form, completed and signed
If your name does not appear on any residency documents, you may present a birth certificate, marriage license, or domestic partner registration certificate to trace your relationship to the person whose name does appear on the residency documentation.

Measure H's Definitions.

Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Section 1803(g)).

Material Interest in Rental Property: an individual has a Material Interest in Rental Property if they, or any member of their Extended Family, own, manage, or have a 5% or greater ownership stake in Rental Units in the county of Los Angeles, or if they or any member of their Extended Family owned, managed, or had a 5% or greater ownership stake in Rental Units in the county of Los Angeles in the past three (3) years (Section 1803(i)).

Tenant: a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental housing agreement to the use or occupancy of any Rental Unit (Section 1803(aa)).

CITY OF PASADENA
Economic Interests Affidavit - MANDATORY
1, 7a<A^ ^<- Ct^-^k/ _ (printed name), declare under penalty of perjury under the law of the State of California that the information provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete.

Signed this 0.^'* day of "Ta^vuw^
Signed: lj^ _^ ^(^4^^--
Printed
, 20^i .
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ame: S&<^^^6 Cg&^Lr
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
I,.'^smt<, i? 4 Lf-cdv(printed name), declare under penalty of perjury under the law of the State of California that the foregoing is true and correct:

1. I am a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental agreement or lease (oral, written, or implied) for the use or occupancy of a rental unit.

2. I am either a) named in a rental housing agreement or lease, or b) have provided proof of a relationship to a person named \T^^gf^s^QfsSEOSDU^3l£B^S^Ke the rights of a tenant.

3. I reside at the following address:!
Pasadena, California ^; hi (zip code)
RED REDACTED(street),
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.

Signed this W day of 'January
Signed: /Z^
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Printed Name: 'SAnw s '^L CrCd-
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CITY OF PASADENA

NOMINATION PETITION - WORKSHEET
T<AFf\^S Cr^U\A.
(Name of Candidate)(J
P^s^dw^ R.€Yvkfl -Hou&in^ ^AgcC
(Office and District or Seat)
Total Signatures
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Date: <2-^>( 3105-^,
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CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THE

Applicant Name: L.<^C?pol(3tp VJh^£<L-i-••—1/-YTZ^
Home Address:

Mailing Address:

Email Address:

Business Phone:

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Date Availableto Start: ftp^^.^0^^
REDACTEt) Home Phone: ^n££i^—£i-^^™C^PV^^.'
Board Seat Type: Indicate the type of Board seat in which you wish to fill (mark one or more):

Tenant Member (7 seats, one per Council district, resen/ed for tenants) Representing City Council District
At-large Member (4 seats, open to any Pasadena resident without respect to tenancy or Council District)
Alternate Tenant Member (1 seat, reserved for tenants)
Alternate At-large Member (1 seat, open to any Pasadena resident without respect to tenancy or Council District)
Community Service - List boards, commissions, committees, and organizations on which you are currently serving or have served, offices held and in what city. (Z^.oo ffM^v^ ci^^^e'
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Employment - Title and duties, current and past (acceptable to attach resume as an alternative), i i i P, ^ //
(2-^exo cAoL<\y^t re'bome^^
Education - Include professiojial or vocational licenses or certificates. -I^V^iO ft-^rc^AiC'^ f^^^\/^

1. Have you ever worked for the City of Pasadena? (If yes, please YES || NO list dates/department)

2. Are you related to any employee, appointed or elected official ofthe City of Pasadena? (If yes, please indicate name and relationship)
YESD NOEl

3. Are you aware that financial disclosure is required annually?(e.g., sources of income, loans and gifts, investments, interests in real property)

4. Rules of law and ethics prohibit members from participating inand voting on matters in which they may have a direct orindirect financial interest. Are you aware of any potentialconflicts of interest which may develop from your occupation,or economic holdings, in relation to your responsibilities as amember of the Rental Housing Board? (If yes, please indicate any potential conflicts)
YES
YESa
NO
NO
D

5. Do you,or your extended family1 members, have a material YESinterest in rental property in the County of Los Angeles within the last three years?

6. Do you reside at a property owned or managed by a member of YESthe City Council, or any member of the City Council's extendedfamily, or in which any member of the City Council, or memberof the City Council's extended family, has any ownership stake in said property?

7. Have there been, or are there now, any personal or business YEScircumstances which might reflect adversely on the propriety ofyour serving as a member of the Pasadena Rental Housing Board?

8. Are you aware of the time commitment necessary to fulfill the YES obligations of the Pasadena Rental Housing Board?
D NO
NO
D NO
NOD
Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Charter Section 1803(g)).

9. Are you aware that you may serve no more than eight
consecutive years as a member of the Pasadena Rental
Housing Board?
YESNOa

10. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate:
»-<- 2o2£>£ C=^p1<<W ^A&Xl. L^r^W-c^ d.ccjn^ c&i^^. .|
Oc^^V^i~ <2£f2S. P_j/rlyi^^ WVol-H -OAv^T p^pSrkA <^ fc^^n rrtl<*C:7^-^!^^|\ I'\A.^ ex-^.4^'^, ^^,1^ ^^\ r&.ntaL \/^A^\f3o\^\^ ^ [^ Oou^\-^/

11. How would you add value to the Pasadena Rental Housing Board? ^•vft-^ p3LsV 2 yjnr^ \ k^^^^^,v\ ^A^T.'n a u^A-\A PO^(^^; +° o^^ A^fenp^^ a.^faC,^ Po^xrWyk i^fU\),^'4--t& <f^.^ PC^AUP ^^ -HiiL\k>n^ ^'~^> ^^ f^ <^A^ ^ A m^-(poe^ »^ 4^c^b©j0^<a^ ^fl^- Jc&^\f^j» TW^ fbm<^ <^k -iW v<€^ z(- lTc^6o^n^W^e^i (M^~^v^bn^ ^^ >^ ^ |>Vf^j.,T^te P>mr& f&i^ ^ v;e^z(- lnot o^ner^Wi<(^i (v.y^ldv^bn^ '^^ ^^-

12. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
f^f^-rf ^o^'^'^' r^f^ (^A\^ f^4 i^i-e£t<s&<>j &^7^)}^ c^ b..^nr-1 rti/i/i-S-i w^ •G~/^i4^ toc^ I'ves'w^ivi^' ^ae?-,, 4& l^u'^ ^•W:P CtriA (Wiu^ ^
^to}i)WkL{ lofivieG+- 4T?y^^y4c:s, IA; Lr^ </<»?^L
^i£?^Sibl^

13. How would you help to achieve these objectives and goals? Oiti ^Y^a, I aS\\\ <y^-nrrp. £Q^CU -Hved'FCFWr^-H<P. UQI 11 ^r- fc^1-1^ £t1<5
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^,"*\£>^r, ;/\ (^b/i^- ^^o^jV'\oo/^<^-^l^i^^ nvA- V^LC nji^->, I \^/vl tT> (P^ ^ Wiiy., f^ iTCvV^ACiui^ ^)i i^^, ^^W^l^. -^VtC'^-t^A- >WliJ^ W^ 4^V^4-^ jM^Lj cs^^^ hv<^ IteiWr-ArK? £E:7. bi;i 1/^P^. niAA Vl^^il^yA^ iCsiHv (Ttt^^Up. na^ l(?^t4T<Vkt;^. GOi4/t^~f>S- TV^ godk o-v^ fft)iec^v6& ^-Hi^ tewA fv^t- {^^•HUL ^r|T<£i^^ c^ fe^-h? C^Jl t^^ ^^'te. i, Lfip co IA& Ts»^t A (-to^z^Z-(printed name), declare under penalty of perjury under the law ofj the State of California that the information reported in this Form RHB-001 is true, accurate, and complete.

Signed this \1t^ day of M-g.rrA^ 20 ^5.

Signed: H= ^1
Printed Name: \j^f0\^o \)o^\&\ L-7<?^.

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1. If you are a registered voter, please complete and sign the following declaration and the City Clerk will verify your signature on file with the Los Angeles County Registrar of Voters.
(
I am a resis
I reside at
CA C(1W-J> (^IP code I
Signed:
of Pasadena
i.^:

REDACTEDACTED(street), Pasadena,
:4/

2. Printed Name: U'^C^I^o ^ ^aA^\
If you are not a registered voter, please provide clear, readable two forms of proof of residency acceptable to the Department of Motor Vehicles (DMV) for a REAL ID, listed below (Cal. Code Regs. tit. 13, § 17.00 and § 15.01 (d)).

Please provide clear, readable copies of two (2) documents from the following list and attach to this application:

Home utility bill or cellular phone bill
Records from any state or national bank, state or federal savings association, trust company, industrial loan company, state or federal credit union, or any institution or entity that has issued a credit card
Insurance documents, including medical, dental, vision, life, home, rental or vehicle
Medical documents
A document issued by a U.S. government agency, meaning an entity, office, or authority governing over a country, state, county, city, municipality, district, agency, department, or any other political subdivision of a country or state Mortgage bill
Employment documents
Tax return (either Internal Revenue Service (IRS) or California Franchise Tax Board (FTB)
Rental or lease agreement with the signature of the owner/landlord and the tenant/resident
School documents issued by a public or private primary, secondary, or post- secondary institution, college, or university that includes the applicant's date of birth. If using a foreign school document, it must be sealed by the school and include a photograph of the applicant at the age the record was issued. •
•
•
•
•
•
•
Change of Address Confirmation by the U.S. Postal Service Property tax bill or statement
Letter attesting that the applicant resides in Pasadena from a homeless shelter, shelter for abused women, non-profit entity, faith-based organization, employer or government agency within the United States
Deed or title to residential real property
Voter registration confirmation letter or postcard issued by the California Secretary of State or the Los Angeles County Registrar of Voters Proof of payment of resident tuition at a public institution of higher education in California
An original copy of an approved Claim for Homeowners' Property Tax Exemption (BOE-266) form filed with the Los Angeles County Assessor Court documents that list the applicant as a resident of Pasadena California Certificate of Vehicle or Vessel Titles or registration (i.e., a title to, or a DMV registration for, a boat, truck or car)
A DMV No Fee Identification Card Eligibility Verification (DL 933) form, completed and signed
If your name does not appear on any residency documents, you may present a birth certificate, marriage license, or domestic partner registration certificate to trace your relationship to the person whose name does appear on the residency documentation.

Measure H's Definitions:

Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Section 1803(g)).

Material Interest in Rental Property: an individual has a Material Interest in Rental Property if they, or any member of their Extended Family, own, manage, or have a 5% or greater ownership stake in Rental Units in the county of Los Angeles, or if they or any member of their Extended Family owned, managed, or had a 5% or greater ownership stake in Rental Units in the county of Los Angeles in the past three (3) years (Section 1803(i)).

Tenant: a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental housing agreement to the use or occupancy of any Rental Unit (Section 1803(aa)).

CITY OF PASADENA
Economic Interests Affidavit - MANDATORY
1, I Ac'pTA^c' Q^>^ G7^l^te (printed name), declare under penalty of perjury under the law of the State of California that the information provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete.
17^ Signed this
Signed: V\^>
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Printed Name: L^&a?\&o Vc^l'^\ ^loAzc^CZ-
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
'^^^ and Tenant Alternate Seats
(Form RHB-003)
I, L.ec<'x>l^L'' \^i^\ '^F.'w^ez. (printed name), declare under penalty of perjury under the law of the State of'California that the foregoing is true and correct:

1. I am a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental agreement or lease (oral, written, or implied) for the use or occupancy of a rental unit.

2. I am either a) named in a rental housing agreement or lease, or b) have provided proof of a relationship to a person named in a rental agreement that entitles me the rights of a tenant.

3. I reside at the following address:

Pasadena, California _ (zip code)
(street),
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.

Signed this \^\ da^of ^^n^\
Signed: UtW) \ ^6^1
Printed Name: Lfi-}Q^V^D I }xT^\ ^-i'^rtZ/i
, 20 -2.5.
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^

REDACTED
rDaniel GonzalezPasadena, California 9110;REDACTED
EducationSep. 2007-Jun. 2010
Master of Education
UCLA Graduate School of Education & Information Studies Sep. 2002 -Jun. 2007 University of California, Los Angeles (UCLA) Bachelor of Arts in Political Science and History (with Honors) Minor in Environmental Systems and Society
Cumulative GPA: 3.98
Cumulative GPA: 3.24
LanguagesFluent in English; Fluent in Spanish
Credentials Sep. 2013 State of California: Permanent Single-Subject Teaching Credential in Social Sciences Jun. 2008 Bilingual, Cross-cultural, Language & Academic Development (BCLAD): Certified for Instruction SoftwareMAC OS Chrome—Android
Windows Adobe Creative Suite
Microsoft Office
Google Drive
HTML5
ess
Blackboard
Canvas
Employment Jul. 2021 - Present ELD Instructional Coach Wallis Annenberg High School—Los Angeles, California Coordinate with leadership team on weekly professional development and department-level coaching ELPAC test administrator; designated ELD instructor; prior long-term substitute for AP English Literature Administrative designee at ELAC meetings, and IEP meetings for English Learners with Disabilities Host sessions for AP and ELPAC test preparation, as well as resume and personal statement writing Jul. 2015-Jul.2021 Dean of Student Services Bright Star Schools—Los Angeles, California ELPAC test coordinator; hosted coaching and professional development • Spanish interpreter at all events, including IEP meetings and family workshops • School website developer; video producer for promotional content and graduation ceremonies Jul. 2010 - Jun. 2015 Lead Coordinator and Instructor YouthBuild Charter School—Los Angeles, California • Created project-based curriculum for World History, U.S. History, Economics, and Independent Study courses Wrote and earned a $5,000 grant to establish music and arts programs on campus Oct. 2013 - Present Academic Consultant Private Practice—Los Angeles, California Assist clients with admission to UCLA, USC, UC Berkeley, Stanford, Yale, Cornell, Pomona College, and others • Have helped clients win over $400,000 in scholarships, including the Gates Millennium scholarship Distinctions 2014-2017 Toberman Neighborhood Center: Keynote Speaker at annual graduation gala 2008
2007
UCLA Graduate School of Education & Information Studies: Selected as a Dean's Scholar and awarded the Cassanova Family Trust Fellowship in the amount of $6,000 University of California, Los Angeles: Awarded the Charles E. Young Humanitarian Award for exemplary community service; 1 of 3 students earning this prestigious honor Extracurriculars
u
Nov. 2004-Jun. 2014 Hermanos Unidos Los Angeles, California Former Executive Board Member of student support network at various California universities Former Director of Community Service, Website Moderator, and Graphic Designer Sep. 2006 - Jun. 2007 UCLA Latino Leadership Council UCLA—Los Angeles, California Website Moderator for the first-ever Engage Conference at UCLA—a student-run event introducing students of color to career opportunities with professional firms; helped raise $20,000 in sponsorships Jan. 2005-Jun. 2007 DREAM Scholarship UCLA-Los Angeles, California Director and co-founder of the DREAM Scholarship at UCLA; raised and distributed $12,000 in scholarships

CITY OF PASADENA

NOMINATION PETITION - WORKSHEET
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(Office and District or Seat)
Total Signatures
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CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THE
li

PASADENA RENTAL HOUSING BOARD
FORMRHB-OQ1
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The information contained on this form will be used by the City Council to fill vacancies on the Pasadena Rental Housing Board. Please answer all questions. You are invited to attach additional pages, a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Applications will be purged from the City's files January 31 of each year. If you have not been appointed to the Rental Housing Board and still desire to be considered for appointment, please resubmit an updated application, or advise City staff in writing that the initial form is still current and can be used for an additional year.

Applicant Name: Lourrlo^ D. f-ronT-ale-L
Home Address:

Mailing Address:

Email Address:

Business Phone:

Home Phone:

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RicJpna CA IIIW
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Date Available to Start: Mdi^ Z.OP-3
Celt Phone:

Board Seat Type: Indicate the typeofBoard seat in which you wish to7iTT(markone or more):

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Employment - Title and duties, current and past (acceptable to attach resume as an alternative).

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a
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Education - Include professional or vocational licenses or certificates.

Mft ir. Soc'ial Setcnc^? C/i^pflra+w/ ^cl^c^^on 2Q)4
RP. *,^ G,cAJAr ^,^&^-?0l3
Al^ jn G-<'^^ r^l u^4t un ^roi^^r 5^uJI IAS - "2.0) I

1. Have you ever worked for the City of Pasadena? (If yes, please YES list dates/department)
S—or^ ftC • 900Z,-2.003^004, P<xr^ rtno! Refrr^n.

Rcc.rC.Q+iciO Leador.

2. Are you related to any employee, appointed or elected official of YES the City of Pasadena? (If yes, please indicate name and relationship)
NO
D NOEf

3. Are you aware that financial disclosure is required annually? (e.g., sources of income, loans and gifts, investments, interests in real property)

5. Do you,or your extended family1 members, have a material YES interest in rental property in the County of Los Angeles within the last three years?

7. Have there been, or are there now, any personal or business YES circumstances which might reflect adversely on the propriety of your serving as a member of the Pasadena Rental Housing Board?

8. Are you aware of the time commitment necessary to fulfill the YES obligations of the Pasadena Rental Housing Board?
D NO
NO
a NO
NO D
' Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Charter Section 1803(g)). d

9. Are you aware that you may serve no more than eight
^ consecutive years as a member of the Pasadena Rental
( Housing Board?
YESNOa

10. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate:

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11. How would you add value to the Pasadena Rental Housing Board?

12. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
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13. How would you help to achieve these objectives and goals? Q
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I, Lounlos D. Goft-uilcZ. _ (printed name), declare under penalty of perjury under the law ofjjj the State of California that the information reported in this Form RHB-001 is true, accurate, and ^ complete, li
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Signed this 2-| day of M^rrk _, 2023 . l|| 11|
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3/20/23

PASADENA RENTAL HOUSING BOARD AT LARGE AND ALTERNATE MEMBER Pasadena Rental Housing Board Application

10. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/housing justice/landlord tenant relationships/real estate:

Housing
Have first-hand experience living in overcrowded housing and facing housing insecurity at mercy of a landlord. An issue that continues to be the case for neighbors, undereducated people with lower incomes and with undocumented status often.

Housing justice
I live and was raised in Northwest Pasadena attended public schools and I am familiar with the cities resources and challenges faced by working class residents. From unequal education, gentrification, well paid manufacturing and service jobs leaving the area are some of the contributing factors that have displaced people. In the past rents were affordable, something increasingly challenging to come by.

Homelessness is a complex issue but mostly impacted by lack of affordable housing and largely impact black and brown people and single parent households. For the most part there have been no bumpers on the free market.

Landlord tenant relationships
Have the perspective as a rental property owner of a duplex where I live in and rent the additional unit and have created affordable housing because I believe there is space for landlords to make a profit while still providing equitable affordable housing.

11. How would you add value to the Pasadena Rental Housing Board? I would add value to the board by being precarious about housing issues and bringing my life experience as a tenant to becoming a landlord, I am living my values by providing affordable housing. Understand the realities first hand of living as an undocumented resident in Pasadena fearing living in a property where we were at the mercy of the landlord because there were limited options for income in my household as a young person.

As an adult I have had the ability to purchase and rehabilitate a duplex property and made the purposeful decision to be part of the solution and not the problem by providing affordable housing.

I am Bilingual in Spanish and English and know the community for 2 generations. Have observed the damage of what not having rent control has done to homes.

LOURDESGONZALEZ
3/20/23

PASADENA RENTAL HOUSING BOARD AT LARGE AND ALTERNATE MEMBER I have proven experience working as an advocate and a liaison between county services, housing organizations, mayor's office, and other political stake holders with the LA county's efforts to address homelessness.

Proven experience working as an academic advisor at PCC and Cal State LA and successfully assisted students empower themselves by listening and providing effective resources.

All career has always been in a justice-oriented areas where I have used a justice-oriented lens in my work. My work as a College Advisor and a Program Manager required for me to also advocate for people's needs. A large part of providing solutions required the background work in building relationships with key stakeholders and I have proven work experience.

12. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
Primary objective is to make sure the city Charter 1811 is executed in holding landlords accountable to following the city's charter rules around affordable housing. I bring in a diverse and well-rounded perspective having had both personal and work experience in justice work.

In additions as an at large candidate, I bring a diversified point of view from being a tenant in a rent control apartment and benefitting from affordable rent in helping me move forward in the income ladder.

13. How would you help to achieve these objectives and goals? I would help achieve these objectives as I am goal oriented, organized, good listener, and an objective point of view. I am diligent, weigh things out before making a decision. Bringing effective at bringing people back to the tasks at hand and have proven facilitation skills, diligent patience. My education background has empowered me with foundational knowledge about the issues affecting tenant justice issues.
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CITY OF PASADENA
Residency Verification - MANDATORY
All applicants must provide proof of residency in a City Council district under section 1811(b) of The Pasadena Fair and Equitable Housing Charter Amendment (Measure H). Proof of residency may be established by either of the following:

1. If you are a registered voter, please complete and sign the following declaration and the City Clerk will verify your signature on file with the Los Angeles County Registrar of Voters.

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I reside
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Please provide clear, readable copies of two (2) documents from the following list and attach to this application:
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Home utility bill or cellular phone bill
Records from any state or national bank, state or federal savings association, trust company, industrial loan company, state or federal credit union, or any institution or entity that has issued a credit card
Insurance documents, including medical, dental, vision, life, home, rental or vehicle
Medical documents
A document issued by a U.S. government agency, meaning an entity, office, or authority governing over a country, state, county, city, municipality, district, agency, department, or any other political subdivision of a country or state Mortgage bill
Employment documents
Tax return (either Internal Revenue Service (IRS) or California Franchise Tax Board (FTB)
Rental or lease agreement with the signature of the owner/landlord and the tenant/resident
School documents issued by a public or private primary, secondary, or post- secondary institution, college, or university that includes the applicant's date of birth. If using a foreign school document, it must be sealed by the school and include a photograph of the applicant at the age the record was issued. :.«a
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•
•
•
Change of Address Confirmation by the U.S. Postal Service Property tax bill or statement
Letter attesting that the applicant resides in Pasadena from a homeless shelter, shelter for abused women, non-profit entity, faith-based organization, employer or government agency within the United States
Deed or title to residential real property
Voter registration confirmation letter or postcard issued by the California Secretary of State or the Los Angeles County Registrar of Voters Proof of payment of resident tuition at a public institution of higher education in California
An original copy of an approved Claim for Homeowners' Property Tax Exemption (BOE-266) form filed with the Los Angeles County Assessor Court documents that list the applicant as a resident of Pasadena California Certificate of Vehicle or Vessel Titles or registration (i.e., a title to, or a DMV registration for, a boat, truck or car)
A DMV No Fee Identification Card Eligibility Verification (DL 933) form, completed and signed
If your name does not appear on any residency documents, you may present a birth certificate, marriage license, or domestic partner registration certificate to trace your relationship to the person whose name does appear on the residency documentation.

If the residency document reflects a name that differs from the tracing document due to a name change (for example, marriage, divorce, or court order), name change documentation is required.
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CIPf OF PASADENA
Supplement to Statement of Economic
Interest (FPPC Form 700)
(Form RHB-002)
All applicants must complete a Statement of Economic Interest (FPPC Form 700) and "Economic Interests Affidavit" attesting to the information reported in applicant's Form 700.

Instructions: The Pasadena Fair and Equitable hlousing Charter Amendment (Measure H) prohibits Tenant Board and Alternate Tenant Board members from having "Material Interests in Rental Property" (defined below) at the time of their appointment and during their service. All applicants for all Board seats (both Tenant and At-Large) must report their own and their Extended Family's interests and dealings in rental properties in Los Angeles County in the three (3) years before submitting an application. The City is adopting the Fair Political Practices Commission's Form 700 for this purpose, but Measure H requires information about interests in rental property in Los Angeles County for three years, not the one year the FPPC Form otherwise uses. Under City Charter Section 1811(b), these documents are public records; they will not be confidential.

Measure H's Definitions.-
Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Section 1803(g)).

Material Interest in Rental Property: an individual has a Material Interest in Rental Property if they, or any member of their Extended Family, own, manage, or have a 5% or greater ownership stake in Rental Units in the county of Los Angeles, or if they or any member of their Extended Family owned, managed, or had a 5% or greater ownership stake in Rental Units in the county of Los Angeles in the past three (3) years (Section 1803(i)).

Rental Unit: any building, structure, or part thereof, or land appurtenant thereto, or any other rental property rented or offered for rent for residential purposes, whether or not such units possess a valid Certificate of Occupancy for use as rental housing, together with alt housing services connected with use or occupancy of such property, such as common areas and recreational facilities held out for use by the Tenant (Section 1803(x)).

Tenant: a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental housing agreement to the use or occupancy of any Rental Unit (Section 1803(aa)).

CITY OF PASADENA
Economic Interests Affidavit - MANDATORY
(printed name), declare under penalty of perjury under the law1, I /^urC^S Gonpalcz. of fhe State of California that the information provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete.

Signed this 'Z
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
1, I ourdlo^ l<ron'z<xlC7- _(printed name), declare underpenalty of perjury under the law of the State of California that the foregoing is true and correct:

1. I am a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental agreement or lease (oral, written, or implied) for the use or occupancy of a rental unit.

2. I am either a) named in a rental housing agreement or lease, or b) have provided proof of a relationship to a person named in a rental agreement that entitles me the rights of a tenant. d
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3. I reside at the following address:

Pasadena, California _ (zip code)
(street),
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.

Signed this l^ day of J^/^trr^
Signed^^—^-^-C-^ ^^J^r^.^^^
Printed Name: L-<3l/^A5 (•3<3/»7jQ I &Z-
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OBJECTIVE
Announcement: Rental Housing Board
Title: Large member, and at-large alternate
Grade: City Charter section 1811

QUALIFICATIONS SUMMARY
Career Advisor & Program Manager with 5+ years of Analyzing and identifying areas of needed development in academic advisement, and infection control management at interim housing (IH) sites addressing issues and providing effective solutions. Quickly learned complex system of interim housing operations and provided effective verbal and written reports in a timely manner. Initiated cross-campus collaborations and developed targeted information sessions that aligned with student needs and interests.

EDUCATION
MA in Social Science & Comparative Education, University of California, Los Angeles (UCLA), 2014 GPA 3.8/4.0
Conducted research surrounding formal and informal American post-secondary education for diverse learner groups from underserved backgrounds, with a focus on first-generation Latinx students.

Relevant coursework: Research design and statistics. Linear Statistics models • Relevant projects: Comprehensive report analysis evaluating various education methodologies in post- secondary education
Extracurricular activities: Peer learning facilitator at UCLA delivering in-depth mentoring and tutoring to 19 undergraduate transfer students
BA in Gender Studies, Graduated with Honors, UCLA, 2013 GPA 3.6/4.0
Conducted an original qualitative research project on sexual health education for young Latinos as a Ronald E.

McNair Scholar and received Gender Studies Department Honors.

EXPERIENCE
Program Manager, June 2020 to December 2020
Housing For Health (HFH), Department of Health Services, LA-As the lead of a COVID Response Team (CRT), collected site data, conducted preventive site assessments, coordinated COVID testing with CRT team, assisted interim housing (IH) sites for people experiencing homelessness to solve problems to minimize COVID outbreaks.

Communicated organized, diligent, creative and equity-based solutions to 40 IH sites given the resource-limited settings and ambiguous environment of COVID pandemic developments over the period 6 months (June to December).

Managed partnerships with site visits to address issues and provide accurate information regarding universal infection control and environmental health practices Interacted regularly through written and oral communication providing technical assistance and training to IH site managers and staff
Wrote initial assessment reports shortly after site visit with relevant information for infection control and COVID testing plan
Trained IH staff on how to conduct testing on admission and integrate passive outreach strategies for surveillance
• Coordinated with Los Angeles County Department of Public Health (DPH) to support outbreak investigations, applied consultative skills between DPH and IH sites for outbreak management and compliance
^~~ • Created and delivered diverse and inclusive education resources, to both personnel and clients, to manage prevention, testing and outbreaks
Problem solved and supported facilities to prevent future outbreaks Proactively communicated relevant information with the DPH to facilitate outbreak investigations and ensured that facilities made necessary changes to comply with DPH recommendations for infection control
Advisement Coordinator, 2016 to 2020
STEM Education Consortium (STEMEC), Cal State, LA-As lead advisor conducted thorough analysis of program and college wide student needs to improve student services for people pursuing STEM degrees. Quadrupled program participants (from 50 to 200+) by leading, organizing, and facilitating engaging in-person and digital presentations to students, faculty, and staff and cultivating campus and community partnerships. Empowered college students with one-on-one counseling, building trust by listening and providing approachable empathetic communication and respecting students' diverse backgrounds.

Applied comprehensive knowledge of university policies, procedures, and resources to help students navigate a broad range of obstacles to completing their degree programs, including financial disqualification and academic probation
Established partnerships with on-campus advisor community and directors of advising centers to ensure that all offices stayed up to date on university resources and policies Promoted the Accelerated Bachelor's in Nursing Program by reaching out to Cal State LA'S post- baccalaureate program director for a presentation
Lauded by superiors for constantly expanding advising services (including creation of advising events and workshops) and for contributing to a positive, team-based work culture Created and conducted annual training with on-campus advising units to promote STEM majors Enhanced academic guidance for NATS majors by creating, facilitating presentation for college advisors Engaged in constant networking communication with supervisor and colleagues to stay up to date on evolving frameworks and strategies for supporting students Adjunct College I Instructor, Fall Semester, 2017
Pasadena City College Pathways - Pasadena City College, Pasadena, CA - Leveraged holistic expertise in academic counseling to deliver an in-person introductory course on academic success forfirst-year college students. Applied knowledge of both web-based and classroom instruction to create, formal and informal presentations, and continuously improve course content with quality information that aligned with students needs.

Resource Coach, 2014 to 2016
Math Engineering Science Achievement (MESA) Program, Pasadena City College -As the first to hold this position, equipped 230+ students with best practices for academic, career, and financial planning by developing the role in a student-centered fashion. Enhanced experiences creating tools of support to a diverse student body •Developed a clear path of transfer student needs to support a collaborative project with the academic counseling unit by creating surveys and analyzing data
Problem solved with students to improve time management skills while juggling personal and work activities
Identified barriers in college admission application and took action to make program application accessible to undocumented students
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Program Assistant, 2014 to 2015
KIPP Through College (KTC) - KIPP LA Schools, Los Angeles, CA - Cotlaboratively supported transition of 600+ high school students into college by liaising between KTC and a high school counseling unit to coordinate events and campus tours, co-managing a budget, and co-developing financial counseling resources for students' families.

Translated handouts from English to Spanish.

Full-time Student, 2008 to 2014 ~ Earned BA and MA, including completion of extensive qualitative and quantitative research into American post-secondary education for underserved populations. Served as a peer learning facilitator at UCLA for 3 months, delivering in-depth mentoring and tutoring to 19 transfer students.

Credit Analyst II | Marketing Specialist | Customer Service Rep, 2004 to 2008 Bank of America, Pasadena, CA-After beginning tenure as a CS rep, rapidly promoted to build trust-based, consultative relationships with low to moderate-income customers by delivering extensive education and guidance on credit management and tailored resource, product, and service recommendations. Worked extensively with predominantly Spanish-speaking clientele.

TECHNICAL PROFICIENCIES
Canvas Learning Platform | Googte Suite | SPSS | MS Office Suite

LANGUAGES
Spanish, advanced proficiency
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CITY OF PASADENA

NOMINATION PETITION - WORKSHEET
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APPLICATION FOR APPOINTMENT TO THE

Home Address:

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Cell Phone:

Board Seat Type: Indicate the type of Board seat in which you wish toTTTT(mark one or more):

Home Phone: <l^~ ^
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Tenant Member (7 seats, one per Council district, reserved for tenants) Representing City Council District
At-large Member (4 seats, open to any Pasadena resident without respect to tenancy or Council District)
Alternate Tenant Member (1 seat, reserved for tenants)
Alternate At-large Member (1 seat, open to any Pasadena resident without respect to tenancy or Council District)
Community Service - List boards, commissions, committees, and organizations on which you are currently serving or have sen/ed.^offices held and in what city.

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employment - Title and duties, current and past (acceptable to attach resume as an alternative).
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Education - Include professional or vocational licenses or certificates.

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1. Have you ever worked for the City of Pasadena? (If yes, please list dates/department)
YES NO

2. Are you related to any employee, appointed or elected official of the City of Pasadena? (If yes, please indicate name and relationship)
YESD

3. Are you aware that financial disclosure is required annually? (e.g., sources of income, loans and gifts, investments, interests in real property)

5. Do you,or your extended family1 members, have a material YES || NO interest in rental property in the County of Los Angeles within the last three years?

6. Do you reside at a property owned or managed by a member of YES |_| NO the City Council, or any member of the City Council's extended family, or in which any member of the City Council, or member of the City Council's extended family, has any ownership stake in said property?

7. Have there been, or are there now, any personal or business YES | | NO circumstances which might reflect adversely on the propriety of your serving as a member of the Pasadena Rental Housing Board?

8. Are you aware of the time commitment necessary to fulfill the YES @^ NO | | obligations of the Pasadena Rental Housing Board?
Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Charter Section 1803(g)).

9. Are you aware that you may serve no more than eight
consecutive years as a member of the Pasadena Rental
Housing Board?

YES-NOD

10. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate:
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11. How would you add yalup to the Pasadena Rental Housing Board? <-s0^ tfL-f-{'^L'J ^^.

12. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
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13. How would you help to aphieve these objectives and goals? Sjz^- a~(-i/r^'^^J ^L/jL^
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Pasadena Rental Board Application, March 2023
Allison Henry, District 3 Tenant applicant, At-large applicant. Alternates applicant Community Service
Board Member and Block Captain, Garfield Heights Neighborhood Association.

Mayor's Housing Task Force—appointed by Mayor Victor Gordo to make recommendations on the Housing Element.

Housing is Key/Housing 101 trainings/workshops in La Pintoresca Library, Villa Park, and Pasadena City College online (hosted by my organization San Gabriel Valley Tenants' Alliance, co-hosted with the Job Center, Lake Ave Church).

Employment
See attached resume.
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Education
BA English, BA History, University of California, Riverside MA English, California Polytechnic State University, San Luis Obispo TEFL/TESOL/TESL Certificate, Oxford Seminars
2022 Graduate, San Gabriel Valley Housing Policy Leadership Academy, Southern California Association of Governments (SCAG)

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Describe your relevant life experience, professional training, and/or education in the following areas:

HousJng/HousingJustice/Landtord Tenant Relatipnships/Real Estate:

I have lots of relevant experience to serve on the rental board. I have helped tenants correct illegal rent increases; violations of lease agreements and incorrect notices; eviction and court support; advocated for myself and my immediate neighbors for correct implementation of Measure H with our own landlord; worked with city staff on recommendations for tenant protections for the housing element and ordinances such as the Tenant Protection Ordinance of 2019 and the COVtD eviction moratorium. I am also one of the authors of Measure H and was part of a team that researched housing boards in other cities and deliberated on meaningful tenant inclusion.

I have taken many hours of training on tenant rights through various organizations such as Liberty Hill, ACCE, Housing Now, and my own organization SGV Tenants' Alliance, I co-founded SGV Tenants' Alliance in 2020 to educate and build power for tenants in the San Gabriel Valley. We host monthly meetings and have had educational events on tenant protections, effective research, and candidate forums.

I am a graduate ofSCAG's Housing Policy Leadership Academy- a ten-month course on the full spectrum of housing policy or more simply the 3P's; production, preservation, and protection.

My professional experience with Everyone In and LA Forward includes equitable housing policy advocacy throughout the San Gabriel Valley and Southeast LA cities and LA County. These policies include things beyond the purview of the Pasadena Rental Board like root causes of homelessness; social housing models; community land trust; and preservation of properties with expiring affordability covenants. //. How would you add value to the Pasadena Rental Board? In addition to my professional and community experience, I am a creative thinker and a problem solver.

I know Measure H. I also have knowledge of other parts of city operations and support for tenants such as the Community Services Division. I have long-standing community ties and relationships including with local landlords, tenants, homeowners—neighbors—which means I strive for a community approach. I am also able to read through documents and other attachments, and can think on a systems level.

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What do you view are the primary objectives and goals of the Pasadena Rental Board? The primary objectives and goals of the Pasadena Rental Board are to implement and enforce Measure H with fidelity to the law. The Rental Board should aim to be seen as credible and fair by the community, and to demonstrate Pasadena's commitment to democracy and equity.

13. How would you help to achieve these objectives and goals? I would help to achieve this by having full knowledge of Measure 1-1 and being willing to learn what's necessary to fill in gaps with city systems, laws, and practice. I am a close reader, can think about systems, and value the importance of data. I hope to be part of a team with the board for implementation as spelled out in the measure and what to do when situations arise that are not spelled out in the measure.
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Summary: An experienced baseTHITder, organizer, teacher, strategic thinker, policy advocate, and motivator on local housing and tenants' issues, I also have experience in educational sales, consulting, and language instruction. I am a creative and highly skilled communicator, able to activate communities and organizations. I especially work to empower women and voices marginalized by wealth and power.

Experience:

Housing Justice Organizer
LA Forward Institute October 2 021-present
Build base for LA Forv^ard in the San Gabriel Valley and Southeast LA Cities for equitable housing policy
Supported/Drove community engagement for 6th Cycle Housing Elements in Claremont, Pomona, Arcadia, Temple City, Monrovia, San Dimas, Alhambra, West Covina for more equitable protections and programs.

Educate activated community members and elected officials on policies such as rent stabilization, just cause eviction, inclusionary zoning ordinances, lived experience of tenants and unsheltered neighbors.

Represent LA Forward and SGV region in state and local housing coalitions such as Housing Now!, Keep LA Housed, Housing Movement Lab, Our Future LA- Serving as Project Manager and Facilitator for a joint-venture Collective Advocacy on Housing for Best Start Region 1 with SAJE and Sandra McNeill Consulting. • Create and deliver presentations for events like Housing Element Power Hour, Ballots and Beers SGV Edition; and Metro TOC + Housing.

Analyze regional data, housing elements, and housing policies to advise elected officials and community members on best and equitable practices.

Co-Founder, Organizer
San Gabriel Valley Tenants' Alliance April 2020- present Provided Housing is Key trainings and workshops for tenants and community based organizations including for Pasadena City College LancerCare; Pasadena Collective of the Roses; and Lake Ave Church in Pasadena.

Facilitate monthly meetings and tenant-centered workshops such as Know Your Tenant Rights; how to apply for rental and utility assistance; and COVID-19 housing protections.

Manage SGVTA budget and social media,
Write various communications including press releases, op-eds, and social media posts.

Build base of tenants and tenant supporters in SGV cities, including supporting creation of AIhambra Tenants Union and West Covina Tenants Union.

East San Gabriel Valley Field Organizer
Everyone In LA January 2020-February 2021
Managed Eastern San Gabriel Valley, covering 15 cities and playing a critical role in growing our base in the SGV with over 150 coalition partners and 120,000 supporters.

Comanaged and led Measure} field program for the San Gabriel Valley.

Facilitated and developed curriculum for a training program that recruited thousands of new housing supporters in SGV communities to advocate at city and county levels to end homelessness.

Co-created and managed several coalitions that successfully advocated for and passed policy to protect tenants and create more affordable housing.

Regularly represented Everyone In interests in prominent local media outlets and coalitions, including Healthy LA Coalition and Re-Imagine LA.

Co-founded two local advocacy groups; San Gabriel Valley Tenants' Alliance and Monrovia Housing and Tenants Advocates.

Tenant Organizer, Policy Advocate, Campaign Manager, Volunteer Coordinator, Treasurer Pasadena Tenants Justice Coalition /Pasadena Tenants Union October 2016—August 2020 Built base around rent control and tenant protections in Pasadena working closely with partner orgs like ACCE.

Organized local tenant actions including pre-AB1482 loophole closures and moratorium including Pasadena's 2019 Tenant Protection Act, and 2020 COVID19 eviction moratorium.

Wrote grants for campaign funding; wrote press releases and acted as media spokesperson. • Provided tenant solidarity and support with UD notices, letters, and court appearances.

Working closely with organizations like ACCE and AHF, coordinated volunteers and efforts for PTU and the 2017-18 rent control campaign.

Grafted language of 2017-18 and 2020 rent control and just cause legislation.

Planned budget and expenditures and filing deadlines with election law for FEHCA.

Account Executive, California and Hawaii
Performance Matters December 2 015-September 201 7
Closed sales of learning and assessment digital platform with district and county educational leaders such as superintendents and assistant superintendents..

Account Executive of the Quarter for Q3 2016, achieving over 150% of quota.

Developed California specific elements in existing product.

Wrote responses to RFP/RFIs issued by potential district, state, and county educational offices.

Director of Educational Partnerships, Southern California and Washington Solution Tree August 2014-December 2015
Closed sales ofpd management platform with district superintendents, assistant superintendents, curriculum & instruction directors, directors of student achievement, and Title 1/LAP coordinators achieving $2.3M in business.

Academic Program Coordinator and English Instructor
Mentor Language Institute, Hollywood, Ca November 2013-July 2014 • Managed faculty, conducted professional development, and directed academics at MLI Hollywood.

Taught all levels of listening/speaking, reading, and grammar.

Regional Content Specialist, California and southern Arizona Macmillan Higher Education USA November 2008-August 2013 Consulted with instructional staff and utilized best teaching practices for implementation of educational platforms at 2 and 4-year schools, and increased sales across the discipline-Iine.

Trained sales reps on revenue driving media presentations, best practices, and new products.
c
^
English Discipline Specialist, US Western Division
Houghton Mifflin/Cengage Publishers December 2005-November 2008 • Increased English sales Western regions by $1.1 million, HM Discipline Specialist ofthe Year, 2007.

Planned "Teaching Today's Writers" events in Pasadena and Denver, Marketing Manager: Composition, Psychology, and Sociology W. W. Norton & Company May 2003-July 2005
Grew sales over previous editions, including a 300% increase in Personality Puzzle.

Added feature "Sociology in Practice" to Introduction to Sociology.

College Sales Representative, Florida
W. W. Norton & Company
• Increased sales and brand loyalty in Florida territory.

Trained and mentored new sales representatives,
July 2000-July 2005
Instructor, English as a Foreign Language
San Luis Obispo, Dublin, Orlando September 1997-December 2005 Taught and created assessments for all levels of grammar, reading, writing, and speaking Created special curriculum for business students, diplomats, and short, non-academic programs.
• Test prep: TOEFL and TOEIC Cambridge First Certificate in English.

Legal Assistant/Researcher
Holstein, Taylor, and Unitt (Riverside),
Diane E. Davies (Morro Bay)
Tenant and Housine Oreanizations:

Mayor's Appointee, Pasadena Housing Element Task Force
Co-founder, San Gabriel Valley Tenants'Alliance
Founder, Monrovia Housing and Tenants Advocates
Co-founder, AE+SJ (art +social justice)
January 1993-fune 1997
April 2021
March 2020
February 2020
March 2019
Public Forums/Educational Events:

February 2021; Women, Housing Precarity, and the Not-so Golden Years October 2020; SGV Candidate Forum on Housing and Homelessness June 2020; Know Your Neighbors, Know Your Rights
April 2020; SGV Tenant Town Hall
October 2019:AtHome With Octavia Butler
Published work:

LA Progressive, Aug 2020 https://www.laprogressive.com/covid-eviction-crisis/.

Education:

B.A. English and History, University of California, Riverside Thesis: "Changes in Funerary Practices During the Black Plague" M.A, English, California Polytechnic State University, San Luis Obispo TEFL/TESOL/TESL Certificate, Oxford Seminars, Los Angeles 2022 Graduate, SCAG Housing Policy Leadership Academy
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CITY OF PASADENA
Residency Verification - MANDATORY
All applicants must provide proof of residency in a City Council district under section 1811(b) of The Pasadena Fair and Equitable Housing Charter Amendment (Measure H). Proof of residency may be established by either of the following:

1. If you are a registered voter, please complete and sign the following declaration and the City Clerk will verify your signature on file with the Los Angeles County Registrar of Voters.

I am a resir<an+ l~*f nic+r"~+ M
REDACTED I reside at
CA ^/f0^ (zip code).
nf+ha<-1-»-> ^;4... -< n~-^lena
REDACTED(street), Pasadena,
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Signed: ^-A-
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Printed Name: y4///.?^f f-^/\

2. If you are not a registered voter, please provide clear, readable two forms of proof of residency acceptable to the Department of Motor Vehicles (DMV) for a REAL ID, listedbelow (Cal. Code Regs. tit. 13, § 17.00 and § 15.01 (d)).

Please provide clear, readable copies of two (2) documents from the following list and attach to this application:

Home utility bill or cellular phone bill
Records from any state or national bank, state or federal savings association, trust company, industrial loan company, state or federal credit union, or any institution or entity that has issued a credit card
Insurance documents, including medical, dental, vision, life, home, rental or vehicle
Medical documents
A document issued by a U.S. government agency, meaning an entity, office, or authority governing over a country, state, county, city, municipality, district, agency, department, or any other political subdivision of a country or state Mortgage bill
Employment documents
Tax return (either Internal Revenue Service (IRS) or California Franchise Tax Board (FTB)
Rental or lease agreement with the signature of the owner/landlord and the tenanVresident
School documents issued by a public or private primary, secondary, or post- secondary institution, college, or university that includes the applicant's date of birth. If using a foreign school document, it must be sealed by the school and include a photograph of the applicant at the age the record was issued. •
•
a
•
•
•
Change of Address Confirmation by the U.S. Postal Service Property tax bill or statement
Letter attesting that the applicant resides in Pasadena from a homeless shelter, shelter for abused women, non-profit entity, faith-based organization, employer or government agency within the United States
Deed or title to residential real property
Voter registration confirmation letter or postcard issued by the California Secretary of State or the Los Angeles County Registrar of Voters Proof of payment of resident tuition at a public institution of higher education in California
An original copy of an approved Claim for Homeowners' Property Tax Exemption (BOE-266) form filed with the Los Angeles County Assessor Court documents that list the applicant as a resident of Pasadena California Certificate of Vehicle or Vessel Titles or registration (i.e., a title to, or a DMV registration for, a boat, truck or car)
A DMV No Fee Identification Card Eligibility Verification (DL 933) form, completed and signed
If your name does not appear on any residency documents, you may present a birth certificate, marriage license, or domestic partner registration certificate to trace your relationship to the person whose name does appear on the residency documentation.

Material Interest in Rental Property: an individual has a Material Interest in Rental Property if they, or any member of their Extended Family, own, manage, or have a 5% or greater ownership stake in Rental Units in the county of Los Angeles, or if they or any member of their Extended Family owned, managed, or had a 5% or greater ownership stake in Rental Units in the county of Los Angeles in the past three (3) years (Section 1803(i)).

Tenant: a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental housing agreement to the use or occupancy of any Rental Unit (Section 1803(aa)).

CITY OF PASADENA
Economic Interests Affidavit - MANDATORY
(printed name), declare under penalty of perjury under the lawi, /V//'rc^ /^/s of the State of California that the information provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete.

Signed this / ?- day of Mg^-^^ , 20_^J.

Signed: ^~~^ ^~~~
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Printed Name:/4//i^ /T/€^^-<
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
i, 4fl/t^» ^/ir^
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^T_(printed name), declare under penalty of perjury under the law of the State of California that the f6regoing is true and correct:

1. I am a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental agreement or lease (oral, written, or implied) for the use or occupancy of a rental unit.

2. I am either a) named in a rental housing agreement or lease, or b) have provided proof of a relationship to a person named in c'aiahhil—MBUMtefltitlaUB^tlUaflUMS a tenant.

3. I reside at the following address.

Pasadena, California ^//<9<-^ (zip code)
REDACTEDREDACTED(street),
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.

Signed this / 7- day of /^a^<^\ ______, 20 l-J.

Signed: ^~^~
Printed Name: ^///S3^ ^^7^t
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CITY OF PASADENA

NOMINATION PETITION -WORKSHEET
lt>€'^ \^<-^^i
(Name of Candidate)
pd^B
(Office and District or Seat)
Total Signatures
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Date: 3/2 3 A ^)
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CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THE

PASADENA RENTAL HOUSING BOARD
FORM RHB-001
The information contained on this form will be used by the City Council to fill vacancies on the Pasadena Rental Housing Board. Please answer all questions. You are invited to attach additional pages, a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Applications will be purged from the City's files January 31 of each year. If you have not been appointed to the Rental Housing Board and still desire to be considered for appointment, please resubmit an updated application, or advise City staff in writing that the initial fprm is still current and can be used for an additional year.

Applicant Name:"x/~\v\/-\
Home Address:

Mailing Address

REDACTEDREDACTEDREREDACTED
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Email Address:

Business Phone:

Home Phone:

REDACTEDREDACTEDREDACTED
Date Available to Start-^Y
Cell Phone:REDACTED
Board Seat Type: Indicate the type of Board seat in which you wish to fill (mark one or more):

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1. Have you overworked for the City of Pasadena? f/f yes, p/ease YES |v/ list dates/department)
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NO
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2. Are you related to any employee, appointed or elected official of YES | | NO the City of Pasadena? (If yes, please indicate name and relationship)

3. Are you aware that financial disclosure is required annually? (e.g., sources of income, loans and gifts, investments, interests in real property)

5. Do you,or your extended family1 members, have a material interest in rental property in the County of Los Angeles within the last three years?

6. Do you reside at a property owned or managed by a member of the City Council, or any member of the City Council's extended family, or in which any member of the City Council, or member of the City Council's extended family, has any ownership stake in said property?

7. Have there been, or are there now, any personal or business circumstances which might reflect adversely on the propriety of your serving as a member of the Pasadena Rental Housing Board?

8. Are you aware of the time commitment necessary to fulfill the obligations of the Pasadena Rental Housing Board?
YES
YES
NO
NO
YES
YESD
NO
NO
^
^

YESD NO
YES NO
Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Charter Section 1803(g». r

9. Are you aware that you may serve no more than eight
consecutive years as a member of the Pasadena Rental
Housing Board?
YESNOa
ws
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a

10. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate:
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1T. How would you add value to thf^ Pasadena Rental Housing Board? ~II^ U-^^ "T: l A), I i c^/:U i/^ii.A(L. b^<^A^/ -<' h^^&- fe7X^>&,^^. i^-^ Lonr^t/^ i.-i,^ d^.^^.'y»Ap-^^r£y!A^^<sA<i,, nr\A ;r'>cl.v,'-s^H LJ.:^^i^/-^| l^. 4^ in-^^r'^- d<^^^^- p^.-^-^4':^^ ^r-)^ |
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12. What do you view are the primary objectives
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ctives and goals of the Pasadena Rental Housing
Board?
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13. How would you help to achieve these objectives and goals? L\}\] f i-^lP /-Tv m^k.^^-^^^ "T A^^^v 4^r^ 477 m^K<7/L/\/ '^^r^ ~^ ^y-\J H-\>r'3
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I, l^X^\/V~i.-y-\ '0 ^wcy^printed name), declare under penalty of perjury under the law of the State of California that the information reported in this Form RHB-001 is true, accurate, and || complete.

Signed this ^-5 da^fif 0^/T~'K-,20.

Signed-:c
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Printed Name:^1^V^-NC^—
0 AMENDED
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0 Brandon Lamar Rental Board Questionnaire
Community Service:

Human Relations Commission (Chair)
CBOC for Measure PCC
Pasadena NAACP Economic Development and Housing (Chair) Pasadenans Organizing for Progress (Chair)
Leadership Pasadena
Measure H Steering Committee Member
Employment:

California Director, Youth Advocate Programs Inc.

Question 10.

Relevant Life Experience.

I have been a tenant in Pasadena supporting myself since 2013. Before that living with my parents, we were tenants for over 14 years which is the best because I have lived experience when it comes to housing and housing justice. I have my own experiences when it comes to communicating and advocating for myself with management.

Professionally.

I have previous work experience as a housing manager for a non-profit that focuses on transitional and permanent housing for transitional age youth. I have experience working with property management company's specifically in the areas of rental locations, screenings, Lease negotiations, and eviction procedure when it came to clients and families. I've also worked with organizations that focused on housing policies such as Pasadenans Organizing for Progress, and Pasadena NAACP. With these organizations we have worked to advocate to get inclusive housing policies and affordable housing. I've also have relevant training housing justice training through HUD. I also have experience volunteering working with tenant rights organizations like Pasadena Tenant Union and Serving on the Steering committee for Measure H. Ive also Volunteered for Pasadena Homeless Count for the past 4 years.

Question 11:

I think I will add value because I have lived and professional experience working with diverse groups, organizations, and individuals with different perspectives. I am able interpret different perspectives and opinions while working as a team player to make sound decisions. I would work with the board and city staff to develop and implement educational programs to help landlords and tenants understand their rights and responsibilities. This could include workshops on lease agreements, eviction procedures, and fair housing laws. I would help with research and analysis on topics related to rental housing in Pasadena. This would include collecting data on rent prices, vacancy rates, and housing affordability, as well as analyzing trends and making policy recommendations. I would be able to foster community engagement by organizing public forums and meetings, as well as soliciting feedback and input from stakeholders. This could help build trust and transparency in the Board's operations and decision-making processes. I have a tot of experience gathering different communities throughout Los Angeles Brandon Lamar Rental Board Questionnaire
County to advocate and organize. I would also be able to collaborate with other organizations in Pasadena and beyond to share knowledge and resources, as well as coordinate efforts to address rental housing issues. This could include partnerships with tenant advocacy groups, housing developers, and government agencies.

Questions 12:

The objective is to assist the city in being fair and just regarding housing justice. I also believe that it is here to help build a positive bridge between landlords, tenants, and the city of Pasadena while creating accountability. The primary objectives and goals of the Pasadena Rental Housing Board as I believe are to regulate and enforce the city's rental housing laws stated by Measure H in order to ensure safe, decent, and affordable housing for all tenants in the city of Pasadena. More specifically, I believe the Board will aim to, • Protect the health and safety of tenants.
• Prevent discrimination. Prevent discrimination against tenants on the basis of race, color, religion, sex, national origin, familial status, or disability. This includes enforcing fair housing laws and regulations.

Promote housing affordability. Promote housing affordability by enforcing rent stabilization regulations and ensuring that landlords are not engaging in price gouging or other unfair rental practices stated by Measure H.
• Provide resources and education to tenants and landlords. Provide resources and education to both tenants and landlords in order to help them understand their rights and responsibilities under Measure H. This includes providing information on lease agreements, eviction procedures, and fair housing laws. • Foster positive landlord-tenant relationships. The Board should aim to foster positive relationships between landlords and tenants by providing mediation and dispute resolution services when conflicts arise.

Overall, the primary objectives and goals of the Pasadena Rental Housing Board are centered around ensuring that tenants in the city of Pasadena have access to safe, decent, and affordable housing, while also promoting positive landlord-tenant relationships and enforcing fair housing laws and regulations through Measure H.

Question 13.

I will make sure I do my part to ensure that this group and I are fair and just to everyone. I will not make any decisions without considering all of the facts in the matter. I will not only hold myself accountable but I will also hold my peers on this board accountable.

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CITY OF PASADENA
Residency Verification - MANDATORY
All applicants must provide proof of residency in a City Council district under section 1811(b) ofThe Pasadena Fair and Equitable Housing Charter Amendment (Measure H). Proof of residency may be established by either of the following:

1. If you are a registered voter, please complete and sign the following declaration and the City Clerk will verify your signature on file with the Los Angeles County Registrar of Voters.

I am a rec,

REDACTED
REDACTED I reside a|
CA^l^^f I (zipcod^T
Signed:
of the City of Pasadena 5^6S2b.W! ^
(street), Pasadena,
ne:^~~r>^y/-^^'^v—^ 'D l—^ rY^^^v^"

2. Printed Name
If you are not a registered voter, please provide clear, readable two forms of proof of residency acceptable to the Department of Motor Vehicles (DMV) for a REAL ID, listed below (Cat. Code Regs. tit. 13, § 17.00 and § 15.01(d)). gift
Please provide clear, readable copies of two (2) documents from the following list and attach to this application:
hlome utility bill or cellular phone bill
Records from any state or national bank, state or federal savings association, trust company, industrial loan company, state or federal credit union, or any institution or entity that has issued a credit card
Insurance documents, including medical, dental, vision, life, home, rental or vehicle
Medical documents
A document issued by a U.S. government agency, meaning an entity, office, or authority governing over a country, state, county, city, municipality, district, agency, department, or any other political subdivision of a country or state Mortgage bill
Employment documents
Tax return (either Internal Revenue Service (IRS) or California Franchise Tax Board (FTB)
Rental or lease agreement with the signature of the owner/landlord and the tenant/resident
School documents issued by a public or private primary, secondary, or post- secondary institution, college, or university that includes the applicant's date of birth. If using a foreign school document, it must be sealed by the school and include a photograph of the applicant at the age the record was issued. •
•
•
•
Change of Address Confirmation by the U.S. Postal Service Property tax bill or statement
Letter attesting that the applicant resides in Pasadena from a homeless sheltei shelter for abused women, non-profit entity, faith-based organization, employer or government agency within the United States
Deed or title to residential real property
Voter registration confirmation letter or postcard issued by the California Secretary of State or the Los Angeles County Registrar of Voters Proof of payment of resident tuition at a public institution of higher education in California
An original copy of an approved Claim for Homeowners' Property Tax Exemption (BOE-266) form filed with the Los Angeles County Assessor Court documents that list the applicant as a resident of Pasadena California Certificate of Vehicle or Vessel Titles or registration (i.e., a title to, or a DMV registration for, a boat, truck or car)
A DMV No Fee Identification Card Eligibility Verification (DL 933) form, completed and signed
If your name does not appear on any residency documents, you may present a birth certificate, marriage license, or domestic partner registration certificate to trace your relationship to the person whose name does appear on the residency documentation.

CITY OF PASADENA
Supplement to Statement of Economic
Interest (FPPC Form 700)
(Form RHB-002)
Ail applicants must complete a Statement of Economic Interest (FPPC Form 700) and "Economic Interests Affidavit" attesting to the information reported in applicant's Form 700.

Material Interest in Rental Property: an individual has a Material Interest in Rental Property if they, or any member of their Extended Family, own, manage, or have a 5% or greater ownership stake in Rental Units in the county of Los Angeles, or if they or any member of their Extended Family owned, managed, or had a 5% or greater ownership stake in Rental Units in the county of Los Angeles in the past three (3) years (Section 1803(1)).

Tenant: a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental housing agreement to the use or occupancy of any Rental Unit (Section 1803(aa)).

CITY OF PASADENA
Economic Interests Affidavit - MANDATORY
I, l'—5!/^^v^->r\ l-sCTr^/-i^—(printed name), declare under penalty of perjury under the lawof the State of California that the information provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete.

Signed this ^^»day ofrV^^s<7^^ , 20_2^
Signed:

Printed Name:: •^-^^T^ 0. LCA\/-^ YT.
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
^-n^or\(printed name), declareunderpenaltyof perjury under the law of the State of California that the foregoing is true and correct:

1. I am a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental agreement or lease (oral, written, or implied) for the use or occupancy of a rental unit.

2. I am either a) named in a rental housing agreement or lease, or b) have provided proof of a relationship to a person named in a rental agreement that entitles me the rights of a tenant.

3. I reside at the followina address: (street),
Pasadena, California^ \\fsr\ (zip code)
OR
This form is not applicable to my application as I am not seeking a Tenant Board or :1
!1'3
.^
Tenant Alternate Seat.

Signed this 9-3 da^of 'lOQar^^ 2oQ.<
Signed: f /" ^^^T~~
Printed Name:^^^y^c^^^^J^vwz—^^
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CITY OF PASADENA

NOMINATION PETITION - WORKSHEET
.m^^ •
(Name of Candidate)
Pft^ ^^^-^3
(Office and District or Seat)
Total Signatures
Total OK
Date:
35 Dl
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Checked by:a^-
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CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THE

PASADENA RENTAL HOUSING BOARD
FORM RHB-001
RECEIVE£»i
2023MAR27 PM 3s54;
II n
The information contained on this form will be used by the City Council to fillvacaracre?on th®:.up[r^lPasadena Rental Housing Board. Please answer all questions. You are invited to attach additional 'S pages, a copy of your resume, or submit supplemental information which you feel may assist the City Council in its evaluation of your application. Applications will be purged from the City's files January 31 of each year. If you have not been appointed to the Rental Housing Board and still desire to be considered for appointment, please resubmit an updated application, or advise City staff in writing that the initial form is still current and can be used for an additional year.

Applicant Name: j\-^MC(
Home Address:

Mailing Address:

Email Address:

Business Phone:

Home Phone:
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REDACTEDREDACTED^^^/^&yi^ ^^//^f I
^TED REDACTEDREDACT
RFnAHTFn

REDACTED
Date Available to Start: ^ /i<^->^^
iCell Phone:

Board Seat Type: Indicate the type of Board seat in which you wish to fill (mark one or more):

Tenant Member (7 seats, one per Council district, reserved for tenants) Representing City Council District ?
At-large Member (4 seats, open to any Pasadena resident without respect to tenancy or Council District)
Alternate Tenant Member (1 seat, reserved for tenants)
Alternate At-large Member (1 seat, open to any Pasadena resident without respect to tenancy or Council District)
Community Service - List boards, commissions, committees, and organizations on which you are currently serving or have served, offices held and in what city. ^•e ^^h^^pal^ ft.^l ^!a-ycli^S' l^y.'<^^nii.a ^^^-cl^cL p^y^ ^</^fJi $'e-y l^ui^icc^^ ^p ti^'Y-f-\ r^p^ jn er? €./ ^.,€^7/-7-^ c/e p^^fZcZe/?^ dyrj, •Id
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&i4 e.1 ^ci^/-.sr ^L<^ (l-<y?^'/"^cL- Cow [/\A6(.y]a ^y^avfff y Le. TiLc' afc<^ &5^Uu Employment - Title and duties, current and past (acceptable to attach resume as an alternative).
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Education - Include professional or vocational licenses or certificates. eJ-f-t/cjl&y!^^ p^^ct^r?^ ^^~y Cotl^C.

1. Have you ever worked for the City of Pasadena? (If yes, please YES |» | NO list dates/department)

2. Are you related to any employee, appointed or elected official of YES ^^ NO j)^|the City of Pasadena? (If yes, please indicate name and relationship)

3. Are you aware that financial disclosure is required annually? (e.g., sources of income, loans and gifts, investments, interests in real property)

4. Rules of law and ethics prohibit members from participating in and voting on matters in which they may have a direct or indirect financial interest. Are you aware of any potential conflicts of interest v.'hich may deveiop from your occupation, or economic holdings, in relation to your responsibilities as a member of the Rental Housing Board? (If yes, please indicate any potential conflicts)
YES
YES
El NO
NO
NO
NO

5. Do you, or your extended family1 members, have a material YES | | interest in rental property in the County of Los Angeles within the last three years?

7. Have there been, or are there now, any personal or business YES j | circumstances which might reflect adversely on the propriety of your serving as a member of the Pasadena Rental Housing Board?

8. Are you aware of the time commitment necessary to fulfill the YES | ^| NO obligations of the Pasadena Rental Housing Board?
NO
D
Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Charter Section 1S03(g)). r9. Are you aware that you may serve no more than eightconsecutive years as a member of the Pasadena Rental Housing Board?
YES0 No D

10. Describe your relevant life experience, professional training, and/or education in thefollowing areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate:
^e.^e.r^i^/7 l^ fi.^e^-^e.vi ^\^^ A^ \f^''\-r ^.vi ^ ^ ^ ^VL^ ,•>-< 2_^_ ^,4'^L^ v ^P^fl^l^f<^^^ ^V[ \/^fkrrC^c^5~>a-rc^ ffi/^. r7^ ^"^7<c?. /^ 7^Y ^^ r^^f-T^l cL^-- ft-^^h.-^

11. How would you add value to the Pasadena Rental Housing Board? ^
^^ \^^(l (/ ("VM7- / ^ i~^ -ir^r? -t-^ fo^ Y^^<? ^^ %y (^-noj yQ i/e. f f/ ^ U^ ^ [ PL. ^ A^i ^_ ^r ^ A // ^ ^ ^€.1^ ^. /--e- y 3^ ^c^^/^. / (^'^ ^ ^f"<aL '^•y ^|YJ! ^^'7' ^ A //'7^ ^^^v\. /-^vj^^/ ^ (y^ ^ I^ u ci^^^ r i^^ c/ /'/ /'^ c^" <f^€- v/1 \/^Y\ ^.YI ^a.5(^ d. €^i^ Y ^ i e-^r- j'e.-r- /^, |"'' " \tyz^^^y^^k^^12. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
qu^ fp. C(f^f(^(a. J^y y ^^y-^nd^T- ^/yj;- A.^&r-^; ^ J.-e/<^_<T |^J^ ~^5^^ie^ l< / -r- - I

13. How would you help to achieve these objectives and goals? ^a.^f-i (Li~fa^c(/7 ^ ^(3^ac, (^ ^^^VtCo-n-e^ v ^i^i^^y^^^'i^c^ .-^
ly^n 5^^-^^ 1^5 nz^^la^ y ^<s^?^'W^J"
:a
UQ. 'T^-r^c^^^
Cal'ifo
(printed name), declare under penalty of perjury under the law of the State of Cafifornia that the information reported in this Form RhlB-001 is true, accurate, and J complete.

Signed this 0 J day of _^^,-, 20^^.

Signed: /^/^ T^T-^^-
Printed Name:{Z.T^^r^^
-..'
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CITY OF PASADENA
Residency Verification - MANDATORY
All applicants must provide proof of residency in a City Council district under section 1811(b) of The Pasadena Fair and Equitable Housing Charter Amendment (Measure H). Proof of residency may be established by either of the following:

1. If you are a registered voter, please complete and sign the following declaration and the City Clerk will verify your signature on file with the Los Angeles County Registrar of Voters.

I am a resj,
I reside
CA ^(\
District No. ^ of the City of Pasadena
~T
tf
REDACTEDaREDACTED
/
(street), Pasadena,
SignedIg ^ 7^y^^$"
A ^
^
.-'*'
Printed Name:^.^ T^-r^V
•

Please provide clear, readable copies of two (2) documents from the following list and attach to this application:

Home utility bill or cellular phone bill
Records from any state or national bank, state or federal savings association, trust company, industrial loan company, state or federal credit union, or any institution or entity that has issued a credit card
Insurance documents, including medical, dental, vision, life, home, rental or vehicle
Medical documents
A document issued by a U.S. government agency, meaning an entity, office, or authority governing over a country, state, county, city, municipality, district, agency, department, or any other political subdivision of a country or state Mortgage bill
Employment documents
Tax return (either Internal Revenue Service (IRS) or California Franchise Tax Board (FTB)
Rental or lease agreement with the signature of the owner/landlord and the tenant/resident
School documents issued by a public or private primary, secondary, or post- secondary institution, college, or university that includes the applicant's date of birth. If using a foreign school document, it must be sealed by the school and include a photograph of the applicant at the age the record was issued. •
u
•
•
Change of Address Confirmation by the U.S. Postal Service Property tax bill or statement
Letter attesting that the applicant resides in Pasadena from a homeless shelter, shelter for abused women, non-profit entity, faith-based organization, employer or government agency within the United States
Deed or title to residential real property
Voter registration confirmation letter or postcard issued by the California Secretary of State or the Los Angeles County Registrar of Voters Proof of payment of resident tuition at a public institution of higher education in California
An original copy of an approved Claim for Homeowners' Property Tax Exemption (BOE-266) form filed with the Los Angeles County Assessor Court documents that list the applicant as a resident of Pasadena California Certificate of Vehicle or Vessel Titles or registration (i.e., a title to, or a DMV registration for, a boat, truck or car)
A DMV No Fee Identification Card Eligibility Verification (DL 933) form, completed and signed
If your name does not appear on any residency documents, you may present a birth certificate, marriage license, or domestic partner registration certificate to trace your relationship to the person whose name does appear on the residency documentation.

Material Interest in Rental Property: an individual has a Material Interest in Rental Property if they, or any member of their Extended Family, own, manage, or have a 5% or greater ownership stake in Rental Units in the county of Los Angeles, or if they or any member of their Extended Family owned, managed, or had a 5% or greater ownership stake in Rental Units in the county of Los Angeles in the past three (3) years (Section 1803(i)).

Tenant: a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental housing agreement to the use or occupancy of any Rental Unit (Section 1803(aa)).

CITY OF PASADENA
Economic Interests Affidavit - MANDATORY
I^ T^T^-^r(printed name), declare under penalty of perjury under the law of the State of California that the information provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete.

Signed this Z)7 day of ^ ^
Signed: A-^J^f T^^^-^-T
., 20 J^.

Printed Name: fi-^I^C_ ^~bir'3-€^
*i
r
99 a
p. b?
y.

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10 ^ °Q
'•f.^ ^% MTED

CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
1, A-/(^/^ 1^7^'<^ _(printed name), declareunderpenaltyof perjury under the law of the State of California that the foregoing is true and correct:

1. I am a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental agreement or lease (oral, written, or implied) for the use or occupancy of a rental unit.

2. I am either a) named in a rental housing agreement or lease, or b) have provided proof of a relationship to a person named i|i,a ^ntal agreement that entitles me the rights of a tenant. ;CT
•a
a

3. I reside at the following address
Pasadena, California <?^/^ ? (!
REDACTED EDACTED(street),
/
c
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.

Signed this ^ J day of _^2^_
Signed: /4-c/^/^ 7^7^-^
-,20_
Printed Name: f\ d^ I ^ (O^r-^^5
u•iI
;:1
I
a
3 CITY OF PASADENA

NOMINATION PETITION -WORKSHEET
(^rdcU 'Torrf.S
(Name of Candidate)
^ ^ ^^'^J3
(Office and District or Seat)
Total Signatures
Total OK
Date:
4^
3~1
^
Checked by:.^
/
r
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^
~7
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^ s
'-%^ ^s's».

CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THEPASADENA RENTAL HOUSING BOARD FORM RHB-001
The information contained on this form will be used by the City Council to fill vacancies on thePasadena Rental Housing Board. Please answer all questions. You are invited to attach additionalpages, a copy of your resume, or submit supplemental information which you feel may assist theCity Council in its evaluation of your application. Applications will be purged from the City's filesJanuary 31 of each year. If you have not been appointed to the Rental Housing Board and stilldesire to be considered for appointment, please resubmit an updated application, or advise Citystaff in writing that the initial form is still current and can be used for an additional year.

Applicant Name:

Home Address:

Mailing Address:

Email Address:

Business Phone:

Home Phone:
5/,->i^ Vw^^^
REDACTED REDACTED/^J-^^-^ ?/1^1

REDACTED
Date Available to Start:

Cell Phone:REDACTED
Board Seat Type: Indicate the type of Board seat in which you wish to fill (mark one or more):
j^_ Tenant Member (7 seats, one per Council district, reserved for tenants) Representing City Council District S'
..-
At-large Member (4 seats, open to any Pasadena resident without respect totenancy or Council District) Alternate Tenant IVIember (1 seat, reserved for tenants) ^/ Alternate At-large Member (1 seat, open to any Pasadena resident withoutrespect to tenancy or Council District) Community Service - List boards, commissions, committees, and organizations on which youare currently serving or have served, offices held and in what city. ^
w
.1t.
s
•ail
Employment - Title and duties, current and past (acceptable to attach resume as analternative). 17'4-'/z>/-' - ^l-lS^^.I^. (.i-'y !''c-//.ee^ '• ^pr^^e I'.'/r/^']^ •.^•e^£/£^r/\ fj.^.-l ^/^'-'<'-^.^ fffrj^ ,VC - Lfy ^..^ij C./e'ik', ^Qd'^e ^^e^ K^ffrc!s,.- '^''S-o^f <'y-S^!-''^f. ^S-^fS..M^fi,--i.^e.!r,vi-i,^i^-f "'ii/^^^r'')~' ^^-^/A;^..,/^,-^ Ct.,, j-l ^s-s^--'- <"G.-,S-^^^-^J", •i"as
ai.a'
Education - Include professional or vocational licenses or certificates. ."^i':^-l^rt^ •:"7/y ^•/-^t - ^'7*^'f''<-^ (/',^^/<-^/.^. «sr' fi.^p^'rffrt Tc.-/'^' <?^<2J>. 1 Have you ever worked for the City of Pasadena? (If yes, please YES list dates/department)
NOQ

2. Are you related to any employee, appointed or elected official of YES the City of Pasadena? (If yes, please indicate name and relationship)
NOD

3. Are you aware that financial disclosure is required annually? (e.g., sources of income, loans and gifts, investments, interests in real property)

5. Do you,or your extended family1 members, have a material YES interest in rental property in the County of Los Angeles within the last three years?

7. Have there been, or are there now, any personal or business YES circumstances which might reflect adversely on the propriety of your serving as a member of the Pasadena Rental Housing Board?

8. Are you aware of the time commitment necessary to fulfill the YES obligations of the Pasadena Rental Housing Board?
D NOE3
NO
NO
NO
in
D
1 Extended Family; any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Charter Section 1803(g)>.

9. Are you aware that you may serve no more than eight
consecutive years as a member of the Pasadena Rental
Housing Board?
YES F1 NOa

10. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate:
^L /•\t-tve ^'-£€-1 -z. /^*i^'i'<^ T^.'-i^/7/'' /-'a-''-' C'^'-e^ .-^i/tf' .i-''t-''^/-i- , ^.i/ /fe-i^-e <S-«S'^»./ /.»tK./'t-yc/ .B®
//,1 e^/^.^'/i ^•.-^t^^Jf',1^^ 4 /^ ^ ..xaj/^.
/'

11. How would you add value to the Pasadena Rental Housing Board? .Z~/» ^,//y/'/'/i?-^ —y ,<^ ".!»•' ^-'"•"yA.^.-'L/i''e' <;.: ^ £l •/•c'yW.^'f^ ^T A."/^-;' ^..;' ^•'-.i's.'4-<i-A--..'e-.^''-l> 0 7L' t ^S^/y) ^1" 5~pvv''k/-e v'-.^ir) 'r<-fh^!i'ei../ .-j-e^e/f^.-/i^i1' A- ^f vivt/it'^. /' £i'v} I'v.-j-./ti/-,^-^ >^-c- ("^•^1 •itSi^/,' Sf7-<^j^7'iy^y^ a^ci vft^ k^c/fr^^ D,-.A/-//^r.,
/
c

12. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
7i? ,'•! fli't,'v^~-i, / i'i;^ ^ \- ff'6;'^/"/•i^f; /. i f/^^-S r/'e-•^ f/e'j/.j ».' <ffrf /-f i^/a •t-f.i £^e-7 > /^ •^t"-':.i?^"i-f^/v>-,^-'•-/ J^r'6.'^{e":t,.^ <'6'^!f / w,'V ^ . a-(',A'^4»^^. ^yi.t ^^.^ .-•£.//.'€ •/v^ ''f/^/.e^ ^. r^ff ^e-^.S'i^r^ '''-i^YW-A/3 /
y,^i»/-f^e!/7h&'//M <-<7/</ ~-c' c:^.^'.,j'/^ /fa-c,/ . i^f^^^/^,^ A./-, ^v/} /^>^..^-L-,- 'Z^ •/«---i J/f.-^^ ^.-iJ '>! /I •f,~s"^f^ ttSt.-',^v/.ieti'€-'ri *" c/e / cv^.2i/.{-cf~,~'j/ie'~c.'/f ce'^^.^-w^/er',

13. How would you help to achieve these objectives and goals? •^ ^t'-fi-e '^c-' t'i.-v'O::!/ t'^'vi.../^'x 1"^1 i//!/.'/•..^•/'//Cl? ;a/—<''!';^^^'-'' -^^/^ ^»/''t3'i.-,0-, •7/ tf.c^*^ 7<^S..-, <".'< 1.^^^ 's;
'/
St'y-^isif^. '/~6'»^ £-/-(%../-^.- .»,'•"^c-^r' c/'/•f.y ^sf,-A./etyS l-i^'i^/c ^ •/-e.'c'' ^•^ •y c^ef/if.y ^r-'n"/fi^yt-/,:'',.• <-'*'' ^t^'} /f^i ^ ^ ' y
ft/^ .<•>.; »-.-/r' y) <-"/^<yZ-7A>//"?•»?/•/'"i?.S'/n4.;/97"J. J7~ ^>---'^.''^/ tt .^ ya-1: n/e /'<;?^i a'"~-t.^--^/'("'^'' /t '•,• •I ^ <r't/t/re:i/::a ,B r^oc'^,./^-,•^ — 7^
I, s /, fl i- /! _y^^ i- ,»-A(printed name), declare under penalty of perjury under the law of the State of California that the information reported in this Form RHB-001 is true, accurate, and complete.
/4 Signed this /-?^ day of ^•e^^.i.r^
~7
,20 2 ? .

Signed: <T ^—^-^^
u
Printed Name: S;/r^^ 'ihfi.r'i-e^
"^
MS-IM^ ^^
^^^: ^TED

CITY OF PASADENA
Residency Verification - MANDATORY
All applicants must provide proof of residency in a City Council district under section 1811(b) of The Pasadena Fair and Equitable Housing Charter Amendment (Measure H). Proof of residency may be established by either of the following:

1. If you are a registered voter, please complete and sign the following declaration and the City Clerk will verify your signature on file with the Los Angeles County Registrar of Voters.

I am a resident of District No. 3 of the_'asadena
I reside at
CA _f//^
REDACTED REDACTED(street), Pasadena,
^£~l^f ^
Signed:<^^^^.•Z^5/^.
5?i-fl^^0
C:n
Printed Name: $';'./^^ ^-'^^^
,/ 0--7-
"3
\2. If you are not a registered voter, please provide clear, readable two forms of proof of residency acceptable to the Department of Motor Vehicles (DMV) for a REAL ID, listed below (Cal. Code Regs. tit. 13, § 17.00 and § 15.01 (d)).

Please provide clear, readable copies of two (2) documents from the following list and attach to this application:
c
•
•
•
Home utility bill or cellular phone bill
Records from any state or national bank, state or federal savings association, trust company, industrial loan company, state or federal credit union, or any institution or entity that has issued a credit card
Insurance documents, including medical, dental, vision, life, home, rental or vehicle
Medical documents
A document issued by a U.S. government agency, meaning an entity, office, or authority governing over a country, state, county, city, municipality, district, agency, department, or any other political subdivision of a country or state Mortgage bill
Employment documents
Tax return (either Internal Revenue Service (IRS) or California Franchise Tax Board (FTB)
Rental or lease agreement with the signature of the owner/landlord and the tenant/resident
School documents issued by a public or private primary, secondary, or post- secondary institution, college, or university that includes the applicant's date of birth. If using a foreign school document, it must be sealed by the school and include a photograph of the applicant at the age the record was issued. •
Change of Address Confirmation by the U.S. Postal Service Property tax bill or statement
Letter attesting that the applicant resides in Pasadena from a homeless shelter, shelter for abused women, non-profit entity, faith-based organization, employer or government agency within the United States
Deed or title to residential real property
Voter registration confirmation letter or postcard issued by the California Secretary of State or the Los Angeles County Registrar of Voters Proof of payment of resident tuition at a public institution of higher education in California
An original copy of an approved Claim for Homeowners' Property Tax Exemption (BOE-266) form filed with the Los Angeles County Assessor Court documents that list the applicant as a resident of Pasadena California Certificate of Vehicle or Vessel Titles or registration (i.e., a title to, or a DMV registration for, a boat, truck or car)
A DMV No Fee Identification Card Eligibility Verification (DL 933) form, completed and signed
If your name does not appear on any residency documents, you may present a birth certificate, marriage license, or domestic partner registration certificate to trace your relationship to the person whose name does appear on the residency documentation.

If the residency document reflects a name that differs from the tracing document due to a name change (for example, marriage, divorce, or court order), name change documentation is required.

I
I
B
5is^of§;; ^t-,
+;
"0.!° %^^: ireo

CITY OF PASADENA
Supplement to Statement of Economic
Interest (FPPC Form 700)
(Form RHB-002)
Ali applicants must complete a Statement of Economic Interest (FPPC Form 700) and "Economic Interests Affidavit" attesting to the information reported in applicant's Form 700.

Material Interest in Rental Property: an individual has a Material Interest in Rental Property if they, or any member of their Extended Family, own, manage, or have a 5% or greater ownership stake in Rental Units in the county of Los Angeles, or if they or any member of their Extended Family owned, managed, or had a 5% or greater ownership stake in Rental Units in the county of Los Angeles in the past three (3) years (Section 1803(i)).

Tenant: a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental housing agreement to the use or occupancy of any Rental Unit (Section 1803(aa)).

CITY OF PASADENA
Economic Interests Affidavit - MANDATORY
I, 5 iw. '^-n if-1 '^rw. _ (printed name), declare under penalty of perjury under the law of the State of California that the information provided and reported in this Form RhfB-002 and the attached Form 700 is true, accurate, and complete.

L-
,s ^
Signed this ^/ day of /Ueirch
Signed:^v^<A^2^z^"—^
Printed Name:5;','^-''7 y/)^'-.'-.^
^
r
p&s^of.6<: ^^ *°+•
i
(0
s.^ ?6^ •5^fED

CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
1, S//ti^/i 11p i-i,]f-!rc^_(printed name), declare under penalty of perjury under the law of the State of California that the foregoing is true and correct:

1. I am a tenant, subtenant, lessee, sublessee or any other person entitled under the terms of a rental agreement or lease (oral, written, or implied) for the use or occupancy of a rental unit.

2. I am either a) named in a rental housing agreement or lease, or b) have provided proof of a relationship to a person named in a rental agreement that entitles me the rights of a tenant.

3. I reside at the following address:)
Pasadena, California oifc>i (zl
REDACTED REDACTED(street),
-i
c
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.
,/^3day of ,F€ ii^^&^if Signed this /j?;
<S3^^-^^ ^:^^—^'
, 20 2 ? .

Signed:

Printed Name: S//M^ //?&^^i.
t!
j
I
a
c

CITY OF PASADENA

NOMINATION PETITION - WORKSHEET
^\
^3\YY\^ Vba^r^
(Name of Candidate)
Pft^6 W^n±^
(Office and District or Seat)
Total Signatures
Total OK
^6
3-^
Date:^^%(2.3
Checked by:_/>^

Pasadena City CouncilApril 19, 2023

Pasadena City Council
April 19, 2023