Disclosure Pursuant to the
City of Pasadena Taxpayer Protection Amendment
Pasadena City Charter, Article XVII
Contractor/Organization hereby discloses its trustees, directors, partners, officers, and those with more than 10% equity, participation, or revenue interest in Contractor/Organization, as follows:
(If printing, please print legibly. Use additional sheets as necessary.)
1. Contractor/Organization Name:
WESTERN EXTRICATION SPECIALISTS, MIC.
2. Type of Entity:
non-government • nonprofit 501(c)(3), (4), or (6)
3. Namel rusS, director, partners, officers of Contractor Organization:
4. Names of those with more than a 10% equity, participation or revenue interest in Contractor/Organization:
DANE M. JACKSON
Prepared by: DAdE m. JAcKSOu
Title: OWNER
Phone: 805-624-7475
Date: 7/19/23
Rev.07.10.2007