{project.template.processClassification} - {project.title} Release Date: {project.releaseProjectDate}
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:
2. Type of Entity:
□ non-government □ nonprofit 501(c)(3), (4), or (6)
3. Name(s) of trustees, directors, partners, officers of Contractor/Organization:
4. Names of those with more than 10% equity, participation or revenue interest in Contractor/Organization:
Prepared by: ________________________________
Title: ______________________________________
Phone:
Date: ______________________________________