AR 19 Attachment A — Pasadena City Council, May 19, 2025

ATTACHMENT A

REDACTED APPLICATION

MATERIALS FOR PASADENA

RENTAL HOUSING BOARD

APPLICANTS

ALL APPLICATION MATERIALS HAVE

BEEN DISTRIBUTED TO THE

CITY COUNCIL
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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. ^x/y^ yn^i^ C^A^o^- Applicant Name:

Home Address:

Mailing Address:

Email Address:

Business Phone: '
Home Phone: /'"
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f/^5Aff^^^ (^ ^ I CO '/
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Date Available to Start:

Cell Phone:
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1 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 wfyat city. P^AD/^^A ^Htt^r^ - ^-XAj^ IJ^'^kvt- /^AEU^.^A") /-Soo / F~/^c-4H /A^^ft-^ At.-A///^- /34^/^b>^.X/<^ 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. rA(3A-' JZ^o^^o /u^i^ o/5' /2(gp^^-&^ 13>S-UMt^ G^ L^ \M^C^C^r1. Have you ever worked for the City of Pasadena? (If yes, please YES j | NO J>^| list dates/department)

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

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
D
NONO
D

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
D0
D@
NONO
D
tended 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?

10. Can you, upon appointment, provide proof of identity and proof of eligibility to work in the United States, as required by Federal law?
YESYES
NONO
DD

12. How would you add value to the Pasadena Rental Housing Board? •rfc: \^f>-^{^ AQ^ V/^ti^ ^b T/-k- Jbc^^o h^ g/t-^i^.A-ft^^1'^, -T^<?^^(- A^D CQ^^^^db^ ^Cc4S'.^ p^/-^-z^-ht/-c. ^ ^^p^^v^^ '7-^€^ •yr^p^^t^^^-i- Op />t^^o///^< 7^-A^-^j- itA.^f-^T^' IfJ^J^-^/^ /€^<^<^A/e./^ ^T^ G^^y^Li<j^^ A-o 7?^^^^//<} •7^1^-r' /17c;^(-<- ^•)^/^7^-/^^RA^^13. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board^ "7?/'zl ^(MA^ Ohj^\^^ ..A^j? ^o^(:^ <9/e' ^-'^' /^473/r^^yc-/S-<^(r/4?t<o^ ^>t^Lf~) ^ h^'SCj.lj') <^^4-t^-€>f^ JCH^l^^^ /4<2)L1^/^-j S'T/^.hlCt^^^Oi'^--^^ /^^/^<SJ ^) -Jrl^f^ f^^T^ (- /^/^-^/W /^T^O ^/y»A^/e/</^/!J '7^/^ ^>4/" 'I l^f^^f 5f^h)l/ Z^^^ ^^D -rh^A^f ^o -^- C+-/ o^ /^^' /^^^^t ^^ , -/

14. How would you help to achieve these objectives and goals? h^ ft C^n^t/^ PAS^ Pf^^i^ lL^5(<^^u^ /^P C^^^Q^o fX- y2li-Cf^S /) ^,^CL<^<.^/^, 6c»--/^v^i^t^ ^/ --t€oo)^/o \jeic<- 'T^ "TV ^ <»o^ ^/^$-,4^-Ao^ A^o-n^^^-j- ^^Ac^-i^-r^s- }cf^Q 0^ h^/^-^^ 77^ /^5^/3^.-i^ /€^^7^6 /-(?^5^-/^ ^^/^ AjU-€^>r 'n> yyi^^/^ <^()/v<. Q^- fyy/^^-^^ ^V^^^t^y /^^l^> (^y^u^ut^^ ^£)p^£^^). 1^ ^>^//fc- ^/^{^Cff^j^^ (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 ''lij^- ^day of fty^{
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, 20-2-C
Signed:

Printed Name: /7-^i^ M^"^^- U^A^^^-S
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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 (Charter Article XVIII). 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.

I reside at
CA ^//^-S (zip code). 7
Signed:
± of the City of Pasadena
<. (street), Pasadena,
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A >^~)
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Printed Name: lcx^ l^^c^ei U^-^^

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:

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 stateMortgage 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 ServiceProperty 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 inCalifornia 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 (Charter Article XVIII) 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 andtheir 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 City Charter provisions in Article XVIII 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.

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 unitspossess 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 andrecreational 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
i, /^//^ ^./^t^ 6^^zw 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 ^/ ^\
Signed: //A
ay _, 20 -^'.
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Printed Name:': £^^^ /^A<^^- (J^A^
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
I, B^^^ M/47c/-/^6^A^?'v7(printed name), declare under penalty of perjury under the law of theState 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),
^z
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.

Signed this ^.// /
Signed:
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Printed Name: ^/^^/e /n^//^ C^A^w^^

EXIE MARIE LEAGONS
RF!~v*fw*
. t./
SUMMARY OF QUALIFICATIONS & PROFICIENCIES -w-r.r- ^.HrK^l PM I.:
• Sub-Contract AdministratTo'ti ' " "•"
• Sub-recipient Monitoiiag' CLER^< • Contract Nego^uo-n OF ^^ DP-[\.!,I * Federal Repordng
* Computer softivare: MS Word, Excel, Publisher,
Power Point, and Outlook
Conttacts & Grants Management
Pre, Post & Close-out
Proposal Preparation & SubmissionBudget Pteparadon
Knowledge of 0MB CircularsFinancial Management

PROFESSIONAL EXPERIENCE
KAISER PERMANENTE (Pasadena, CA)
Sr. Contract & Grants Adxiunisttator 2011-PBESENT
Manages Post Award Team
Guides and facilitates faculty and staff in the development and preparation of research proposals, contracts, sub-contracts, and agreements, to include budgets, documentadoa, and interpretation offunding requirements.

Analyzes and evaluates contract and grant budgets for correct calculation of expenditure categories such as salades, percent of effort, salary adjustment increases, fringe benefits, indirect costs,materials, and equipment.

If in a Central Core Office, serves as a central negotiator and liaison between the University, fundingagencies, and contract entities; researches, drafts, and approves formal responses to requests for proposals, quotarion, contracts, and agreements.

Analyzes and evaluates awarded proposals, contracts, which may include clinical trial agreements, and subcontracts for compliance with funding agency, federal, state, and university reqtiirements. If in a Central Core Office, prepares required acceptance documentation, and obtains official university signatures; recommends approval or rejection of deviations ficom contract specifications.

Assists in the formuladon of processes and procedures for negodadon of contract and grant preawards and post-awaxds to meet university requirements; researches appropriate federal, state, and local requirements to facilitate compliance by all pardes; assists in arbitradon and resoludon of conflicdng interests, as necessary.

Coordinates receipt of awards and contract dociunentadon; maintains proposal and funding records in database systems, and prepares scheduled and special reports, studies and analyses.

Participates and/or assists in special projects, and performs associated administrative dudes, asassigned; may provide funcdonal direcdon to lower level technicians on assigned work.Performs miscellaneous job-related duties as assigned.

Monitor budget to ensure no over-expendituresManage muldple purchasing transacdons, including travel and regular purchases, and includes havingresponsibility for recordkeeping and timely recoaciliadon.

CALIFORNIA INSTITUTE OP TECHNOLOGY 1990-2011
Keck Institute for Space StudiesAdministfadve Assistant 2009-2011 Performs routine data collecdon and basic statistical analysis for award proposals and ongoing fundmonitoring.Coordinate travel arrangements and itineraries for faculty, researchers, and program pardcipants, and processes expense reports including advances, travel reimbursements anid payment requests; assists with logistics associated with domestic or international tcavel; ensures compliance with funding agency travel requirements and export reguladons.

Page 1 of 3 ends

Monitor budget to ensure no over-expenditures
Manage multiple purchasing transacdons, including travel and regular purchases, and includes havingresponsibility for recordkeeping and timely reconciliation.

Coordinate special events such as lunches, recepdons, steering conimittee (and other) meetings,seminars, workshops, studies, and symposia which includes, but is not limited to, orgaaizing event logistics, lodging, ttavel, catering, fadlides, etc.Gathers required information and prepares forms for postdoctoral scholar appointments, graduatestudent fellow appouitments, KISS Disdnguished Visidng Scholar appoinbtnents and/or staff hires.

Career Development Center
Recruiting Coordinator 2007-2009
• Managed company recruitment database and generate company recruitment reports.Negotiated company conttacts Processed purchase orders via p-card, Oracle and T-Mart, and invoices for payment.Assist in the coordinadon and logisdcal operadons of the career fairs.Maintain the employment vebsite and applicant tracking system; Create and maintain job postings on external job board websites.

Responsible for suppordng tecruidng funcdons including meeting with recruiters, schedulinginterviews, orgarJzing travel arrangements for outside recruiters, resenting conference rooms.

Department of Physics
Grants Management 1999-2007
Assisted Faculty in applyiag fot new or continued support.

Advised Faculty on funding possibilides: Federal or private.Reviewed/prepared non-sdenrific pordons of proposal including budget development, recoiTimending correcdons to proposal and budgets and identifying administradve issues reqiiiring further re\dew.Managed spending oflarge/complex accounts to ensure conformance to reguladons specified by eachagenqr; provide cost estimates and projections for various financial components of the award.Interpret and communicate policies and procedures, agency regulations, applicadon deadlines, agencyreports, award related requests, etc. • Monitored Sub-redpients
Developed and generated periodic reports on status of research and discredonaiy accounts, includingsummary and detailed expenditures and available balances.

Advise Faculty of potential problems (over or under spending funds) and provide recommendattons for correcdve acdon.Prepared financial projections for principal invesdgators \vith emphasis on preventing overspending.Interacted vith funding agendes and project accounting on matters of award administradon includingdelinquent financial status reports and award dosures.Generated paperwork relating to grant makitenance, i.e. equipment, travel, spedal requests.Reviewed and administered award account balances, expiradon dates, and major changes in budget.

Infonned Administrator or Chaiixnan of any spending not in confotmance with Division/Insdtutepolides.Assisted widi space surveys, effoi.-t reporting and otlier grant related acdvides.

Other duries/projects as assigned.

Purchasing Department
Acquisidon Representative 1996-1999
Managed procurements and sendees and processed purchase requisidons Provided sub-contract administradon, including payments.

Negodated contract terms and conditions.
• Responsible for contract administcation; prepared and evaluated requests for quotadon.

Developed and wrote source jusdfication documents.

Administrative duties include coordinadng travel arrangements, scheduling appointments, processing invoices for payment, and handling receiving and returns of materials purchased.

Assistant Buyer 1994-1996
Responsible for researching and purchasing supplies for various departments, and vendor sourdng andpacing.

Page 2 of 3 ends

Interfaced with both customers and vendors involved in the acquisidon process, semng as a liaison. Managed contract administtadon.

Organized and mabtained data files.

Buyer Assistant 1990-1994
Data entry into mainframe system to generate purchase order numbers and documents.

Updated and maintained data files on PC based system.

Handled high volume phone calls.

Sorted and distributed incoming mail.

Handled distribution and flow of documents widTin the department & outside.

EDUCATION
UNIVERSITy OF REDLANDS, Redlands, CA
MBA, enipbasls in Finance
UNIVERSITY OF LA VERNE, La Verne, CA
B.S., Organizadonal Management
2006
2003

PROFESSIONAL DEVELOPMENT
Nationsd Council of University Research Administtators: Sponsored Project Administrauon Training I & II Contracts: Reading, Writing & Negotiating
Legal Aspects of Purchasing
'References availahk tipon request.

Page 3 of 3 ends

CALIFORNIA FORM700

FAIR POLITICAL PRACTICES COMMISSION
P/ease type or print in Ink.

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE

A PUBLIC DOCUMENT
7^ ^PP Q(
Date Initial Filing Received
Filing Olliclal Use Only

RECEIVED
n>
NAME OF FILER (LAST) u^^^5 (FIRST) l€^/^- (MIDDLE) ' '- • ( " 4- J3 ^/w^en. d ^

1. Office, Agency, or Court
Agency Namq/ fDo not use acronyms) M4^ ^!/^
^i I r OF ^S^DENA
^A^AO/^/^ TA^AO/Sf^fQ /€/^^<" f>o/^^]/U^^_ Division, Bbard^ Department, Disjfict, if applicable Your Position > If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: _ Position:

2. Jurisdiction of Office (Check at least one box)
D State
D Multi-County
^City of I^AP^^^
D Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction)
D County of
D Other

3. Type of Statement (Check a( least one box)
Q Annual: The period covered is January 1, 2024, through December 31, 2024.
•orThe period covered is / / _, through
December 31, 2024.

D Leaving Office: Date Left . J. _/.
(Check one circle below.)
D The period covered is January 1,2024, through the date of leaving office.

J_ _/_
•orD Assuming Office: Date assumed Q The period covered is the date of leaving office.
^f Candidate: Date of ElecUon •^'U/-{-<— and office sought, if different than Part 1:.

J_ J_ through
y^.

4. Schedule Summary (required)
Schedules attached
> Total number of pages including this cover page: ^-^
Q Schedule A-1 • Investments - schedule attached
Schedule A-2 - Investments - schedule attached
0 Schedule B • Rea/ Property - schedule attached
•or- D None • No reportable interests on any schedule
~T
'Schedule C • /ncofne, Loans, & Business Positions - schedule attached Q Schedule D • /ncome - Gifts - schedule attached
[_] Schedule E - /ncome - Gifts - Travel Payments - schedule attached i

5. Verification / / ^S>9P^U (c^4- MAIUNG ADDRESS STREET ' (Business or Agency Address Recommended - Publfc Document) ' %^0^
UlTY "STATE ZIP CODE

DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
•/ I have used uii luasonable diligence in preparing this statement I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a public document.

I certify under penalty of psrjury under the laws of the State of California that the foreggftg Is tryfe and'correc Date Signed t/A//-z^- Signature
(monm, (tax yeffl) f/ (Faeyeorigina!lfayyfpapei<sta!snSmTmrywrSngoB«S!t.) / // FPPC Form 700 -Cover Page (2024/2025)
[email protected] • 866-275-3772 • www.tppc.ca.gov
Page-6
CALIFORNIA FORIV1 700

SCHEDULE B
Interests in Real Property
(Including Rental Income)

FAIR POLITICAL PRACTICES COMMISSION
Name
>- ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
..57^fco^o^r
CITY.
f^<AD^^A.-

FAIR MARKET VALUE
Q $2,000 - $10,000Q $10,001 - $ioo,oooQ $100,001 - $1,000,000 'Over $1,000,000

NATURE OF INTEREST
Q^Ownership/Deed of Trust
[_] Leasehold
IF APPLICABLE, LIST DATE:

J /24

ACQUIRED
LJ Easement
y—/24_

DISPOSED
Yra. remaininn Other

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
Q$0-$499 Q (500-$1,000 Q $1,001 - $10,000
$10.001 - $100,000 | | OVER $100,000
SOURCES OF RENTAL INCOME: If you own 8 10% or greaterInterest, list the name of each tenant that is a single source of income of $10,000 or more.

None
> ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
,^7^00^0 I/
CITY
P/^^Ap^l.^V

FAIR MARKET VALUE
$2,000 - $10,000$10,001 - $100,000
Q $100,001 - $1,000,000
Over $1,000.000
IF APPLICABLE, LIST DATE:

NATURE OF INTEREST
[J Ownership/Deed of Trust
Q Leasehold
Yrs. remaining
J /24

ACQUIRED
I]Easement
DJ 124. DISPOSED
Other

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
Q $0 - $499 Q $500 - $1,000 Q $1.001 - $10,000
@ $10,001 - $100,000 Q OVER $100,000
SOURCES OF RENTAL INCOME: If you Own a 10% Or greater
interest, list the name of each tenant that is a single source of income of $10,000 or more.
ione
You are not required to report loans from a commercial lending institution made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans andloans received not in a lender's regular course of business must be disclosed as follows:

NAME OF LENDER*
h)^iJ5 /^4-b
ADDRESS (Business Address Acceptable)

BUSINESS ACTIVITY, IF ANY, OF LENDER

INTEREST RATE
A^% D None
TERM (Months/Years)
^3 ^nA_
/

HIGHEST BALANCE DURING REPORTING PERIOD
Q $500-$1,000 Q $1,001 - $10,000Q $10,001 - $100.000 @IOVER $100,000 II Guarantor, tf applicable
NAME OF LENDER*
fV)A^L^^e ^^^C^f^^T
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVIPr, IF ANY, OF LENDER

INTEREST RATE
_^_ % Q None
TERM (Months/Years) y^

HIGHEST BALANCE DURING REPORTING PERIOD
$500 - $1,000 Q $1,001 - $10,000
Q $10,001 - $100,000 I53/OVER $100.000
Guarantor, if applicable
Comments:

FPPC Form 700 -Schedules (2024/2025)
[email protected] • 86G-275-3772 • www.fppc.ca.gov
Page-12

SCHEDULE B
Interests in Real Property
(Including Rental Income)
CAl-tFORNIAFORM
^PAIRr.OUTlCALiPRACTICESCONlMISSION^
Name
»- ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
--;
cn
^-/^/L^.
7 FAIR MARKET VALUE
Q $2,000 . $10,000
D $10,001 - $100,000^$100,001 -$1,000,000 Q Over $1,000,000

NATURE OF INTEREST
J^Ownerehip/Deed of Trust
IF APPLICABLE, LIST DATE:

J—J2^_

ACQUIRED
Easement
J-J7ADISPOSED
Leasehold
Yra. remaining Other

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
Q$0-$499 Q $500-$1,000 Q $1,001 - $10,000
$10,001 - $100,000 Q OVER (100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more. [3 None
ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS / / ^—
CITY ,/~z_
;^^%-<; ^^Y i/^>
~T
FAIR MARKET VALUEQ $2,000 - $10,000
Q $10,001 - sioo,ooo ^3l00,001 -$1,000,000Q Over $1,000,000

NATURE OF INTEREST
R) Ownership/Deed of Trust
Q Leasehold
Yrs. rennainlng
IF APPLICABLE, LIST DATE:
7—J24- —/—^-

ACQUIRED DISPOSED
II Easement
DOther

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
[—|$0-$499 |—| $500 - $1,000 ^['$1,001 - $10,000
[~] $10,001 - !100,000 Q OVER (100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of income of $10,000 or more.

D None
You are not required to report loans from a commercial lending institution made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows:

NAME OF LENDER*
1^6^
ADDRESS (Business AddresyAcceptable)
0 M«^<^.^
~s~

BUSINESS ACTIVITC, IF ANY, OF LENDER

INTEREST RATE
_6_ .% Q None TERM (Months^ears) 7!>

HIGHEST BALANCE DURING REPORTING PERIOD
Q »soo - »l,ooo Q $1,001 - $10,000
$10,001 - $100,000 ^OVER $100,000
II Guarantor, if applicable
NAME OF LENDER*/ /
/^/A
ADDRESS (Business Address Acceptable)

BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEi^EHi- RATE
-% Q None
TERM (Months/years)
HIGI !E:S i UALANCE DURING REPORTING PERIOD
Q $500 - $1,000 Q $1,001 - $10,000Q 310,001 - $100,000 Q OVER (100,000 II Guarantor, if applicable
Comments:

FPPC Form 700 - Schedule B (2024/2025)
[email protected] • 866-275-3772 • www.fppc.ca.gov
Page-12

SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
CALIFORNIA FORM 700

FAIR POLITICAL PRACTICES COMMISSION
Name
> 1. INCOME RECEIVED > 1, INCOME RECEIVED

NAME/)F SOURCE OF INCOME
-Af^vi- ^[tfCYAg^^
ADDRESS (Business Address Acceptable)
A
'—•' .

BUSINESS ACTIVITY, IF ANY, OF SOURCE
j$^/ Cff^+f^j
YOUR BUSINESS POSITION^>^ Cff^h^^ 4 ^/\f^A>^"h ^<p^^.

GROSS INCOME RECEIVED \ } No Income - Businsss Posjiion 0,"!y Q $500-$1,000 D $1,001-$10,000
$10,001 - $100,000 C^OVER $100,000

CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary || Spouse's or registered domestic partner's Income '' \ (For self-employed use Schedule A-2.)
Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.)
Q Sale of
(Resf property, car. boat. etc.)
Loan repayment
[I Commission or || Rental Income, list each source of t)0,000 or more (Describe)
Q Other.
tDescribel
NAMEjOF SOURCE OF INCOME
Awu fp^pr^if
ADDRESS (Business Address Acceptable)
/^SA&^^)
BUSINE! ..If nl< I.^F SOURCE
]^^^- ll^^^-LC^
YOUR BUSINESS/^OSITION /
GROSS iNCOME RECEi'.'ED
Q $500-$1,000
^$10,001 -$100,000
No income - Business Posiiion Oniy$1,001 -$10,000OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVEDII Salary ]] Spouse's or registered domestic partner's Income (For self-employed use Schedule A-2.)
D Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.)
Q Sale of
(Real property, car. boat. etc.)
II Loan repayment
Commission or |/I\Rental Income, list each source of S10.000or more (Describe)
[] Other.
(Describe)
> 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD You are not required to report loans from a commercial lending institution, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender'sregular course of business must be disclosed as follows:

NAME OF LENDER- INTEREST RATE TERM (Months/Years)
-%
ADDRESS (Business Address Acceptable)
None

BUSINESS ACTIVITY, IF ANY, OF LENDER

HIGHEST BALANCE DURING REPORTING PERIOD
Q $500-$1,000
$1,001 -$10,000$10,001 - $100,000
Q OVER $100,000

SECURITY FOR LOAN
]I None || Personal residence
m Real Property
Street address
City
II Guarantor
Q Other.
(Descrtbe)
Comments:

FPPC Form 700 - Schedule C (2024/202S)
[email protected] • 866-275-3772 • www.fppc.ca.gov
Page-14
<
JO^PAS^ ^ff^^
roy ^^^^' K- 8 ^fffSsQsaSL ^t'-k
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^

RECEIVED
?8;SAPRZ) ^3,22
CITV r ^ 'v CLERK
C?TY OF PASADENA
Pasadena Rental Housing Board
^ 7«
.1 ^, ^
% .</
°ft.WEC ^
y

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 theCity 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: S^IMO/J <^T/RBO^
/» • —
Home Address:

Mailing Address:Email Address:

Business Phone:

Home Phone:
'J^|T)€A/^- 04 ^HO-TAS- A Io^^
t
Date Available to Start: fMMe'SXATSZ-^
Cell Phone: "
Board Seat Type: Indicate the type of Board seat in which you wish to fill (mark one or more):

C/Jte- - OLeDrT /(IS^tT JE^^TA^CC- €SUC4TIQ(/. /O^V|-&/A/<' 'T^/A/^C /J^ Cf2C^[T {ye -y ^\^-S(K/(^ CA^)TT T/ayy TO ^L^>I ^ ^/^ AweeT (h/ to^- ^/<^u^-. Tf^li/vfL ^1^ eg- '20-2-^
Employment - Title and duties, current and past (acceptable to attach resume as analternative). C-Wk^L ^F ^T ^e^/&/23> gC - ou/j(/r//<c -»- ^W^IA/^; Pft^i^ftc^ f/^ {^A^^^A 7 U%- AAc^e$* f 70^-•2?^ e^P/^/P/^tftEGCfC ftOtff IN C^S-Uh^. F7/W/CF ft ^ t^hft-^rw^r -CAPITAL c^e, cfT(?A^ Lcoy^ ^^5c C'^cxpo -^^i^)
t
Education - Include professional or vocational licenses or certificates. ^•^ PH/S^sr — u^\W^f~^ ^ LO^C^J ^ OK - L>viv%r^y <^F '©^^Foz'b , UK

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

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

3. Are you aware that financial disclosure is required annually? YES ^| NO | | (e.g., sources of income, loans and gifts, investments, interests in real property)

4. Rules of law and ethics prohibit members from participating in YES f^l NO (| 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)
f cy-CAVfJ j-2. A/^TM^G' ^ P^f/W/^. 5o rr1S' P^?t^ ] h^/ ^AF ^R> ftfayt! f^^tjF (F -m^ 6?Mr 'ro T^ %w2,>

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 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 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
NONO
D
@
a NO
NO
El
D
Mended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or unde. niece or nephew, grandchild, or cousin (Charter Section 1803(g)).

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

10. Can you, upon appointment, provide proof of identity and proof YES of eligibility to work in the United States, as required by Federal law?
NO
a
NO Q

11. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate:
re;e~ AT^CH^-^T

12. How would you add value to the Pasadena Rental Housing Board? <e-& yHtACHn^^/T

13. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
^€e ATrAcMi-re-k/T

14. How would you help to achieve these objectives and goals? ^6- AH-Ac^h^VT
1, '^>/ncA/ C-i 115J?-^Y> (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, andcomplete.

Signed this rf2c9 day of AP^-'^- 20'2$'
Signed: ~^n^d^
Printed Name: OM(^ ^l^Bcf^S
of 2^3
g:
yt-r *°
%
^
•s?0 .A 'S^ED
^

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 (Charter Article XVIII). 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.

I reside at
of the City of Pasadena
CA Ci f^'7- (zip code).
(street), Pasadena,
Signed: <h-^~^
Printed Name: <^/H^/^/ ^^^^Y

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

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 CaliforniaAn 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 Caiifornia Certificate ofVehide or Vesse! Titles or registratiQ.n (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.
^
bT
^
so
•fi
^
TED
^

Instructions: The Pasadena Fair and Equitable Housing Charter Amendment (Charter Article XVIII) 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 theirservice. 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 PracticesCommission's Form 700 for this purpose, but City Charter provisions in Article XVIII requires information about interests in rental property in Los Angeles County for three years, not the oneyear the FPPC Form otherwise uses. Under City Charter Section 1811 (b), these documents are public records; they will not be confidential.

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)).

Rental Unit: any building, structure, or part thereof, or land appurtenant thereto, or any otherrental property rented or offered for rent for residential purposes, whether or not such unitspossess 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
I, ^ IMOf^ C^ fl5l!Cf^C> (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 AW ^ -,20^5
Signed: -<^.^x:Printed Name: Sf^CfJ ^RRO^S
PAS of
^
s 5'
•s
s;
reo
I,

CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
^7 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 fo!!o'wing 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 2© day of /4/^fL
Signed: ^ (
, 20
Printed Name: ^\h0^ ^]BW^S

SIMON GIBBONS

APPLICATION FOR PASADENA RENTAL HOUSING BOARD-SUPPLEMENTARY

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

I have co-owned and managed 12 apartments in Pasadena since 2019. During that time I have worked hard to ensure a safe and comfortable space for our tenants, including making upgrades to infrastructure such as parking and utilities, and making sure that all maintenance and repairs are carried out quickly and effectively.

I am also responsible for financial management for several LA-based rental properties owned by other people, and this includes working with tenants to set up payment plans, discounts, or other methods to try to keep residents in their homes.A good example of working with tenants was during 2020, when I set up discounts for all tenants from the start of the pandemic in March and April to help manage their finances duringthe uncertain period. As the business's own financial situation permitted, I offered further discounts during the second half of 2020. This helped to keep many tenants from building up debt during the eviction moratorium.

I'm working to bring financial justice to people as a volunteer with CARE (Credit Abuse Resistance Education) to bring financial and credit advice to children and adults across LA County. Previously in the banking sector I was responsible for Treating Customers Fairly programs at Citibank and Lloyds Bank, which helped ensure that customers were clearlyinformed and that there were mechanisms to spot and fix unfair pricing or terms. I also worked with a UK debt and mental health charities to develop debt management processes.

12. How would you add value to the Pasadena Rental Housing Board? I'm concerned about a lack of relevant expertise in rental property management on the Board, so I would like to bring my own experience to bear. I'm also experienced in managing successfulprojects, including IT implementations and customer-facing systems, which have been aweakness of the Board so far. Finally, my career has mainly been in financial management:
currently I'm the person asking detailed questions from the Council Chamber floor about the Board's ability to pay its own way. By joining the Board, I want to help it avoid a major financial problem in the next few years.

Some people have expressed concern about my involvement in the CAA's lawsuit around Measure H. I'd like to emphasize that I respect and follow the law: I immediately carried outrent rollbacks at the end of 2022,1 have followed all rules and regulations, and I registered myrental units on time.

Nonetheless, I have the right to express my concerns about the lopsided nature of the Board'smembership. I see no disconnect between faithfully upholding the oath of office to fairly and impartially work for affordable housing, and working to bring a new balance to the Board's structure.

SIMON GIBBONS

APPLICATION FOR PASADENA RENTAL HOUSING BOARD-SUPPLEMENTARY

13. What do you view as the primary objectives and goals of the Pasadena Rental Housing Board a) Providing effective and timely resolutions for disputes between tenants and landlords b) Regulating rent levels
c) Promoting neighborhood stability and affordability in Pasadena

14. How would you help to achieve these objectives and goals? I intend to treat the Board's goals seriously, in line with the oath of office. I want to help drive effective dispute resolution and mediation of rent petitions by using my knowledge and detailconsciousness to make sure that all sides are heard fairly. I also want to use my financial experience to drive a more rigorous budget process. Finally, I will help to ensure that regulations for landlords are clear and effective, for instance by working to speed up processes forpublishing permitted rent increases and interest payable on security deposits.

CALIFORNIA FORM 700

FAIR POLITICAL PRACTICES COMMISSION
Please type or print in ink.

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE

A PUBLIC DOCUMENT
?P,?S .ap? 9 (
Date Initial Filing Received
Filing Officfaf Use Only

RECEIVED
OKe ^ -.

NAME OF FILER (LAST)
Gibbons
(FIRST)
Simon
(MIDDLE)
Michael CfTV CL.F0^
<~c.

1. Office, Agency, or Court ^"YOF PASADENA
Agency Name fDo no( use acronymsj
City of Pasadena
Division, Board, Department, District, if applicable
Pasadena Rental Housing Board
Your Position
At-large member
> If filing for multiple positions, list below or on an attachment. fDo not use acronyms) Agency: Position:

2. Jurisdiction of Office (Check at least one box)
I State
I Multi-County
Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction)
•r City of Pasadena
County ofOther

3. Type of Statement (Check at least one box)
j Annual: The period covered is January 1, 2024, through December 31, 2024.
•orThe period covered is / / _, through
December 31, 2024.

Leaving Office: Date Left J-
(Check one circle below.)
I The period covered is January 1,2024, through the date of leaving office.
-orAssuming Office: Date assumed _/_ J_ The period covered is _/_ J. through !•] Candidate: Date of Election May 5- 2025
the date of leaving office.
and office sought, if different than Part 1:

4. Schedule Summary (required)
Schedules attached
> Total number of pages including this cover page: "y2- [ J Schedule A-1 • Investments - schedule attachedf/\ Schedule A-2 - Investments - schedule attached \/\ Schedule B • Rea/ Property - schedule attached
•or-! None - No reportable interests on any schedule
'• Schedule C - fncome, Loans, & Business Positions - schedule attached Schedule D • Income - Gifts - schedule attached
I Schedule E - Income - Gifts - Travel Payments - schedule attached

5. Verification

MAILING ADDRESS STREET
fBusiness or Agency Address Recommended - Pubffc Documenf} J
CITY
Pasadena
STATE
CA

ZIP COOE
91107
DAYTIME TELEPHONE NUMBER"
(

EMAIL ADDRESS
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information containedherein and in any attached schedules is true and complete. I acknowledge this is a public document.

I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date Signed 4/20/2025 Signature -€h.^-,
(monlti, day, ysai) (Ffe the originally signed paper statemsnt with your Sling offidal.J FPPC Form 700 -Cover Page (2024/Z025)
[email protected] • 866-275-3772 • www.fppc.ca.gov
Page-6
California Form 700 Schedule A-2 and Schedule B
Name: Simon Gibbons
Attachment for Reportable Single Source of Income over $10,000 during 2024

1. Kiera Fuller and Alex Neilson

2. Janet Gibbs

3. Alyssa Mancuso4. Joshua Thomas & Marcos Corrales

5. Edgar Diaz and Nicole Artero6. Paul Goyne7. Ana Alvarez and Marc CalderA8. Alyssa Torres and Angelina Cotton

9. Maria Delgado

10. Rachel Chen and Brandon Chan

11. Cindy & Taase Mose12. Amy Rodriguez and Brently Sanders SCHEDULE A-2
Investments, Income, and Assets
of Business Entities/Trusts
(Ownership Interest is 10% or Greater)
CALIFORNIA FORM 700

FAIR POLITICAL PRACTICES COMMISSION
NameSimon Gibbons
> 1. BUSINESS ENTITY OR TRUST > 1. BUSINESS ENTITY OR TRUST BT Shepherd LLCName
5 Pasadena CA 91107
Address (Business Address Acceptable)
Check one
i Trust, go (o 2 ',•1 Business Entity, complete the box, then go to 2

GENERAL DESCRIPTION OF THIS BUSINESS
Rental Property Management

FAIR MARKET VALUE
I ] $0-$1,999 I ] $2,000 - $10,000 I i $10,001 - $100,000I [$100,001-$1,000,000Ill Over $1,000,000 IF APPLICABLE, LIST DATE:
y_^/24-

ACQUIRED
7_J24_

DISPOSED
NATURE OF INVESTMENT'•I Partnership | | Sole Proprietorship | Other YOUR BUSINESS POSITION Managing Partner
Name
Address (Business Address Acceptable)C/ieck one
I Trust, goto 2 [ J Business Entity, complete the box, then go to 2

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
1 I $0-$1,999i I $2,000 - $10,000I I $10,001 - $100,000I J $100,001 - $1,000,000 ; I, Over 51,000,000
IF APPLICABLE, LIST DATE:

ACQUIRED DISPOSED
NATURE OF INVESTMENT] I Partnership F"! Sole Proprietorship i "| Other

YOUR BUSINESS POSITION
»• 2. IDENTIFYTHE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATAB>- 2. IDENTIFYTHE GROSS INCOME RECEIVED (INCLUDEYOUR PRO RATA SHARE OF THE GROSS INCOME 10 THE ENTITY/TRUST) • SHARE OF THE GROSS INCOME IQ THE fNTITY/TRUST) $0 - $499
I $500-$1,000I $1,001 -$10,000
I I $10,001 - $ioo,ooo[•j OVER $100,000
> 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE (Attach a siparate sheet II necessaiy.) I None or f Names listed below
See attachment
> 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR

LEASED BY THE BUSINESS ENTITY OR TRUST
Check one box:
$0-$499
-! $500-$1,000
$1,001 -$10,000
$10,001 - $100,000OVER $100.000
> 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE (Attach a soBarato shoot If nccsssary.) None or Names listed below
> 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR

LEASED BY THE BUSINESS ENTITY OR TRUST
Ii INVESTMENT '• REAL PROPERTY
Name of Business Entity, if Investment, Qi Assessor's Parcel Number or Street Address of Real Property Pasadena CA 91107
Description of Business Activity erCity or Other Precise Location of Real Property

FAIR MARKET VALUE
I I $2,000 - $10,000I I $10,001 -$100,000] I $100,001-$1,000,000 [•i Over $1,000,000
NATURE OF INTERESTllli Property Ownership/Deed of Trust IF APPLICABLE, LIST DATE:

J24_

ACQUIRED
J_^24_

DISPOSED
Stock [ ] Partnership
Leasehold
Yrs. remaining
|1 Other
pheck box if additional schedules reporting investments or real property are attached
Check one box:

INVESTMENT 1 REAL PROPERTY
Name of Business Entity, if Investment, er Assessor's Parcel Number or Street Address of Real Property Description of Business Activity S!t City or Other Precise Location of Real Property

FAIR MARKET VALUE
$2,000 - $10,000
I i10,001 - $100,000I $100,001 -$1,000.000
I Over $1,000,000NATURE OF INTEREST
Property Ownership/Deed of Trust
IF APPLICABLE, LIST DATE:

J24_ __J^J^_

ACQUIRED DISPOSED
Stock I Partnership
[ Leasehold Yrs. remaining Other
Check box if additional schedules reporting investments or real propertyare attached Comments: FPPC Form 700 - Schedule A-Z (20Z4/20ZS)
advlcelSlfppc.ca.gov • 866-273-3772 • www.fppc.ca.gov Page-10 California Form 700 Schedule A-2 and Schedule B
Name: Simon Gibbons
Attachment for Reportable Single Source of Income over $10,000 during 2024

1. Kiera Fuller and Alex Neilson

2. Janet Gibbs

3. Alyssa Mancuso4. Joshua Thomas & MarcosCorrales

5. Edgar Diaz and Nicole Artero

6. Paul Goyne

7. Ana Alvarez and Marc CalderA

8. Alyssa Torres and Angelina Cotton

9. Maria Delgado

10. Rachel Chen and Brandon Chan

11. Cindy & Taase Mose

12. Amy Rodriguez and Brently Sanders
CALIFORNIA FORM700

SCHEDULE B
Interests in Real Property
(Including Rental Income)

FAIR POLITICAL PRACTICES COMMISSION
NameSimon Gibbons
> ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY
Pasadena CA 91107

FAIR MARKET VALUE
I [ $2,000 - $10,000i 1(10,001-$100,000
I $100,001 -$1,000,000
If] Over $1,000,000
NATURE OF INTEREST[•I Ownership/Deed of Trust
IF APPLICABLE, LIST DATE:

ACQUIRED DISPOSED
I Easement
Leasehold
Yrs. remaining Other

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
I ]$0-$499 | ' $500-$1,000 | ' | $1,001 - $10,000
f 1. $10,001 - $100,000 (•! OVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source of income of $10,000 or more.

I None
See attachment

ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS

CITYFAIR MARKET VALUE
$2,000 - $10,000
f ' $10,001 - $100,000I $100.001 -$1.000,000
1, Over $1,000,000
NATURE OF INTERESTI Ownership/Deed of Trust
IF APPLICABLE, LIST DATE:
__y_^/24_ _J—J24_

ACQUIRED DISPOSED
Easement
Leasehold
Yrs. remaining Other

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
j $0-$499 [ i $500-$1,000 | $1,001 - $10,000
I $10,001 - $100,000 ] OVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more.

I" I None
*You are not required to report loans from a commercial lending institution made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows:

NAME OF LENDER*ADDRESS (Business Address Acceptable)

BUSINESS ACTIVITY, IF ANY, OF LENDER

INTEREST RATE
-%
TERM (Months/Years)
None

HIGHEST BALANCE DURING REPORTING PERIOD
I I $500-$1,000 i 1 $1,001-$10,000
I i $10,001 - $100,000 i ! OVER $100,000
j i Guarantor, if applicable
NAME OF LENDER*
ADDRESS (Business Address Acceptable)

BUSINESS ACTIVITY, IF ANY, OF LENDER

INTEREST RATE
-%
TERM (Months/Years)
None

HIGHEST BALANCE DURING REPORTING PERIOD
I $500-$1,000I $10,001 - $100,000
Guarantor, if applicable
] $1,001 -$10,000I OVER $100,000
Comments:

FPPC Form 700 . Schedule B (Z024/2025)
[email protected] • 866-275-3772 • www.fppc.ca.eov
Page-12
Addendum to California FPPC Form 700 Schedule C
Name: Simon Gibbons
During 2024, my spouse (Hermina Astalis) and I (Simon Gibbons) provided salaried management services to the following companies in Los Angeles County:

Company Company Address Business Activity Business
Position
Gross Income
received in 2024as Salary
Rose Berlin LLC
Rose Cairo LLC
'.os Angeles,
CA 90029
Rental Property Property
Manager
••<. Los Angeles,
CA 90029
Rental Property Property
Manager
Rose London ;
LLC , \ Los Angeles,
CA 90029
Rental Property Property
Manager
$10,000 -$100,000
$10,000 -$100,000$10,000 -
$100,000
Rose Rio LLC ;e
\ Los Angeles,
CA 90029
Rental Property Property
Manager
$10,000-$100,000

SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
CALIFORNIA FORIV1 700

FAIR POLITICAL PRACTICES COIVIMISSION
NameSimon Gibbons
\> 1. INCOME RECEIVED

NAME OF SOURCE OF INCOME
See attachment
ADDRESS (Business Address Acceptable)BUSINESS ACTIVIPl', IF ANY, OF SOURCE

YOUR BUSINESS POSITIONGROSS INCOME RECEIVED
I j $500-$1,000I I $10,001 - $100,000
No Income - Business Position OnlyI $1,001 -$10,000] OVER $100,000

CONSIDERATION FOR WHICH INCOME WAS RECEIVED
I Salary Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.)
!; 1 Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.)
Sale of
(Real property, car. boat, etc.)
\ \ Loan repayment
j i Commission or | Rental Income, (fs( each source ol $10,000 or more (Describe)
Other
> 1. INCOME RECEIVED

NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)

BUSINESS ACTIVITY, IF ANY, OF SOURCE

YOUR BUSINESS POSITION
GROSS INCOME RECEIVED |~] No Income - Business Position Only I I $500 - $1,000 |J $1,001 - $10,000
] i $10,001 - $100,000 !_..j OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED[ I Salary | ] Spouse's or registered domestic partner's Income (For self-employed use Schedule A-2.)
I ! Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.)
!""] Sale of. (Reaf property, car, boal, etc.)
Loan repaymentCommission or I Rental Income, /is( each source of $10,000 or mom (Describe)
Other.
(Describe)
> 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD IDesuibe)
You are not required to report loans from a commercial lending institution, or any indebtedness created as part ofa retail installment or credit card transaction, made in the lender's regular course of business on terms availableto members of the public without regard to your official status. Personal loans and loans received not in a lender'sregular course of business must be disclosed as follows:

NAME OF LENDER* INTEREST RATE TERM (Months/Years)
-% None
ADDRESS (Business Address Acceptable)

BUSINESS ACTIVITY, IF ANY, OF LENDER

SECURITY FOR LOAN
None I I Personal residence

HIGHEST BALANCE DURING REPORTING PERIOD
i I $500-$1,000
I I $1,001 - $10,000
i I $10,001 - $100,000[ I OVER $100,000
Real Property S(ree( address
City
Guarantor
Other
fDescrfbeJ
Comments:

FPPC Form 700 - Schedule C (20Z4/Z025)
[email protected] • 866-275-3772 • www.fppc.ca.gov
Page-14
District 3 & At Large

RECEIVED
^R-i, ^^.^C'T^%..

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Pasadena Rental Housing Board
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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 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 still desire 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: -AlV \ WA U ^\/\n
Home Address:
t 0
^-<- i
Mailing Address: S^/i'u2_ ^ 5 &/SD L/€_-
I /iAS^^_2UP^
1 Email Address:

Business Phone:

Home Phone:

I \^ ^. I -tDate Available to Start: l .^^^.^Y(^^
Cell Phone:
\-
^
Board Seat Type: Indicate the type of Board seat in which you wish to fill (mark one or more):

S<^2
^

1. Have you ever worked for the City of Pasadena? (If yes, please YES |^| NO list dates/department) CA_Af^^~{ i4.\^^r P^(S D

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)

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
D
NO
NO
D

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 uncte, niece or nephew, grandchild, or cousin (Charter Sedion 1803(g)>.

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

10. Can you, upon appointment, provide proof of identity and proof YES ^j NO | | of eligibility to work in the United States, as required by Federal law?

11. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate: S^^ O.-t^G.rJi'^)

12. How would you add value to the Pasadena Rental Housing Board? ^X€L_ ^-t^^'J^

13. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?

14. How would you help to qchie^e these objectives and goals? ^^- ^-('c^c.L^^ i, -^M lfS3L'-( H< ^'^(. (/t7 (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 ^ day of /^'{^F^^\ 20^.

Signed: ^~ ^ €^^
Printed Name: 1//SM ^^^^c
/
of
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?<

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CITY OF PASADENA
Residency Verification - MANDATORY
All applicants must provide proof of residency in a City Council district under section 1611(b) of The Pasadena Fair and Equitable Housing Charter Amendment (Charter Article XVIII). 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 ofVoters. am a resident of District No. 3 of the City of Pasadena I reside at
CA ^KoM (zip code). (street), Pasadena,
Signed;^^
Printed Name: M'w ^^^//.
/

Please provide clear, readable copies of two (2) documents from the following list and attach tothis 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 documentsA document issued by a U.S. government agency, meaning an entity, office, orauthority governing over a country, state, county, city, municipality, district,agency, department, or any other political subdivision of a country or state Mortgage billEmployment documents
Tax return (either Internal Revenue Service (IRS) or California Franchise TaxBoard (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 postsecondary 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 StatesDeed or title to residential real properi:y 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 PasadenaCalifornia Certificate of Vehicle or Vessel Titles or registration (i.e., a title to, or a DM'v 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 courtorder), name change documentation is required. b? PAS
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reo
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Instructions: The Pasadena Fair and Equitable Housing Charter Amendment (Charter Article XVIII) 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 andtheir Extended Family's interests and dealings in rental properties in Los Angeles County in thethree (3) years before submitting an application. The City is adopting the Fair Political Practices Commission's Form 700 for this purpose, but City Charter provisions in Article XVIII requiresinformation about interests in rental property in Los Angeles County for three years, not the oneyear the FPPC Form otherwise uses. Under City Charter Section 1811(b), these documents are public records; they will not be confidential.

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 ownershipstake 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 otherrental property rented or offered for rent for residential purposes, whether or not such unitspossess a valid Certificate of Occupancy for use as rental housing, together with all housingservices 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
I, M\^^ U^4/Z, (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 L\ day of /^f<^^\Signed:.
_, 20 Z5.

Printed Name: Ali{^>\ ^AFi
% 2^ ^ ^
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•K^^
§?^s y

CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
1, /^ 11 ( ^<SA ^< ^(/'\ /^L| (pri nted 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. i

3. I reside at the following address: Pasadena, California '7// c?i"( (zip code) -^ I. (street), OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.

Signed this <~i day of^-^^A_, 20 ^
Signed: -k( [ [^A ^ A/\ ^-^^Printed Name: -^/ U ^M H ^ ^^n ^^-
I
Allison Henry
I Linkedin:

Summary: I have over 10 years of outreach, policy, and organizer experience in housing. I value relationships and education for productive empowerment of communities around more equitable housing policy.

April 2023-present
Experience:

At-large member Pasadena Rental Housing Board
City of Pasadena
• A lead author of the Pasadena Fair and Equitable Housing Charter Amendment (Pasadena Measure H), specifically the rental board and rental registry chapters.• Host 6 community workshops and engaged more than 700 community members as Lead of the Education and Outreach committee. • Serve on the Policy and Regulations Committee and Relocation Policy Committee, helping to build departmental infrastructure and build out staff capacity.

Lead Organizer, San Gabriel Valley November 2021-March 2025 LA Forward Institute • Increase LA Forward base by approximately 1,000 San Gabriel Valley and Southeast LA Cities community members, and hosted more than 12 voter education events and policy teach-ins.

Co-create and facilitate 4 transformative community and leadership development policy and campaign academies with over 100 participants.Secure new contract with Best Start Region 1 [3-year grant project in collaboration with two other partners to develop housing policy leadership); currently serve as lead project manager and curriculum developer for a cohort of400+ members.

Lead policy and data analysis of housing elements, and housing policies to supportcommunity and stakeholder engagement for 6th Cycle Housing Elements in SGV cities for more equitable protections and programs in 6 cities, with over 50 public comments.

Co-Founder, Organizer April 2020- present
San Gabriel Valley Tenants'Alliance
Manage budget and communications like press releases, op-eds, and social media posts. • Build base to over 400 tenants and tenant supporters in 6 SGV cities.

Member, Housing Element Task Force April 2021-July2022
City of Pasadena
• Appointed because of my lived experience and experience in tenants rights and rent stabilization policy to guide efforts for the 6th cycle Pasadena housing element. • Led motion for Housing Task Force Recommendation to City Council to adopt a local rent stabilization ordinance by the end of 2022.

Regional San Gabriel Valley Field Organizer January 2020-February 2021 Everyone In LA
Covered 15 cities; grew our base in the SGVto over 150 coalition partners and 120,000supporters.

Co-managed and led Measure} field program for the San Gabriel Valley.

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

Tenant Organizer, Policy Advocate, Campaign Manager, Treasurer Pasadena Tenants Justice Coalition /Pasadena Tenants Union October 2016—August 2020 Secured over 12,000 signatures for rent control and tenant protections in Pasadena with ACCE, LA Voice, AHF, and Housing Now!
Organized tenant actions including pre-AB1482 loophole closures and moratorium, Pasadena's 2019 Tenant Protection Act, and 2020 COVID19 eviction moratorium.Volunteer coordinator and communications manager for PTU during 2017-18 rent controlcampaign.

Account Executive, California and HawaiiPerformance Matters December 2015-September 2017
Director of Educational Partnerships, Southern California and Washington Solution Tree August 2014-December 2015Academic Program Director and English Instructor Mentor Language Institute, Hollywood, Ca
November 2013-July 2014
Regional Content Specialist, California and southern Arizona November 2008-August 2013MacmiIIan Higher Education USAEnglish Discipline Specialist, US Western DivisionHoughton Mifflin/Cengage Publishers Marketing Manager: Composition, Psychology, and Sociology W. W. Norton & Company
College Sales Representative, Florida
W. W. Norton & Company
Instructor, English as a Foreign Language
San Luis Obispo, Dublin, Orlando
Legal Assistant/Researcher
Holstein, Taylor, and Unitt (Riverside),
Diane E. Davies (Morro Bay)
December 2005-November 2008
May 2003-July 2005
July 2000-July 2005
September 1997-December 2005
January 1993-June 1997
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
Atlison Henry, District 3 Tenant applicant, At-large applicant. Alternates applicant Pasadena Rental Board Application, March 2025
Community Service
Former Board Member, 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.

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)
Describe vouLrelevantJife experience, professionaj training, and/or education in the following areas:Housing/HousingJustice/LandIord Tenant Relationships/Real Estate:

Currently I am one of the four at-large members serving on the Pasadena Rental Housing Board. I was lead of the ad hoc communications and outreach committee. That committee, working with Allegra Consulting and interim-director Phillip Leclair, took a lead role in creating a contact list of over 700contacts, supporting 6 public facing workshops, transit media and utility bill inserts, and items likeeducational brochures and fliers.

I have lots of relevant experience to serve on the rental board. I have helped tenants correct illegal rentincreases; 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 COVID 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 Hilt, 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
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 RentaLBoard?
As a current member, I add consistency and productivity based on my first two years of service on the Pasadena Rental Housing Board. I thoroughly read the agendas and public comments; deliberate on resolutions, regulations, and motions; and provide critical thinking on issues that come before fora fair outcome consistent Vu'ith the charter amendment.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 includingwith local landlords, tenants, homeowners—neighbors—which means I strive fora communityapproach. I am also able to read through documents and other attachments and can think on a systemslevel. It is with this systems level thinking and knowledge of various city departments that I pushed forthe rent stabilization department to utilize our Pasadena community services representatives at the Jackie Robinson Center as temporary counselors, leading to the hiring of one of those employees as the first permanent housing counselor for the rent stabilization department. The community services representatives had been working on tenant landlord issues similar to what would be required of housing counselors to support the implementation of the charter amendment.

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 so that the Pasadena Rental Housing Board has integrity and to demonstrate Pasadena's commitment to democracy and equity.

How would you help to achieve these objectives and goals?I would help to achieve this by having full knowledge of Measure H and being witling to learn what's necessary to fill in gaps with city systems, laws, and practice. I am a close reader, can think aboutsystems, and value the importance of data. I hope to be part of a team with the board forimplementation as spelled out in the measure and what to do when situations arise that are not spelledout in the measure. I also try to educate members of the public as well as board members about theprocess and procedures of public meetings since for many this is their first experience with serving on acity body or participating and commenting in public meetings. I also give fair hearing to opposing viewpoints and consider all stakeholders.

CALIFORNIA FORIVl700

FAIR POLITICAL PRACTICES COMMISSION
Date Initial Filing Received
Filing Official Use Onf/
P/ease type or print in ink.

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE

A PUBLIC DOCUMENT
7m ^K-I. pyn.nrRECEIVED NAME OF FILEf? (LAST) ^{\r4. (FIRST) Mi, ^A (MIDDLE) - .. .^. ^.. S^2-ai4^^CLERK 1, Office, Agency, or Court ^'yWr^SAOENA
^ncy Name (Do nof use acronyms^ PA <?^^/^^ j2^i-6^ U^ijS/^ ^ivur^ S^^xTz) ^QM^ooJ^ Division, Board, Department, District, if applicable ^ ^^A^t^AUl //'^;S'M<
Your Position
> If filing for multiple positions, list below or on an attSchment. (Do not use acronyms) i/' /? yi +
Agency: Position:

2. Jurisdiction of Office (Check at least one box)
d State
D Multi-County
^1 City of 9^^yM^L
D Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction)
Qg-County of /^S AiA^J^S
D Other

3. Type of Statement (Check at least one box)
Q Annual: The period covered is January 1, 2024, through December 31, 2024.
•orThe period covered is / /
December 31, 2024.

D Leaving Office: Date Left J_ J_
through
(Check one circle below.)
D The period covered is January 1,2024, through the date of leaving office.

D Assuming Office: Date assumed _/_ J_
-orQ The period covered is _/_ _/_ through
1S7 Candidate: Date of Election t^O'^^Lthe date of leaving office. and office sought, if different than Part 1:

4. Schedule Summary (required)
Schedules attached
> Total number of pages including this cover page: ^-
Q Schedule A-1 • Investments - schedule attached
|_] Schedule A-2 • Investments - schedule attached
Schedule B - Rea/ Property - schedule attached
•or- Q None • No reportable interests on any schedule
"^Schedule C - Income, Loans, & Business Positions - schedule attached Q Schedule D • Income - Gifts - schedule attached Schedule E • Income - Gifts - Travel Payments - schedule attached

5. Verification

MAILING ADDRESS STREET
(Business or Agmcy Address Recommended - PuWc Documentl cin' STATE ZIP CODE
/v" T- ^S^.^L^ ^ WO^ DAYTIME TELEPHONE NUMBER EMA.IL ADDRESS s
_/_ I have used all reasonable diligence in preparing this statement I have reviewed this statement and to the best of m'/knowledge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a public document.

I certify under penalty of perjury under the laws of the State of California that the foregoing Is true and correct.

Date Signed ^/<-// 2JT Signature
(monn, da/ yeai) 'orfgmaty signed paper statement Xtth your Sny oflfa'af.) FPPC Form 700 -Cover Page (2024/2025)
advlcelgifppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page-6

SCHEDULE C
Income, Loans. & Business
Positions
(Other than Gifts and Travel Payments)

CALIFORNIA FORM
FAIR POLITICAL PRACTICES COMMISSIONNameMJ/SM ^^nr^
/
> 1. INCOME RECEIVED
^ME OF SOURCE OF INCOME
^n/')^J l^^tu-6^.

ADDRESS fBusmess Address Acceptable) ^ -t
BUSINESS ACTIVITY, IF AN/OF sbURCE Dr^
—^^-^
C^^too^
COUR BOSINESS POSJTIONSG'\J l^oj Or^\\z^r
GROSS INCOME RECEIVED Q No Income - Business Position Only LJ $500-$1,000 D $1,001-$10,000
$10,001 - $100,000 Q OVER $100,000

CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary || Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.)
Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.)
Q Sale of
(Real prvperty. car. boat. etc.)
II Loan repayment
I] Commission or [| Rental Income. list each source of Sio.ooo or more (Describe)
C] Other.
(Describe)
> 1. INCOME RECEIVED
NAME OF SOURCE OF INCOMEADDRESS (Business Address Acceptable)BUSINESS ACTIVITY, IF ANY, OF SOURCE

YOUR BUSINESS POSITION
GROSS INCOME RECEIVED Q No Income - Business PosiUon Only Q $500 - $1,000 Q $1,001 - $10,000
$10,001 - $100,000 Q OVER $100,000

CONSIDERATION FOR WHICH INCOME WAS RECEIVED
II Salary || Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.)
D Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.)
Q Sate of
(Real property, car, boat. etc.)
I] Loan repayment
Commission or |] Rental Income, list each source of 110,000 or more (Describe)
Other
(Describe)
»• 2, LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD * You are not required to report loans from a commercial lending institution, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows:

NAME OF LENDER*
ADDRESS (Bua'ness Address Acceptable)

INTEREST RATE
"h Q None
TERM (Months/Years)

BUSINESS ACTIVITY, IF ANY, OF LENDER

SECURITY FOR LOAN
Q None Q Personal residence

HIGHEST BALANCE DURING REPORTING PERIOD
$500. $1,000$1,001 -$10,000
Q $10,001 - $ioo,ooo
OVER $100,000
[_] Real Property Street address
Cfly
[_] Guarantor
Q Other.
(Describe)
Comments:

FPPCRirm700 - Schedule C (2024/2025)
advIcetBfppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page-14
District 3 & At Large

RECEIVED
2025^21 PHI... ^.
,.cr!'v CLERK C^Y OF ^SADENA
^PAS^
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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 filesJanuary 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:

Home Address:
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Mailing Address: ^06{^f^ )
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Email Address:Business Phone:
hlome Phone:
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Date Available to Start:
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Cell 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-Iarge 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. ^pft^Ls^ \0^r^<y CC^n^-4-3.<J>(»<5aA^ ti^^^r^^^i^r-^uv^^^t^)^-' ^-oyb^ .'ToP/Pci<>(x(^Lv^j0^ Cb r^^iy-^ .^sp^^AYv^j^AYw^ ^>r <T>a<,A,cltv^v^ ^~ cv\^ -^O^VY\^^ / C-i^r-rA/Y-V ^I'C.^- ^(Sl^ •<f>f- ^>C^C\(i&ynPV '1^0-^7^ 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. ^Jr^r^^C ^ C^PD^-~IA/\\^ ^ -Qi^ i^^ri^^ ^--^^k c>^0o] %^ - Yw^^aV^^ ^^V. ^ ^\:^^ ° u 'iCA ^

1. Have you ever worked for the City of Pasadena? f/fyes, please list dates/department) ^ -^ -^/+v^J f^yS
YES NO
D

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)

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 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 anypotential conflicts) YES
YES
NO
DNO
D
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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 extendedfamily, or in which any member of the City Council, or member of the City Council's extended family, has any ownership stakein said property?

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

8. Are you aware of the time commitment necessary to fulfill the YES obligations of the Pasadena Rental Housing Board?
D NO
NO \V
DNO
N<NO Q
Extended Family: any spouse, whether by mam'age or not, domestic partner, parent, child, sibling, grandparent, aunt or unde, niece or nephew, grandchild, or cousin (Charter Section 1803(g)).

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

10. Can you, upon appointment, provide proof of identity and proof YES of eligibility to work in the United States, as required by Federallaw? NO
NO
D

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

VVQVV'^ ^C^v^Ca^^ ^7-4^^^ -R^ ^C V^(3^^ Vw^^P -h? 1^c<J 4^ ^r^A'i <4^ c^ rjk^- <?»^ f^^;. -^- 0^ VYc^ ^oA^ ^r '^HP. -c V^G^. Vw^f ^/^'Ce^v ^cO^^ro^ <Qe^w4-vw'^- ar\f-) ^^VvJ<^<^-Ve.- t^j^v^^ ^12. How would you add value to the Pasadena Rental Housing Board? ^->;\\ dc'r\^r\ixe. \-V-v^ (^C3>T^v (A/^ ^w>. <s34~c^4-^^ ^,r~ ^\-^.
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13. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board? ~-^7~> V^tAAA CK IY^f\r^P^ Y^A-\^€C,r\ 4-<a^cy^\-^ ^^\<^ |<?v^fco^ V^>V^\\^ Ovhll^o^L/'.vy-.^c1 -H^^ ^/)k^v^^-V^^<-^ oC >^WjE\6t\^ <^ ^A. ^ - \^» » I (I • ^ „ \- . > I . \\ - .\ ^- 1. < V^J^\^ UA '*S C\\<b(7 -^-n L.y>(-^ IA^»:\\^- r ;Vy ^o^.^^'V ^y^ c^ t7A\ ^^P^T^'V^v^yy^V \-D W^'\^^ <>^r<2^ <Sgi ^wo^ ^^Atf ^ Y-5 ^i^a^o^ ^-^ 4L^^

14. How would you help to achieve these objectives and goals? ^1^^ (C^>n-^^ww^_ ^-o -k3^^ )?^<c^fy k^ilr^ \^wvv^_ t-^ -k'3Lff^ )Qrn,'cl^'^ ^(AilQ)^^, ,^ -t^e^ \^VH^^ Ol\^o t,^^y,^4'fo Y^I^^ ^^^ \'r^?)^rvy-A-i<n»^ ^-S> \3€^^^\, ^SYN'<z^e<^/ •'
I, i^>fb^r<^jy\ l-^^yw,^ (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
Signed:
?t day of. a,^,] _, 20^5-
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Printed Name:^Kn^^\Af^ L^n^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 (Charter Article XVIII). 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. ^5 of the City of Pasadena I reside at;
CA G\^D^ (zip code).

Signed: _
_) (street), Pasadena,
^-
Printed Name: irx\ i—<n|W\(?^^~

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

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 CaliforniaAn 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, ora 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 theresidency 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 (Charter Article XVIII) 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 City Charter provisions in Article XVIII 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.

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 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, ^43^^/^41Sy^ I-^O(YY\(V^' (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 -^lday of^^^i'l
Signed: ' /^^^^->==^8^-
_,20j£?
Printed Name:' ^-^yv^c^
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
^TW" (printed name), declare under penalty of perjury under the law of the State of California 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 44!{ps (zsp code)
v^s.
k (street),
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.

Signed this 9-) day of (^/^h') _, 20^?.

Signedi^———?
">
Printed Name: irdnr\ t-~^{.YY-\r>.^^
CALIFORNIA FORM700

FAIR POLITICAL PRACTICES COMMISSION
Date Initial Filing Received
Filing OITidal Use Only

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE

A PUBLIC DOCUMENT RECEIVED
P/ease type or print in ink.

NAME OF FILER (LAST)
^=-^.r^r\r/^- ^cA (MiDDLg)/b^R2! TH 4:07

1. Office, Agency, or Court './i i • ••--i-;ir\r\ CiTYOFPA?;dDTOA Agency Napie ^Do nof use acronyms) U^\'^ O^C i^-s^^^Jt/r\ftA.

Djyjsion, Board,'Department, District, if aj'iplicable
> If filing for multiple positions, list below or on an attachment. (Do not us\ Agency:

Your Position
y^^ac^pA^^A t^nA-^i) V{ffiA^^^^ P/p/pl}\r^~
lyms)
Position:

2. Jurisdiction of Office (Check at least one box)
D State
D Multi-County
a/cityof ^^c\^/^
D Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction) Bounty of L^S /^^^)-^<
D Other

3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2024, through
December 31, 2024.
•or.

The period covered is / / _, through
December 31, 2024.
d Leaving Office: Date Left . _/_ J_
fC/iec/c one circle below.)
D The period covered is January 1,2024, through the date of leaving office.

Assuming Office: Date assumed _/_ J_
•orQ The period covered is _/_ J_ through
the date of leaving office.

Candidate: Date of Election I Y^>i< ^ / and office sought, if different than Part 1:.

4. Schedule Summary (required)
Schedules attached
> Total number of pages including this cover page:

Schedule A-1 - Investments - schedule attached
[_] Schedule A-2 • Investments - schedule attached\_\ Schedule B • Rea/ Property - schedule attached Schedule C • Income, Loans, & Business Positions - schedule attached Schedule D • /ncome - Gifts - schedule attached
D Schedule E • Income - Gifts - Travel Payments - schedule attached •or- 0 None • No reportable interests on any schedule

5. Verification

MAILING ADDRESS STREET
(Business w tnrn"'tiirimcs Rfmmmended - Public Docunynt]

CITC STATE ZIP CODE
^< i/»
^>
'^ * ^^^^^ r.^ ^/^
DAYTIM|TELEPHONE NUMBER [EMAIL 3RESS
I have used all reasonable diligence in preparing this statement, I have reviewed this statement and to herein and in any attached schedules is true and complete. I acknowledge this is a public document.

I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct Date Signed '^1
hvta'{^BaV"
Signature
IWieMTSIlKywr ng officfaf.;
/
FPPCR3rm700 -Cover Page (2024/2025)
[email protected] • 866-275-3772 • www.fppc.ca.gov
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CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO T
PASADENA RENTAL HOUSING BOARt
FORMRHB-001 20?i,OCT3( AM (0: (2
The information contained on this form will be used by the City Council to fi^y^c^ngp^gn the Pasadena Rental Housing Board. Please answer all questions. You ai!§fipYi1@<{(-t^|^{^^itional pages, a copy of your resume, or submit supplemental information which you feet'm§y'^ate6iS{ 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 stitl current and can be used for an additional year.

Applicant Name: Simon Nicholas Ybarra^
Home Address:Mailing Address;
Email Address:

Business Phone:
/ iaCA91101
, Pasadena CA 91101
'm
Home Phone: Cell Phone:

Date Available to Start: December 1,2024
••
Board Se'at Type: Indicate the type of Board seat in which you wish to fill (mark one or more):

Pasadena Tenants Union - Volunteer Housing Counselor
•••
]
!
Employment- Title and duties, current and past (acceptable to attach resume as an alternative).

Resume Attached
Education - Include professional or vocational licenses or ceriificates.

Associate of Arts - Business - Pasadena City College
Associate of Arts - Engineering & Technology - Pasadena City College ">.
r.

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)
YES NO

3. Are you aware that financial disclosure is required annually? (e.g., sources of income, loans andgiHs, 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
NO
NO
i
><.'>>.

5.6. 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?
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 |X1 NO obligations of the Pasadena Rental Housing Board?
' Extsnded Famly: any spousa, whelhsrby mamaga or not, domasllc partner, pafent, chlU, •Ibllng, grandparent, aunt or uncla, niow or nephew, grandchlldi or cousin (Chartar SacUon iao3<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 NO

10. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate: I have been learning about housing policy and precedent as part of my participation In the Pasadena Tenants Union for the last year and a half. Over the summer, I produced an Initial draft of an original research project on California's varying rent regulations and eviction protections to examine the impact of the Costa-Hawkins Rental Housing Act and local laws on eviction rates using data from the Eviction Lab,

11. How would you add value to the Pasadena Rental Housing Board? I bring data analytics training, a rational focus on policy outcomes, and familiarity with state and local housing laws to the table. I am a consensus builder with some experience in meeting facilitation and work-group mediation. I am a logical problem solver, used to reading regulations and identifying loopholes or unintended outcomes. i
(

12. What do you view are the primary objectives and goals of the Pasadena Rental Housing The PRHB's primary objective Is to promote healthy, sustalnabte housing for tenants in Pasadena without undue cost to the rights and Board? profitability of landlords. This is served by Identifying rental units, regulating evictions and rents appropriately to reduce Impact, and discouraging retaliatory behavior or evasion of regulations.

13. How would you help to achieve these objectives and goals? I would strive to improve the quality of regulations passed by the board. I would support its outreach and data gathering efforts. 1 would also set achievable goals to address areas of confusion like the status of vacancy controls for different types of units or tenancies and the recommendation of regulations furthering Pasadena's Etlis Act implementation to the city council.

I Simon Nicholas Ybarra (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, andcomplete.

Signed this S/ day of €?<:-^f>
Signed:,
<"^ _, 20 ?y.

Printed Name: S/.^^/? /^<S^/"A.

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CITY OF PASADENA
Residency Verification - IVIANDATORYRECEIVED
All applicants must provide proof of residency in a City Council distnct L/^^yipnj^^1(^of The Pasadena Fair and Equitable Housing Charter AmQndment (Measure H). Proof of ^es^ncy may be established by either of the following: ^,^ WY CLERK CITV OF FV(SAD£NA 1. If you are a registered voter, please complete and sign the following declaration and the City Clerk will verity your signature on file with the Los Angeles County Registrar of Voters. .1 t
am a resident of District No. s_ of the City of Pasadena ! reside a
CA 81101
(street), Pasadena,
(zip coue).

Signed:

Printed Name: ^iwo-^i y^^i^vc.
<
•

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 (DNIV) 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, industria! 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. b? s^
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CITY OF PASADENA
Affidavit of Tenancy -MANDATORY for Tenan dafd< V E D
and Tenant Alternate Seats
(Form RHB-003) ^ OCT 31 AHIO;13 CITY CL£RK i, Simon Nicholas Ybarra^,^ name), declare under penaltyWrfA^^^w 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. t reside at the following address: Pasadena, California ei.ioi (zip code) _ (street), I
i
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.
'••i.

Signed this 31 day of <Sfc/G'.^e^Signed: <^-y^^>^~^^^
-. 20JJL.
)
Printed Name: f/rtfCi^ y^^^t^k.
•
•
••
•
Change of Address Confirmation by the U.S. Postal Service Property tax bill or statementLetter 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 Vehide or Vessel Titles or registration (i.e., a title to, or a DMV registration for, a boat, truck or car) ADMV 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)
RFCEfVED
WW31 SHfO.-O
Alt applicants must complete a Statement of Economic Interest (FPPC Form 700)^d "economic Interests Affidavit" attesting to the information reported in applicant's Form 70^y^ pA^lnc 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)).

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 I
Simon Nicholas Ybarra(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 31 day of C^cfvberSigned: -, 20J^_.

Printed Name: ^fw^^ Garret.

Simon Ybarra
I

RECEIVED
X7LHPT ri I ftM in. (i

CITY CLERK

CITY OF PASADENA
Professional Skills Microsoft Office (including Access, Power Bl & Visio) Python / Java / HTML / CSS / Javascript Oracle SQ.L
Data Analytics via ArcGIS, Tableau, and SPSS
Education California State University, Los Angeles August 2023 - Present o Information Systems (Software Dev) BS, in progress o Accounting minor, in progress Pasadena City Coiiege January 2021 - June 2023 o Engineering & Technology AA o Business AA Dean's list, 2 semesters
September 2022 - Present
0 Work Experience
Writing Tutor o At Pasadena City College o Acquired CRLA Level 1 Tutor Certification o Developed one-on-one consultation skills to Identify and address student needs o Resolved tickets accurately and quickly during high volume hours Voter Records Clerk September 2020 - November 2020 o At the Los Angeles County Reglstrar-Recorder o Mastered office-speeific technologies as needed (Cherwetl, DIMS, GIS) o Maintained information security appropriate to sensitive records o Identified and resolved file duplications. Input errors, and voter updates . Department Manager May 2015-August 2020 o At Watmart Associates o Trained colleagues in the use of MIS technologies o Monitored department performance for systemic issues o Verified receipt of high-cost jewelry inventory shipments July 2023 - Present Volunteer Experience Tenant Counselor o With Pasadena Tenants Union o Counseling tenants through housing crises by clarifying how state and local housing policy applies to their issue and connecting them to additional resources CALIFORNIA FORIVl7QO
.FAIR POLITICAL PRACT)CE$ COMNIISSION
':•:• Please type or print :ln Ink

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE
Date Initial Filing Received Rlfiig Official ua Only
A PI/6L/C DOCUMENT RECEIVED
<}n?<ftCT'"'?t ^lpi<- ^

NAME OF FILER (LAST)
1^^.
(FIRST)
<i'/n.(?/i
^ 16)'' *
/l/^W^'CLERK

1. Office, Agency, or Court
CiTY OF PASAUfclW.

Agency Name (Do not usa acronyms)
Division, 6oard, Depadmsnt, District, If applicable
P^^lefih R-^/l-kt ^W\M B^
Your Position
> If flflng for multiple posttions, list belo^ or on an attachment f0o no( uss acronyms)App/Ii'M^.

Agency. Position:

2. Jurisdiction of Office (Check at (eas( one box)
a State
a MuIti-Courity
PM.S ^4^
Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction) D County of ... ,.

D Other .

3. Type of Statement (check at least ons box) Q Annual: The period covered is January 1,.2023, through December 31, 2023. •or-The period covered Is / / , , through December 31,2023. • '• •D Leaving Office: Date Left. J_ J.

D Assuming Office', Date assumed J_ J_
'(Checfconscfrcfe.)
D The period covsrsd is January 1,2023, through e date of leaving officer D The period covered Is ' I " L
Candidate: Dats of Section .yff^£-
the date of leaving office,
and office sought, ff diffsrenl than Part 1;,
—, through

4. Schedule Summary (required) Schedules attached
Q Schedule A-1 • InvQstments - soheduls attached
Q Schedule A-2 • /nvesfmshfs - schedule atfacheij Q Schedule B • Real Property - schedule attached -or- @ None - No reportabte fnferQsts on any schedule
>- Total number of pages Including -Ws cover page; 1
Q Schedule C • (nconie, loans, & Busfnsss Posffions - schedute atlached [_] Schedule 'D • Income - Gilts - scheduFe'attached D Schedule E • fncome - Gffls -'Treve! Paymsnts ~ schedule alfached

5. Verification
MAIUNS ADDRESS ' STREET • . (Busfness orAgsnoyAA'fBss fiecofnmended • Pubflc Document) i
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DAYTIME TELEPHONE NUMBER
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P<^^tA^

EMAIL ADDRESS
CTATE
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ZIP CODE
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I havs used all reasbnsblc diligsnce In preparing this statemenl I have reviewefi this statement and to the best $f my knowledgs the Infomiatton contained herein and In any aftached schedules is true and complete, 1 aoknowlsdge this is a public document I certify under psnafty of perjury under the laws of the State of California that the foregoing Is true and correctDate Signed ^t'fyl^ ?/, 2.<^t</ (fflonlh, ilaf, yeal) Signature <y-^^~^^^^ (Rle s original/sl?n8dj)apaf8(a(emantw!l)) yBurBngofficfaf.} FPPC Form 700 -Cover Page (2023/MZ4) [email protected],eo< • 8GG-Z75-3772 • www.filpc.ca.goit Page-5 Instructions
Cover Page
Enter your name, mailing address, and daytime telephonenumber Jn the spaces provided. Because the Form 700 is apublic document, you may list your business/office addressinstead of your home address.Part 1. Office, Agency, or Court • Enter the name of the office sought or held, or the agency or court. Consultants must enter the public agency name ratherthan their private firm's name. (Examples: State Assembly; Board of Supervisors; Office of the Mayor; Department of Finance; Hope County Superior Court).
• Indicate the name of your division, board, or district, If applicable, (Examples: Division of Waste Management;Board of Accountancy; District 45). Do not use acronyms. • Enter your position title. (Examples: Director; Chief Counsel; City Gouncii Member; Staff Services Analyst).
• If you hold multiple positions (i.e., a city council member who also is a member of a county board or commission) you may be required to, file separate and distinct statements with eachagency. To simplify your filing obligations, in some cases you may instead complete a single expanded statement and file It with each agency.
• The rules and processes governing the filing of an
expanded statement are set forth in Regulation 18723.1.

To file an expanded statement for multiple positions,enter the name of each agency with which you are required to file and your position title with each agency in {Mespace provided. Do not use acronyms, Attach an
additional sheet if necessary. Complete one statement
disclosing all reportable interests for ati jurisdictions.

Then file the expanded statement with each agency asdirected by Regulation 18723.1 (c).

If you assume or leave a position after a filing deadline, youmust complete a separate stcitement. .For example, a citycouncil member who assumes a position with a county specialdistrict after the April annual filing deadlin& must file a separateassuming office statement. In subsequent years, the citycounai! member may expand their annuai filing to inciude both positions.Example;Brian Bourne is a city council member for the City of Lincolnand a board member for the Camp Far West Irrigation District~ a multi-county agency that covers the Counties of Placer andYuba. The City is located within Placer County. Brian maycomplete one expanded statement to disclose all reportableinterests for both pffldes and list bath positions on the Cover, .

Page. Brian wilt file the expanded statement with each the City Regulation 18723,1(c), •"?-\;~^.-"'.;; *^;... and the District as directed by Regulation 18723.1 (c), Part 2. Jurisdiction of Office ' :*' Check the box indicating the jurisdiction of your agencyand, if applicable, identify the jurisdiction. Judges, judicial candidates, and court commissioners have statewide
jurisdiction. Alt other filers should rgvi.ew the Reference Pamphlet, page 13, to determine their jurisdiction. if your agency is a mulfi-county office, list each county In which your agency has jurisdiction.
• If your agency is not a state office, court, county office, city office, or multi-county office (e.g., school districts, special districts and JPAs), check the "other" box and enter the county or city in which the agency has jurisdiction, .

Example:

This filer Is a member of a water district board with Jurisdiction in portions ofYuba and Sutler Counties.

1. Ofdco, Aflanoy, or Coyrt
^)<!rqfM«i»f pa Bfl/(B» Wft^
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topidlon
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Prfin.

IZ.Jurltiflcllan of OKIci (ckwiiu.i «»,>»<!
Khlill-Couity YulKtft^titlsrCotutttc*
ni»i<.
aMp«-C«<lC«ritlk««|Iulf(*Jrii4*l|
ato-i"'——-——-
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Part3. Type of StatementCheck at least one box. The period covered by a statementis determined by the type of statement you are filing. If youare completing a 2023 annual statement, do not change the pre-printed dates to reflect 2024. Your annual statement is used for reporting the previous year's economic Interests!-.?, Economic interests for your annual filing covering January 1, 2024, through. Dece.mber 31, 2024, will be disclosecf on your statement filed in 2025. See Reference Pamphlet, page 4.Combining Statements; Certain types of statements tor thesame position may be combined. For example, if you leaveoffice after January 1, but before the deadline for filing your annual statement, you may combine your annual and leaving office statements. File by the earliest deadline.

Consult your filing officer or the FPPC. . .

Part 4. Schedule Summary
• Complete the Schedule Summary after you have reviewed each schedule to determine if you have reportable Interests.
• Enter the total number of compieted pages inctudlng the cover page and either check the box for each schedule you use to disclose interests; or if you have nothing to discloseon any schedule, check the "No reportable interests" box. . Please do not attach any blank schedules.

Part5. Verification
Complete the verification by signing {he statement and
entering the date signed. Each statsrhent must have an
-original ."wet"-signature, unless filecl.yjth.a secure eleGtrpoic signature, (See page 3 above.) All staterrtshts must be signed under penalty of perjury and be verified by t.he .filer pursuant to Government Code Section 81004. See Regulation 16723.1 (c) for filing instructions for copies of expanded statements.When you sign your statement, you are stating, under penalty of perjury, that It Is true and correct Only the filer has authority to sign the statement, An unsigned statementIs not considered filed and you may b.e,.subjebt to late filing penalties.

FPPC Form 700 - Cover Faee (2023/20M)
adulceS>fppc.ca.eou • 868-275-3772' wviw.fppc.ca.gov
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CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THE

Applicant Name: ^\\\/\^W Lyfl^-^-fc MX^^MCZ
Home Address:

Mailing Address: "
Email Address:
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Business Phone:

Home Phone:

Date Available to Start: p-5/ak-f>
Cell Phone: 1
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. IA We^y/.Coj^-V- y,'^^ ^n-K<2^. j l^. ftY^de^. Sc>r^ Tmpcf-^-royAct^ ^^r^e\w^ c\\f\\c v^\^YeQ(L^^ ph^.d&<.VJC.LP\ •&Lcj2^rp^ ^^ic/ y^^'VV^. rJ\'\Y\\r yK^n-Va^^ c i ,tiS ^rb^\P\ pt-<?-V pp 0-3 Cocia^ ^G^n-h2&^.Employment - Title and duties, current and past (acceptable to attach resume as an alternative). \^ f\ny\ei C^AI^ <o^ C^mmu'vr^L^^ av^ ftr^ion (^\ J\^^^« ^\v\9^^ ^^ tA^ l^i^ i i^ya" ^-^-^^ ?^\\C ^nrpl (Lpy.A ^^^^ai^t- ^ mcYJh^v\ CA^i^l <-rs^W oi5^
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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)).

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, I VuMStlY^O- Vfidl<240\^^L (printed name), declare under penalty of perjury under the law oftF?e State of California thiit the information provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete.

Signed this Jlsrjr day of ^QUzxv^OiU^ , 20^c-t.

Signed: C^ \\y^^.( ^ ^r^^ ^-^ 0
Printed Name: Q\^AsY\^- PodO^^CZ-
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
I, \,_AVA^<=^V^ l^-ccty^l<'7(i-<</-^. (printed name), declare under penalty of perjury under the law of the State of California that the forgoing is true and correct:

1. lama 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 followjng address: Pasadena, California c'JUo^ (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 V)Q_cejfvJop^ . 20_^j.

Signed: C ' ^\J^\.-t- VyPrinted Name: CHfUsV\^)- Vi^\^\<^, /
Education - Include professional or vocational licenses or certificates. ^)C.i-A <£.C^\co\ tip LTA.^ ^ wTvS^^. o^ l^^U s^<j^<e?' '\?T^-4-\a^ ^(^^ 0^iV<2^^^ctdh-e.[o^"o{L R^te, ^r^^sh

1. Have you ever worked for the City of Pasadena? (If yes, please list dates/department) YES DNO

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

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
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D
NO
NO
D

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 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 f7] NO || obligations of the Pasadena Rental Housing Board? ended Family: any spouse, vAether by marriage or not, domBstfc partner, parent, chUd, sibling, grandparent, aunt or unda, 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 NO
D

10. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate: VJQ^R^ (\<< A |p^J A^S^S^ilth.te ^W^- ^'^AS ^ui^ rhp ^'rtil \jg\^€Uo^ <OW^eJ^. QpA ^'i/<pJr-^-W^- \'W^L MC ^l^ ^y.col^.-A-^ r'4^^^'^ hA^ ^, ^CP() V^P^-^Mir^ ^<4- h^v^ ^\W<s j4C^^ i^- ^zz^a^^n<; i^n^l -H^ rjhcttle^e^ ^.^\-(?jf^ -^lG^^XlCT^ .<>'Y-A\e3l 7U p^;^^\Y>-t;&^l^^W^(3llA-h6n Qvd r^ll/^r^r.-t-Tfc/} ^

11. How would you add value to the Pasadena Rental Housing Board? '\'V\a(y^h ^AA^ \A)O\"^ -L Yia\^. hone^ iv\^ a)o-i\H-^ -^ in-^(7J^i%^ r 0'w^eSL \ p ^jd ^biw^sA )at24< <s: a ro\ frJLOCy ^1^ e ^^O^^VP j( ^ ^0^ e^,j:-V(?J?v^. ^o-n^nS' i P-AA<^'<?J ^ '^y^l<v4:S ^9^^^ CT^^h^LM_ (^\A -\n\<^z- ^y^s: ^^hpH;F,^KG' 'r>a\^- ^A^a-ft4^ -fo^ hovn^o.MrpJES^12. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
?'\ZHB \!^(\^ C^e^ed \o MpVio^ M<^l\u^^ -H..Tr»2- ^xytv^ t^o(y^_bL ^^v--^^ ^a^^. a.v^ bAV*,n(^A. ^^<.'u-^ ^(ZArTKcP^ -fo'P. |^c?r-h -Pt-^lA^ a^V
\>i\^\ ^\OP©IS ' ^Q}ec-^\\e.^ \^c\ w^. ^I£)YV\C^^ hojsi Y^ s-V^ bi 1 r+g--^- -<-(M\Z. \N\\\\ '^oweo'^^<& /Tirol 4&^^yu^ -^o -(-^^^-yS- ?^^Y^\J'irt1't~^_^iltl 113. How would you help to achieve these objectives and goals? T ^ll\le^^(? m\A^ ^\^^s\-or^ py^^-((^^ ^ a \ey\ t\^s\s\eu^- \n^ S^\\^ \V\ '(^va-a^^ 4o(2- +c.Wi ^ -(U^Vd^ , ^ YNd M ^ ^^11 ^+lt3r[ -^s e^\n+aA->\p y)^e>\ <^ <p^'iv t'^^ ' '^ h^^ ^1 Ir^ (?'y-p^?j^<y ^ ^i^ssW^A \<^&^\p5Jc^ o{- -^ ov^\\^eS i^^\2^^ c^^ -KL^-C "^^, 1^ ^\A-VS-V^'^ ^~cC\\4'^'v^t: (printed name), deciare under penaity of perjury under the law o\ the State of California that the information reported in this Form RHB-001 is true, accurate, and complete.
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Signed this day of O^ceA'Abe^- 20 ^y_.

Signed:

Printed Name:
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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 resident of District No. 'S
I I reside at
CA (^\^0\ (zip code).
of the City of Pasadena
(street), Pasadena,
Signed
Printed Name
: CW-QT^
3:ClAASjnr^

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 statementLetter 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 CaliforniaSecretary of State or the Los Angeles County Registrar of VotersProof 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, ora DMV registration for, a boat, truck or car) A DMV No Fee Identification Card Eligibility Verification (DL 933) form, completed and signedIf 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 ser/ice. 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 EKtended 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 thetr 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 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
I, i^6'L (printed name), declare under penalty of perjury under the law of Vne State of California th&t the information provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete. , C\\NS^r^ Signed this JLerJr day of Deusmbu^- , 20-2^.

Signed: C^ \\>^~><-( ^ ^<^>^ *^J 0
Printed Name: Q^AsYSv^- ^C^Q^L
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
I, \. }{<\u^-\\\^i \^di\^^L^ (printed name), declare under penalty of perjury under the law of theState 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. ! reside at the foHowing address: Pasadena, California ct^t)\ (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 T)<2.rp^Jap.t2- • 20_^(.

Signed: ^ ' H\^A^- \^
Printed Name: CWJ.sV\vvo- ^^^A^vj^
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CALIFORNIA FORIVl700

FAIR POLITICAL PRACTICES COMMISSION
Date Initial Filing Received
Filing Official Usa Only
Pfease type or print in Ink
STATEMENT OF ECONOMIC INTERESTS ^ '^aRoeCOVER PAGE '^ECE .^cooc^ ^^^

NAME OF FILER (LAST)
^.oC^'R^je'L
(FIRST)
O^^s-^ne
(MIDDLE) \^W^^^J-^

1. Office, Agency, or Court -• • ••--•syt.f'^
Agency Name fDo no? use acronyms) C\^\ ^ P^sad-w^
Diw'sion, Board, Department, District, if applicable Your Position ^S(\A^^ ^prtAA ^yJ^yg ^u-^ ^^^-rv^e. -T-eA-vavv^ >- If filing for mulHpte positions, list below or on an attachment fDo not use acronyms) Agency: Position:

2. Jurisdiction of Office (Check at least one box)
D State
D Mulb'-County
^City of '\>C\c^t^.d-Q^\c\
D Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction)
D County of
D Other

3. Type of Statement (Check at least one box)
'Annual: The period covered is January 1, 2023, through December 31, 2023.
•orThe period covered is / /
December 31, 2023.

D Leaving Office: Date Left . J_ _/_
through
(Check one circle.)
D The period covered is January 1,2023, through the date of leaving office.

D Assuming Office: Date assumed J_ _/_
•ord The period covered is J_ J_
Candidate: Date of Election
the date of leaving office.
and office sought, if different than Part 1:.
through

4. Schedule Summary (required)
Schedules attached
> Total number of pages including this cover page: -^
Q Schedule A-1 • Investments - schedule attached
Schedule A-2 - Investments - schedule attached
[_| Schedule B • Rea/ Property - schedule attached
"or- D None • No reportable interests on any schedule
Q Schedule C • /ncome, Loans, & Business Positions - schedule attached Q Schedule D - Income - Gifts - schedule attached
D Schedule E - Income - Gifts - Travel Payments - schedule attached

5. Verification

MAILING ADDRESS STREET
(BllSSfW^ '%r A/»Aftru A/Mnaff Dn^>nimnnrfar( . D^^C DOCUm6nt) CITY ^TATE ZIP COOE
)as^e^v W <^lUo1

DAYTIME TELEPHONE NUMBER I EMAIL ADDRESS
\y
I have used all reasonable diligence in preparing this statement I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a public document I certify under penalty of perjury under the laws of the State of California that the foregoing Is true and coi Date Signed ^| I |7^'2.c-) Signature
(monlh.day.yeffl)
^<-
(Rleheofgfnat/sfsnedp st
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FPPC Form 700 -Cover Page (2023/2024)
advlceSlfppc.ca.gov • 866-Z7S-3772 • www.tppcca.gov
Page-S
SCHEDULE A-2
Investments, Income, and Assets
of Business EntitiesfTrusts
(Ownership Interest is 10% or Greater)
CALIFORNIA FORM 700

FAIR POLITICAL PRACTICES COMMISSION
Name
> 1. BUSINESS ENTITY OR TRUST > 1. BUSINESS ENTITY OR TRUST +-^+ Qiiz-l ^e^-.kin^A ^03., a-c.

Name
^s N (^x^i^ r\^.p^^e^iaft^i^
Address (Business Address Acceptable)
^
Check one 9ck one
d Trust, go to 2 @ EBusiness Entity, complete the box, then go to 2

GENERAL DESCRIPTION OF THIS BUSINESS
M

FAIR MARKET VALUE
$0 - $1.999
$2,000 - $10,000»10,001 - $100,000$100,001 -$1,000,000Over $1.000,000 IF APPLICABLE, LIST DATE:

ACQUIRED DISPOSED
NATURE OF INVESTMENTQ Partnership @/Sole Proprietorship Q. Other YOUR BUSINESS POSITION \\^\e^r
Name
Address (Business Address Acceptable)Check one
D Trust, go to 2 D Business Entity, complete the box, then go to 2

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
$0 - $1,999
$2,000 - $10,000
$10,001 -$100,000»100,001 -$1,000,000Over $1,000,000
IF APPLICABLE, LIST DATE:
7—y2S_

ACQUIRED
y_j23-
DiSPOSED

NATURE OF INVESTMENT
Partnership Q Sole Proprietorship Q CXher

YOUR BUSINESS POSITION
> 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA • >• 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA SHARE OF THE GROSS INCOME IS THE ENTITY/TRUST) • SHARE OF THE GROSS INCOME 10 THE ENTITY/TRUST) D $10,001 - $100,000Q OVER $100,000
$0 - $499
D $500 - $1,000D $1,001 - $10,000>• 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF INCOME OF $10,000 OR MORE (Attach a separate sheet If ncccssaiy.) >ne or | |Names listed below
D $10,001 - $100,000Q OVER $100,000
>• 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR

LEASED BX THE BUSINESS ENTITY OR TRUST
Check one box:

INVESTMENT
|_| $0 - $499[_] $500 - $1,000Q $1,001 -$IQ.OOO
> 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
1NCOIVIE OF $10,000 OR MORE (Attach n separate sheet H necessary.) II None or |_| Names listed below
> 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR

LEASED EY THE BUSINESS ENTITY OR TRUST

Q REAL PROPERTY
Name of Business EnUly,Assessor's Parcel Number or Street Address of Real PropertyDescription of Business Activity BLCity or Other Precise Location of Real PropertyFAIR MARKET VALUE $2,000 - $10,000$10,001 - (100,000$100,001 -$1,000,000Over $1,000,000

NATURE OF INTEREST
f—] Property Ownership/Deed of Trust
IF APPLICABLE, LIST DATE:

ACQUIRED DISPOSED
Q Stock Q Partnership
Q Leasehold Q Other
Yrs. remaining
II Check box if additional schedules reporting Investments or real property are attached
Check one box:

INVESTMENT REAL PROPERTY
Name of Business Entity, if Invesbnent, £[Assessor's Parcel Number or Street Address of Real Property Description of Business Activity ECCily or Other Predse Location of Real Property

FAIR MARKET VALUE
$2.000 - $10,000
$10,001 - $100,000$100,001 -$1,000,000Over $1,000,000
NATURE OF INTERESTI] Property Ownership/Deed of Trust
IF APPLICABLE, LIST DATE:
723_

ACQUIRED
J /23

DISPOSED
Stock D Partnership
Leasehold
Yrs. remaining
Q Other
I] Check box If additional schedules reporting investments or real property are attached Comments: FPPC Form 700 - Schedule A-2 (Z023/2024)
[email protected] • 866-275-3772 • www.fppc.ca.gov
Page - 9
Rabies, Sandra
.•'rom:

Sent:

To:

Subject:

Christine RodriguezWednesday, February 26, 2025 4:47 PM Robles, Sandra
Interest in D5 Tenant Position & At-Large PRHB
[)|| You don't often get email from earn why this is important ^] CAUTION: This email was delivered from the Internet. Do not click links or open attachments unless you tooivthe content is safe. Report phish using the Phish Alert Button. For more information about the Phish Alert Button view article "KB0011474" on the DolT portal.

Hi Sandra,Thank you so much for reaching out to me regarding the open positions for the Pasadena Rental Housing Board. Emailing to confirm my interest in submitting my application for the DS Tenant Position, as well as the At-Large PRHB position. Please let me know if any additional information is required or if you have any questions.

Best,
Christine Rodriguez
She/her
Alternate Tenant, Pasadena Rental Housing Board
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CIT^ OF PASADENA

BIOGRAPHICAL DATA FOR APPOINTMENT TO CITY AW
Fhe information contained on this form is for the City Council to fill vacancies on City Advisory Boardsy^pfl^i&sions, Committees, or Task Forces. You are invited to attach additional pages, a copy of your resume, or submit supplemental mfOrmalifyi ^licfyyp^fpel may assist the City Council in its evaluation of yoitr application. „ • <r ( { Biographical forms may be submitted any time during the year; however, they -will be purged January 3tky6a^yeir.c^6^fiave not been appointed to an advisory body during the preceding year and still desire appointment, please resubmit an updated bibya^/fical form or advise in writing that the initial form is still usable.

On which Commission would you like to serve? Pasadena Rental Housing Board (PRHB) Applicant Name: Christine Lynette Rodriguez
Home Address: , Pasadena CA 91101
Employer: Los Angeles Center for Community Law and Action Work Address: ~ ~ ,Los Angeles, CA 90033
Date available to start:

Home Phone: (
Work Phone: ( )
E-mail:

Community Service - List boards, commissions, committees, and organizations on which you are currently serving or have served, offices held and in what city.

La Defensa, Court watch volunteer, Los Angeles
Social Impact Center, Expungement clinic volunteer, Los Angeles UCLA El Centra, Los Angeles, Reentry Clmic volunteer Los Angeles Art Deco Society, volunteer, Los Angeles Employment - Title and duties, current and past.Los Angeles Center for Community Law and Action, Legal Assistant for tenant rights Employees First Labor Law, Legal Assistant for employee rights Public Counsel, Legal Assistant for foreclosure prevention Matian Law, Legal Assistant for immigration rights Education - Include professional or vocational licenses or certificates.

UCLA School of Law, Master of Legal Studies 2024 Portland State University, Bachelor of Arts, English 2017 Personal - Answer "yes" or "no" to the following questions.

1. Have you ever worked for the City of Pasadena? (If yes, please list dates/department) YES

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

3. Are you aware that financial disclosure may be required annually? (e.g. sources of income, loans and gifts, investments, interests in real property.) YES NO
YES NO
NO
YES NO

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 financial holdings in relation to your responsibilities as a member of the advisory body to which you seek appointment? (If yes, please indicate any potential conflicts).

5. Have there been or are there now, any personal or business circumstances which might YES reflect adversely on the propriety of your serving as a member of any advisory body to which you might be appointed?

6. Are you aware of the time commitment necessary to fulfill the obligations of the advisory body to which you seek appointment?

7. What specifically in your background, training, education, or interests qualifies you as an appointee? Working as a legal assistant for tenant rights equips me with valuable experience and insight that make me an excellent candidate for the Pasadena Rental Housing Board. Through my work, I have developed a deep understanding of housing laws, tenant protections, and the challenges renters face in securing and maintaining stable housing. I have honed my ability to inteq^ret complex legal frameworks and advocate effectively for equitable solutions, ensuring tenants' voices are heard and their rights are upheld. This role has also strengthened my skills in problem-solving, mediation, and collaboration with diverse stakeholders—essential qualities for fostering balanced policies that benefit both tenants and landlords. My hands-on experience advocatuig for homeowaers facing foreclosure demonstrates my commitment to housing justice aud my ability to contribute meaningfully to creating a fair and sustainable housing environment in Pasadena.

8. What do you see as the objectives and goals of the advisory body to which you seek appointment? The objectives and goals of the Pasadena Rental Housing Board are to foster fair and balanced rental housing policies that protect tenants' rights while the rights of homeowners are also upheld. My key objectives would include promoting housing stability in order to limit displacement, ensuring compliance with Measure H, encouraging fair housing practices, being fair with both landlords and tenants to foster community harmony, and provide educational resources regarding housing rights. Both tenants and landlords

9. How would you help achieve these objectives and goals? What special qualities would you bring? To achieve the objectives and goals of the Pasadena Rental Housing Board, I would leverage my professional experience, skills, and dedication to equitable housing policies. Drawing on my background as a legal assistant for tenant rights, I would analyze and support initiatives that promote housing stability and affordability while ensuring compliance with legal standards. My experience mediating tenant-Iandlord disputes has equipped me with strong communication and confiict-resolution skills. I would use these to foster productive conversations between stakeholders and find balanced solutions. Having worked closely with tenants facing housing insecurity, I bruig first- hand insight into the challenges they encounter. This perspective ensures that policies reflect the realities of those they affect. By combming my professional expertise with a genuine passion for housing justice, I would contribute to creating fair and sustainable housing policies that benefit the entire Pasadena community. Signature: QJ^^ ()v^\-7<^ Date:

I hereby certify that the following infivf^aft^n is correct to the best of my knowledge. 12/1/2024
000000000000000000000000000000000000000000000000
One of the goals of the City Council is to balance advisory body appointments in tenns of geographic residence, location,ethnicity, gender, and age. The following information is desirable, but not required for appointment.

Year of Birth: Gender: F Ethnicity: LtA^I^ District # 5 If City resident, number of years:

CITy OF PASADENA
Commissioner Biographical Form - VOLUNTARY
This biographical form will be filed in the Office of the Mayor & City Council; if you are appointed to a commission, it will assist City Hall in responding to questions regarding your background as a commissioner if requested by the news media or interested citizens. This Biographical Form should be submitted along with your commission application.If you choose to complete the form, please be sure that the information provided is factual. It will be the basis for infonnation provided over the telephone and at the public counter. The form may be duplicated and given to the news media and it may also be posted on the City's website.

NAME: Christine Rodriguez
OCCUPATION: Legal Assistant
DISTRICT: 5 YEARS AS PASADENA RESIDENT: 4
EDUCATION & TRAINING:

UCLA School of Law, Master of Legal Studies 2024 Portland State University, Bachelor of Arts, English 2017 SERVICE RECORD:

La Defensa, Court watch volunteer, Los Angeles
Social Impact Center, Expungement clinic volunteer, Los Angeles UCLA El Centra, Los Angeles - Reentry Clinic volunteer MEMBERSHIP & OFFICES HELD IN CIVIC, RELIGIOUS, FRATERNAL OR TECHNICAL ASSOCIATIONS:

Pasadena Tenants Union
Los Angeles Art Deco Society
HOBBIES:

Exploring Los Angeles, riding my bike, fashion design
SIGNATURE= cw^
<JT DATE:_114J-L-707^L I hereby certify that the following information is correct to the best of my hzo-wledge. 0000000000000000000000 0000000000000000000000
When complete, email and send original to: ianaste'wart(a),cilvo fpasadena.net Jana Stewart
Office of the Mayor & City Council100 N. GarfleldAve., RoomS228 Pasadena, CA 91101

RECEIVED
2025 APR ! i FH ?= 0!

CITY CLERK
C!TY OF PASADENA
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CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THE

ApplicantName: G-^iiQ^^ ^4 . L^y-^
Home Address: _^ _ - " "'Mailing Address: ^CtA4\< o^> ^^t\^ " ,^s^o^^,0°i ^ll&l
Email Address:

Business Phone:

Home Phone:

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Date Available to Start:

CellPhone: ^.

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 .r^-
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 youare currently serving or have servpd, offices held yv} in what city. ~^r-^jl^ y&f/^4^^V^fyHy{ A^-^U ^T \A^hA^~U\ V^U/>V\-Q/V\ ^ C^^-SUL^J Employment - Title and duties, current and past (acceptable to attach resume as an alternative).
'l^t^ S^e ^M-ad^^i r^W^M^
Education - Include professional or vocational licenses or certificates. ^<DV^. Cede ^-e i^^^-lrOtVt ^1^^^^^^^^ ^^"(?<?5 ^'h^^^^^f^^^- ^^^ ^r^-ec^ 'riU^cA --s^, \w^ ''C^M'^(^-\-^ [U^H^ ,^rQ^.^~: ^C^^A ?)^ ^ /^<?1 n^'> ^^ TZ--^- ^\^u^\^^4^- ^^\^_-^Syv\^^1^c?^^&yvvfcy ^ '- \AS^Vt-h^e oV^^v^&y c,^^^^^__ ' 'io-^ 1. Have you eVer worked for the City of Pasadena? (lfye§, please list dates/department) a

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

3. 4.

Are you aware that financial disclosure is required annually?(e.g., sources of income, loans and gifts, investments, interests in real property)
YES NO
D
Rules of law and ethics prohibit members from participating in YES [^J NO ^j 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) 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?

5.6.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 memberof the City Council's extended family, has any ownership stake in said property?
Have there been, or are there now, any personal or business circumstances 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 obligations of the Pasadena Rental Housing Board?

7. YES ^ NO ||
YES
DNO
YES
DNO
YES NO
D
Extended Family: any spouse, whether by marriage or not. domestic partner, parent, chiM, 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 YES |^| NO | | consecutive years as a member of the Pasadena Rental
Housing Board?

10. Can you, upon appointment, provide proof of identity and proof YES |^] NO | | of eligibility to work in the United States, as required by Federal law?

11. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/LandIord Tenant Relationships/Real Esta^: A V^^i -4e4vi\ -l^v^d. f ^fe 4^K^<r\^ ^.c.&O iA4^<j>r^V->^^'i \
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F^J>|A^ OUiM^^l nng Bbard' ^n^l^/^O^C-O^WWVl CQWC^V^-Q^ \^K^\^ ^JdA^<s r&(4-(-\^^^/^lt^W^ ^fi9^j^\9 ^\r^<;< o^^^rei^e^^A cl^W^'CAV vcM^^k:. /\4l>^«^^ ^CMAW^ e^ ^^j(Ji\^^Hi ^v^^tSj<^^ ^<? r7v1Ly.^^vvy^n:^ lo&^ \A^.\[^[Jfyi^\ ^6^A -^4^4^ ^ l^tSjAl^pls ^IQK; ^^A ^ {^^[ffrd^ ^s j^r^ <{_^v^.^-^\o^ce . 13. What do you view are the primary objectives and goals of the Pdsadena Rental Housing Board? T L.T>^^ ~^U ^ ^rT,<sW^ 9D^rc<r^pv\^c^ <^u ^(^-P^ l<wU ^ ^«rc <yWvic^\peeA ^•ci^ ffz^re'i1^. -^.t^/A/f l>i'S[k4-t ^^{/^A^\ ^w^^n^ U^«Tc ^\nAc\vifti^ ^ie.w^ ffz^re'i^l ^d/^ff^ Siy\ ^[^ A ^ ^Uc^ -h> u<.<-^! A^ C6v^ J1S ,^S(M^V4c>-^v PTIY^^ 6^v\ <^S<5(\ ^(ri'^^A/L^<^€^lA^ i.^fy^/t fAiA^y^S^u^ ^^ ^.c^ffv\'. 1/(^^^-\\ p^c-^ J£^

14. How would you help to achieve these objectives and goals? \^y ^^^k/i'^fe-k^ rV&-W^vfS ^v^ ^<^v^lo-r^<>/<i>fy^?(/^ |^\?<^^£^ c^ \.^j aJ^ nw^cjs r<^oV^<<5Lcso^e<l <^/v-^ J^^4 <^>iA'~U^T^^eiA(,<;/^ ¥ tvil^ ^c ^cc-tr^^Jfe' <^Ac^t/i ^ ll <n\ ^ M^
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i, ^-cl»'k'^d<^ IM. • L-^-<T<?\ (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
Signed:
day of
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Printed Name:
. 20J^.
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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.
am a resident of District No. \o of the City of Pasadena I reside at
CA C\\\b\ (zip code).

Signed:
(street), Pasadena,
^
Printed Name: Eft 1(^0 W2. 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:

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 Caiifomia Certificate of Vehide or Vesse! Tsties or registratsQp. (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. g:
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Instructions: The Pasadena Fair and Equitable Housing Charter Amendment (Charter Article XVIII) 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 City Charter provisions in Article XVIII 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.

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)).

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
i, t^-< [(y\<^£\ \iy\ t-t/[fi\ (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, 20 2-^
Signed: /' A
\\ day ofJA^LA rVlA
Printed Name: V/d^cA^ l/lA. L^n\
"of
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
1, •^\\y\€^G\V V\- L-t?cK/\ (printed name),declareunderpenaltyof perjury under the law of the State of California that the foregoing is true and correct:

1. lama 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. r

3. I reside at the following address: Pasadena, California <!?\V\,t>\ (zipcode) \ (street), ^
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.

Signed thi^-t?l day of A^nl _, 20'^.

Signed: ,^\H
Printed Name: ^"O^ W\ . La:C^\
Erlinda Lara
CLAIMS MANAGEMENT EXPERT with expertise spanning healthcare systems, benefits, contracts, staff training, auditing, electronic data interchange (EDI),Appeals, Provider Disputes, Dynamic and strategic leader well versed in Claims, BIP Processes, Regulatory requirements, Third Party Administration. Automationprocesses. Configuration, Provider Contract Interpretations, letters of agreement(LOA), Division of Financial Responsibility(DOFR). ( .

Email Address:

SKILLS
Independent Consultant: Pasadena, CA - 01/2021 - Present Network Medical Mgt, Alhambra, CA -10/2019 - 01/2021
Manager, Contract Configuration
Supervised, directed & trained configuration staff on building provider contracts, benefits, LOA, authorization related to Claims payments.
c
X12 HIPAA Healthcare
Transaction Codes
Electronic DataInterchange
Provider Contract
Interpretations Incl
DOFR
Training staff on Claims
processesMS Office Suite
Blue Shield Promise HP, Monterey Park, CA — 05/2019 - 10/2019 Program Manager,PrincipaI
• Managed & led department heads/groups during Blue Shield Medi-Cal product transition process. Crosswalked & migrated Medi-Cal codes to Industry's Healthcare codes to enable theapplication system process claims correctly, including coding edits.

Physician Data Trust, Vista, CA -11/2018 - 05/2019
Manager, Claims
Directed, supervised, trained the entire Claims Unit, developed &modified appeals/grievances, prov disputes, recovery unit.

Handled all DMHC & Health Plans audits & responses. Worked with IT staff to achieve automation processes.

Other Companies:

Gateway Hasp & Mental Health Unit-Contract - 07/2018 -10/2018 • St. Joseph Health Systems: 10/2015- 02/2018
Prospect Medical Group: 04/2015 -10/2015
Torrance Med Cts/THIPA: 01/2010 - 02/2015

EDUCATION
License:

CADEpartmentof
Insurance - OKG6499
Application Systems:

Claimsfacts, MHC/DST, 1DX,
EZCAP, CCAP, Pathways
Managed Care, CyCare, CATS,
AOMS, ProMed, OCR/ICR
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CALIFORNIA FORM7QO

FAIR POLITICAL PRACTICES COMMISSION
Date Initial Filing Received
Filing Official Usa Only
Ptease type or print in ink.

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE

A PUBLIC DOCUMENT RECEIVED

NAME OF FILER (LAST) (FIRST)
L^^a :£.rtl^^ "^.BRTrpK2:Ot

1. Office, Agency, or Court ^uvmj^^ CfTV Hi.:' ^A;-.n-,r.... • ' ^i~\Uu'{ri\ Agepcy Name (Dp not (^ acronyms^
_C-\ly o^ V^s^^^va
Division, Bfoard, Department, District, if applicable Your Position ^^^•e^a \2cvi^.\ U^(A9t^%A^ A^i'c^^t >• If filing for multiple positions, list below or on an attachment. jWno? use acronyms) Agency. _ Position:

2. Jurisdiction of Office (Check at least one box)
D StateD Multi-Coun
B City
;our
of tc<-JL^^?(r©/14^
[_] Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jun'sdiction)
]S County of LOS A^^A€-S»
D Other

3. Type of Statement (Check at feas( one box;
Q Annual: The period covered is January 1, 2024, through December 31, 2024.
•orThe period covered is / / _, through
December 31, 2024.

D Leaving Office: Date Left. _/. _/_
(Check one circle below.)
D The period covered is January 1,2024, through the date of leaving office.

D Assuming Office: Date assumed _/_ _/_
•orD The period covered is J_ _/_ through
Candidate: Date of Election H^e/
the date of leaving office.
and office sought, if different than Part 1:.

4. Schedule Summary (required)
Schedules attached
> Total number of pages including this cover page:

Schedule A-1 - Investments - schedule attached
Q Schedule A-2 • Investments - schedule attachedQ Schedule B • Real Property - schedule attached •or- Kl None • No reportable interests on any schedule
Q Schedule C • fncoroe, Loans, S Business Positions - schedule attached Q Schedule D - Income - Gifts - schedule attachedD Schedule E • /ncome - G/ffs - Travel Payments - schedule attached

5. Verification

MAIUNG ADDRESS STREET

DAYTIME TELEPHONE NUMBER
cm
- PuMc Documenfl
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fEMAIL ADDRESS
STATE
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ZIP CODE
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Iti^vei . - -,. locuuiiaoie aiiigence in preparing this statement I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a public documentI certify under penalty of perjury under the laws of the State of California that thq<foregplng Is true and correct Date Signed ft^'l \\, W^p)
(monin, da/ year)
Signature
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(Rs the ongfnalydgnfid paper sfalement »?tfi ywrSng olSdat.) FPPC Form 700 -Cover Page (Z024/20Z5)
[email protected] • 866-275-3772 • www.fppc.ca.gov
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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 oh 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:

Home Address:

Mailing Address:

Email Address:

Business Phone:

Home Phone:
lA/^c?^./ c? ^ /^^="^/^ o B //?A/
P/)^A^^,^A. ^A <?//^S-
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Date Available to Start: -^"-^ ^^^r£-z Y
Cell Phone:

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

1. Have you ever worked for the City of Pasadena? (If yes, please list dates/department) YES DNO

2. Are you related to any employee, appointed or elected official of the City of Pasadena? (If yes, please indicate name and relationship) YESD NOJ3,

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
D
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?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? DD
NO
NO
DNO
I
NO
D
Extended FamUy: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunl or uncle, niece or naphew, grandchBd, or cousin (Charter SecBon 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 NO Q

10. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate:
^€€ ^7^6-/4:'b

11. How would you add value to the Pasadena Rental Housing Board? ^•e€ ^-H^c>/^\\

12. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
^€ € ^^/}C:H^

13. How would you help to achieve these objectives and goals? ^r€ ,^7/^-//^D
i, l4nc7 (.i ^^ M£ $^^ ??'/ /?// (printed name), declare under penalty of perjury under the law of the State ofCalifornia that the information reported in this Form RHB-001 is true, accurate, and complete.

Signed this 7^ ^ day of ~!>c7C-^^B>-(,^ , 20 ^/ .

Signed:

F i^
Printed Name: L4f?^Lit<^ /^^^^c?&/^^
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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 777e 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.

I reside at
6 CA t1f/c?y (zip code).

Signed:
of the City of Pasadena
_ (street), Pasadena, ^ .

Printed Name: l^r^.c'^y /^if5.?ace.^V

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:

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 inCalifornia 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) -4// 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 hi 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 Definji[ons;
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)).

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, ly^-fl^^^f Mr^/? iy^^A^ (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. ^•i Signed this Z^' day of PcC^^Qf^ , 20 ^^.

Signed:,
<? ^"
Printed Name: t/4^c'^^< Me^».ve,'^>\}
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
I, ^^(7v^-f' M^>^^/£>/^A/ (printed name), declare under penalty of perjury under the law of the State of CafTfornia 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. ! reside at the fo'Sowsng address _
Pasadena, California ^//^jT (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 2 ^
Signed^
J day of 2>c-^r^^/-^ , 20^^.
-y>
Printed Name: / /.4P. ^je\ -r /--? <^'/?c:- &^^
~^
Community Service: WK
•/7i^ cyuT^e^f-^/ -7'E-r/?/i/? ^, <£'^/^t->/4^j,/,^^ ^,^ ^^ Ce^^Ajl-y /^-^^^l-iKLf ^, rh^t.ti^V.csL^T T^^W^-C^^ .
-J. ft^ A^y ^prt<a.^A1-f/ol7 •5'ul"t.>i^S-i' ^f^-c'^v-Cv ?^?- T<-^.<?^/^, Employment:

I've been a licensed real estate agent for over 25 years, representing a broad spectrum of clients, from first-time homebuyers, to growing families, to retirees.

I have also represented investors in the sale and purchase of income properties. My brokerage is Engel & Volkers, right here in Pasadena.

Education:

Pierce College, Woodland Hills, CA
Real Estate Finance and Appraisal
Northern Illinois University, Dekalb, IL
Finance
Real Estate License, State of California - DRE #01120186 Licensed Transaction Coordinator
Property Management Master Certification
Broker Price Opinion Resource CertificationCertified Distressed Property Expert Certification Biannual Ethics Courses, many regarding Fair Housing Practices

10. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relations/Real Estate:As a real estate agent, staying current with continuing education is crucial, particularly in areas such as consumer protection, fair housing, senior advocacy, and ethics, as laws and regulations are constantly evolving. I've taken many courses annually to continually enhance my awareness and expertise.In my extensive experience as a realtor, I've uncovered multiple cases of real estate transaction fraud and aided local, state, and federal investigators toensure just outcomes. During the foreclosure crisis, many homes that were in foreclosure were tenant-occupied. Tenants were often unaware of the foreclosure, and were subject to fraud by people claiming ownership of the property and demanding rents or pushing for evictions. I made a point of educating tenants on their rights to post-foreclosure tenancy and provided them with documents on changes of ownership, to let them know who theyneeded to be paying rent to. This experience has continued to shape myethical approach to transactions to this day, and made me aware of the many challenges tenants can face.

To enhance my understanding of landlord-tenant relations I became certified asa Property Management Master (this is the highest certification from theCalifornia Association of Realtors). I am not a property manager and do not work for a property management company. This certification helps me understand the rules that need to be abided by all parties.

As a tenant, I've been heavily involved in informing my neighbors about the local initiatives and legal changes that affect us. I was an early supporter of thepetition to get Pasadena Measure H on the ballot. I had discussions with myneighbors about the benefits rental protection would provide for our community.

After Measure H passed and was put into effect, I was instrumental ineducating my neighbors about the resulting changes, and assisted them withcompleting their rent rollback forms. I also canvassed throughout Pasadena for signatures to get Los Angeles County Measure A (Homelessness Services and Affordable Housing Ordinance) on the 2024 Ballot.

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

I am a strong and passionate advocate for my community. I make a concerted effort to make my neighbors aware of their rights as tenants and ensure fair treatment.

As a tenant, I fully understand the concerns of renters, and my family and I feel the direct burden of excessive rent increases. As a real estate agent, I am well-versed in the various needs and goals landlords have, and can provide a real-world perspective on the housing shortage and its impact on increasing rental rates.

I believe my unique perspective and understanding encompassing the needsof both parties will help the Board bring about fair and equitable results for tenants while taking into account the needs of landlords.

12. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?:

The Pasadena Rental Housing Board aims to regulate rent increases and protect tenant rights while balancing the interests of both landlords and tenants. I believe this charter and board helps to level the landlord-tenant relationship by giving tenants an opportunity to be heard by voicing theircomplaints and disputes without being under threat of retaliation.

13. How would you help to achieve these objectives and goals?:

My experience as a realtor has equipped me with the skills necessary to bridge divides and foster cooperation. I have a proven track record of bringing diverse groups together, faci'litating productive dialogue, and finding common ground. Iam confident in my ability to approach complex issues with integrity, fairness, and a balanced perspective.

I have successfully managed transactions, coordinated with various stakeholders, and effectively prioritized tasks to achieve desired outcomes. I am adept at listening attentively to different viewpoints, identifying underlying concerns, and negotiating solutions that are mutually beneficial.I have a deep commitment to the Pasadena community and a strong belief in my ability to effectively represent the interests of our neighbors. As a proud resident of Pasadena, I have a vested interest in the well-being of our city. I love where I live and am passionate about working collaboratively with others to address the challenges and opportunities that lie ahead. 1 have found in my 25 years of real estate experience that there's always a wayto find common ground, and aid in the progress of the city. I am committed to working tirelessly to ensure that our community remains a vibrant and inclusiveplace for all.

Thank you for considering my qualifications. I look forward to the opportunity toserve our community.

CALIFORNIA FORM 7 00

PAIR POLITICAL PRACTICES COMWISSION

STATEMENT OF ECONOMIC INTERESTS
COVER PAGE A PUBLIC DOCUMENT F?PCE!Vrr)
Date Initial Filing Received
frtng OSclai Use Only
P/ease type or print in ink. rll'l''i. t~l~l-- ^ NAME OF FILER (LAST) (FIRST) /V1 £:^ ^? 0 ^"/fi ^J l/^B C?t./ ^ ^
•-•(MIDDtEr- I--7I7HIJ:25
^•m.^;:;-ll.-

1. Office, Agency, or Court CfTYCFpA^DENA
\
Agency Name (Do not use acronyms)
-<^^ry c>f: ?A^^J>^V^
Division, Board, Department, District, if applicable Your Position :^^5ftT>'E^ft T\e^^L H-c'i/s/^ ~Bi>/?^
> If filing for multiple positions, list below or on an attachment. (Do not use acronyms) -T^^^.^1 - ^^.-/-fp^-ftTL- T^f.n^Tg c ^ Agency: Position:

2. Jurisdiction of Office (Check at least one box)
a State
D Multi-County
C^pity of 'f>fl$ftT>EA^4
D Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction)
D County of
D Other

3. Type of Statement fc/ieck a( feast one box)
Q Annual: The period covered is January 1, 2023, through December 31, 2023.
-or.

The period covered is / /December 31, 2023.
_/. J.
through
Leaving Office: Date Left
(Check one circle.)
D The period covered is January 1,2023, through the date of leaving office.

Assuming Office: Date assumed
Candidate: Date of Election
_/_ J_
•or.

D The period covered is J. _/_ through
the date of leaving office.
and office sought, if different than Part 1:.

4. Schedule Summary (required)
Schedules attached
> Total number of pages including this cover page: ZL
|_] Schedule A-1 • Investments - schedule attached[_| Schedule A-2 • Investments - schedule attached [_] Schedule B - Rea/ Property - schedule attached
-or- D None - No reportable interests on any schedule
^^Schedule C - /ncome, Loans, & Business Positions - schedule attached [_] Schedule D • /ncome - G/ffs - schedule attached
D Schedule E - Income - Gifts - Travel Payments - schedule attached

5. Verification

MAILING ADDRESS STREET
fSus/ness or Agency Address Recommended • PuWc Document)

CITY STATE ZIP CODE
•p^^ ^^^ ^ / c.^ <? // v^- DAYTIME TELEPHONE NUMBER ) EMAIL ADDRESS I ^.. ,.. A*"S" I have used all reasonable diligence in preparing this statement I have reviewed this staiement and to the best of my knowledge the informab'on contained herein and in any attached schedules is tne and complete. I acknowledge this is a public document I certify under penalty of perjury under the laws of the State of California that the for ^1
Date Signed / Z- £>,{' ^?c^^ 9 fmonth. (fay, ysaij Signature and co
^^-^
(Rfs IDS (ffynally sgned papefj^gab«aq®irfl»<| uflU.I^' FPPC Form 700 -Cover Page (2023/2024)
[email protected].(ov • 866-275-3772 • www.fppc.ca.(ov
Page-5
Instructions
Cover Page
Enter your name, mailing address, and daytime telephone number in the spaces provided. Because the Form 700 is apublic document, you may list your business/office address instead of your home address.

Parti. Office, Agency, or Court• Enter the name of the office sought or held, or the agency or court. Consultants must enter the public agency name ratherthan their private firm's name. (Examples: State Assembly; Board of Supervisors; Office of the Mayor; Department ofFinance; Hope County Superior Court). • Indicate the name of your division, board, or district, if applicable. (Examples: Division of Waste Management;Board of Accountancy; District 45). Do not use acronyms. • Enter your position title. (Examples: Director; Chief Counsel; City Council Member; Staff Services Analyst).
• if you hoiu muitipie posiiions (i.e., a city councii member who also is a member of a county board or commission) you maybe required to file separate and distinct statements with each agency. To simplify your filing obligations, in some cases youmay instead complete a single expanded statement and file it with each agency.

The rules and processes governing the filing of anexpanded statement are set forth in Regulation 18723.1.To file an expanded statement for multiple positions,enter the name of each agency with which you arerequired to file and your position title with each agencyin the space provided. Do not use acronyms. Attach an additional sheet if necessary. Complete one statementdisclosing all reportable interests for all jurisdictions.Then file the expanded statement with each agency as directed by Regulation 18723.1(c).

If you assume or leave a position after a filing deadline, you must complete a separate statement. For example, a citycouncil member who assumes a position with a county specialdistrict after the April annual filing deadline must file a separateassuming office statement. In subsequent years, the city council member may expand their annual filing to include both positions.

Example:

Brian Bourne is a city council member for the City of Lincolnand a board member for the Camp Far West Irrigation District - a multi-county agency that covers the Counties of Placer and Yuba. The City is located within Placer County. Brian maycomplete one expanded statement to disclose all reportableinterests for both offices and list both positions on the CoverPage. Brian will file the expanded statement with each the Cityand the District as directed by Regulation 18723.1(c).

Part 2. Jurisdiction of Office• Check the box indicating the jurisdiction of your agency and, if applicable, identify the jurisdiction. Judges, judicial candidates, and court commissioners have statewide
jurisdiction. All other filers should review the Reference Pamphlet, page 13, to determine their jurisdiction.
• If your agency is a multi-county office, list each county in which your agency has jurisdiction.
• If your agency is not a state office, court, county office, city office, or multi-county office (e.g., school districts, special districts and JPAs), check the "other' box and enter thecounty or city in which the agency has jurisdiction.

Example:

This filer is a member of a water district board with jurisdiction in portions ofYuba and Sutter Counties.

11. Office. Agancy, or Court
Agmcy Mima /Do n>< W •ooiyin^
Fcallicr River liriention Diriricl
Owinon. Boint, D.ptn^t. OirtTrt, il wfe*l*
N/A
fturpwriofl
Board Member
«a««»
K»» fw mt*ipl< pwfrm. hi b4wi »f an •« •todmnL (D* nd tw .owyn^ N/A Prto.

2. Juritdfcyon of Offfct (Ch«c* •( AMri •m »•>;
a"-
gUuiiiCtnrtr
a""'-
Yuba A Suucr Couniict
(-] Jufa* ar Caut Cuwrifwwr pW-At* Jut*<«cfcn)
QCMWlD""'
Part 3. Type of Statement
Check at least one box. The period covered by a statementis determined by the type of statement you are filing. If youare completing a 2023 annual statement, do not change thepre-printed dates to reflect 2024. Your annual statement is used for reporting the previous year's economic interests.

Economic interests for your annual filing covering January 1,2024, through December 31, 2024, will be disclosed on yourstatement filed in 2025. See Reference Pamphlet, page 4.Combining Statements: Certain types of statements for the same position may be combined. For example, if you leave office after January 1, but before the deadline for filing yourannual statement, you may combine your annual and leaving office statements. File by the earliest deadline.

Consult your filing officer or the FPPC.

Part 4. Schedule Summary• Complete the Schedule Summary after you have reviewed each schedule to determine if you have reportableinterests.Enter the total number of completed pages including the cover page and either check the box for each schedule you use to disclose interests; or if you have nothing to disclose on any schedule, check the "No reportable interests" box.Please do not attach any blank schedules.

PartS. Verification
Complete the verification by signing the statement andentering the date signed. Each statement must have anoriginal "wet" signature unless filed with a secure electronicsignature. (See page 3 above.) All statements must be signedunder penalty of perjury and be verified by the filer pursuant to Government Code Section 81004. See Regulation 18723.1(c)for filing instructions for copies of expanded statements.When you sign your statement, you are stating, underpenalty of perjury, that it is true and correct Only the filerhas authority to sign the statement. An unsigned statementis not considered filed and you may be subject to late filing penalties.

FPPC Form 700 - Cover Paje (2023/2024)
•dvlcegifppc.ca.iou • 866-275-3772 • www.fppc.ca.gov
Page-G

SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
CALIFORNIA FORM 700

FAIR POLITICAL PRACTICES COMMISSION
Name
l^pl<.'tl«<,< /^r$^^//?>J
^I.INCOIVIE RECEIVED

NAME OF SOURCE OF INCOME
^4/r- ^i r^/fj> ^ c-^ ^ zo<
ADDRESS fBusfnRftfs Af{r1m/:R Amtt^ahl^}
/»^ ^/f 2>c°—^ / C^ ft y//t^-5~
E^TViT^
BUSINESS ACTIVITY. IF ANY, OF SOURC£. /qe/'A^^^i ^c-^^—rf S".>'<"^ -f TT'fiftA-ifMV-^^K-s ^:p<> <>/^fr"i<:?7/t^ YOUR BUSINESS POSITION — . . _ '"T^^r'^'r^ rr ^y.^ T Ce^-t'iFICh TT. rt .t^s A<i7'rc"J ^p R-^/ A)AT"'^ GROSS INCOME RECEIVED Q No Income - Business Position Only Q $500 - $1,000 Q $i,ooi - $io,ooo ^$10.001 - $100.000 Q OVER $100,000

CONSIDERATION FOR WHICH INCOME WAS RECEIVED
II Salary || Spouse's or registered domestic partner's income (For salf-employed use Schedule A-2.) Q Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.) D Sale of
(Real pmpeity, car, boat, etc.)
I[ Loan repayment
^Commission or |] Rental Income, list each sounw at SW.OOO or mom (Describe)
Q Other
(Descriliel
> 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD > 1. INCOME RECEIVED

NAME OF SOURCE OF INCOME
TH £ <9uT^^^cvi "T&a^
^r>nr"~":c /o..»:^. /(<f-t^— A-—.
•P^^^7>^oOA , c-e iiK'3
BUSINESS ACTIVITY, IF ANY, OF SOURCE CrtAJl;A^^.-'5 ^^ 5-,^A^L^(L^ f^ ?//^ YOUR BUSINESS POSITION o»0 F'<&^> C-^^i-'.^^^^
GROSS INCOME RECEIVED Q No Income - Business PosiUon Only Q $500 - $1,000 ^.$1,001 - $10,000 Q $10,001 - $100,000 Q OVER $100,000

CONSIDERATION FOR WHICH INCOME WAS RECEIVED
II Salary || Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) Partnership (Less than 10% ownership, For 10% or greater use Schedule A-Z.) (Real property car, boat. etc.)
II Loan repayment
I[ Commission or || Rental Income, Vsl each source of S10.000 or more Other,
IDesciibel
/1/(?(/^<?L/ T^^f + fc>-°AJll^|f^
ioesaitie)
* You are not required to report loans from a commercial lending institution, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows:

NAME OF LENDER'ADDRESS (Business Address Acceptable)

INTEREST RATE
-% Q None
TERM (Months/Years)

BUSINESS ACTIVITY, IF ANY, OF LENDER

HIGHEST BALANCE DURING REPORTING PERIOD
Q $500-t1.000
Q $1.001 -$IQ,OOOQ $10,001 - $ioo,ooo
[~] OVER $100,000

SECURITY FOR LOAN
II None || Personal residence
II Real Property Street address
City
I] Guarantor
Q Other
(Desalbel
Comments:

FPPC Form 700 • Schedule C (Z023/20Z4)
advicegifppc.C3.gov • 866-275-3772 • www.fppc.ca.gov
Page-U
Instructions - Schedule C
Income, Loans, & Business Positions
(Income Other Than Gifts and Travel Payments)
Reporting Income:

Report the source and amount of gross income of $500
or more you received during the reporting period. Grossincome is the total amount of income before deducting expenses, losses, or taxes and includes loans other
than loans from a commercial lending institution. (SeeReference Pamphlet, page 11.) You must also report the source of income to your spouse or registered domestic
partner if your community property share was $500 or
more during the reporting period.

The source and income must be reported only if the source is located in, doing business in, planning to do business in,or has done business during the previous two years in your agency's jurisdiction. (See Reference Pamphiet, page 13.) Reportable sources of income may be further limited by
your disclosure category located in your agency's conflict of interest code.Reporting Business Positions:

You must report your job title with each reportablebusiness entity even if you received no income during the reporting period. Use the comments section to indicate
that no income was received.Commonly reportable income and loans include:• Salary/wages, per diem, and reimbursement for expenses including travel payments provided by your
employer
• Community property interest (50%) in your spouse's
or registered domestic partner's income - report theemployer's name and all other required information • Income from investment interests, such as partnerships, reported on Schedule A-1
• Commission income not required to be reported on
Schedule A-2 (See Reference Pamphlet, page 8.)
• Gross income from any sale, inciuding the sale of a
house or car (Report your pro rata share of the total sale price.)
• Rental income not required to be reported on Schedule B • Prizes or awards not disclosed as gifts
• Payments received on loans you made to others• An honorarium received prior to becoming a public official (See Reference Pamphlet, page 10.)
• Incentive compensation (See Reference Pamphlet, page 12.) Reminders• Code filers - your disclosure categories may not require disclosure of all sources of income.
• If you or your spouse or registered domestic partner are self-employed, report the business entity on Schedule A-2.

Do not disclose on Schedule C income, loans, or business positions already reported on Schedules A-2 or B.

You are not required to report:
• Salary, reimbursement for expenses or per diem,
or social security, disability, or other similar benefitpayments received by you or your spouse or registered domestic partner from a federal, state, or localgovernment agency. • Stock dividends and income from the sale of stock
unless the source can be identified.Income from a PERS retirement account. (See Reference Pamphlet, page 1 2.)
To Complete Schedule C:

Parti. Income Received/Business Position Disclosure
• Disclose the name and address of each source of
income or each business entity with which you held a
business position.
• Provide a general description of the business activity if the source is a business entity.Check the box indicating the amount of gross incomereceived. • Identify the consideration for which the income was
received.For income from commission sales, check the box indicating the gross income received and list the name
of each source of commission income of $10,000 or
more. (See Reference Pamphlet, page 8.) Note: If
you receive commission income on a regular basisor have an ownership interest of 10% or more, you must disclose the business entity and the income
on Schedule A-2.
• Disclose the job title or business position, if any, that you held with the business entity, even if you did not receive income during the reporting period.

Part 2. Loans Received or Outstanding During the
Reporting Period
Provide the name and address of the lender.
• Provide a general description of the business activity if the lender is a business entity.
• Check the box indicating the highest balance of the loan during the reporting period.
• Disclose the interest rate and the term of the loan.

For variable interest rate loans, disclose the
conditions of the loan (e.g., Prime + 2) or the
average interest rate paid during the reportingperiod.

The term of the loan is the total number of months or
years given for repayment of the loan at the time the
loan was entered into.
• Identify the security, if any, for the loan.

FPPC Form 700 (2023/2024)
[email protected].(ov • 866-275-3772 • www.fppc.ca.tov
Page-14
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^!y CU-RK CiTYOF^S.OENA
Pasadena Rental Housing Board
^pswaa,, CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THE

Applicant Name: /</c.t\.^^ii C'O -?t"0.

Home Address:

Mailing Address:Email Address:

Business Phone:

Home Phone:
/ ' - / -.^W/ZK^ CA ^/^
~> ^(•r) iL-
•) -> 1
Date Available to Start: <// / 2 5''
Cell 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-Iarge 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. ^<-:s^ /3~ ^.. <;' ...4 ^ -r- R£^C^\/ c (^ ^~ ^ ^^^ .. ^ ^ ^i^ f^'itT)^/^ Cr,uw,^^ /^^'^l Fo^(^i t^^ ^Oc^ /e-^-. %^^{'iu. ^ ^^^ ^ Ifi^l (^r,^^ ^LLT i(^(/} ^ ^oVi-'t^^J> Employment - Title and duties, current and past (acceptable to attach resume as an alternative). <^.e /4-4t^kLA
Education - Include professional or vocational licenses or certificates. ^-,'1^1^^ Av/^ . ^i^e^^' ^<-^'^^ c^^U^- 1\^evuc^/'^^ f/u^^t-f ^^ <^6i\.itft.'^^ P^/)'^^tu^"o4 ^44 ^'^^^ ^.u^.i> 4K:(.-^~C<—- /T^
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 YES the City of Pasadena? (If yes, please indicate name and relationship)
Are you aware that financial disclosure is required annually?(e.g., sources of income, loans and gifts, investments, interests in real property)

3. 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 amember of the Rental Housing Board? (If yes, please indicate any potential conflicts)
NO
B
YES
YES
D
NO
NO1ST
i

5. Do you,or your extended family1 members, have a material YES interest in rental property in the County of Los Angeles withinthe 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?
DD
NO
NO
DNO
NO
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 YES consecutive years as a member of the Pasadena RentalHousing Board?

10. Can you, upon appointment, provide proof of identity and proof YES of eligibility to work in the United States, as required by Federal law?
NO
a
NO Q

11. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate: "f- ^tnug ^-ti!^{ ^ ^s\u,{/^/f.^i^ /••e^/ ^-^^A ^/L^- (4.'>- ^O >^.,<:
'7- ^i/?{.-!'< /''-?t. C-,_;t'ireM.<<i' fZ^-j ^<.^H i/' f-(f.i.^.clf . y2.. /^'^•£s^,? /--L^/ ^{C^l&.i^ .^ r^^^ ^^C^J-^^ ^^( /^') ^ L.t;/'^ ^^y,^Y" ^^.(TS ^<-r

12. How would you add value to the Pasadena Rental Housing Board? /^<y •^/ff.tyvj,',^/}^ />/ ^.L/^y''r--''<^.. ^L'(o/-^,^-h-^L..-^ P^!^.^ S L-Q/f 6; ^ p'^, <.: nftf / .v4'^ /u7 ^<; / /3 ^^^r(1 /I. ^ -//-fc.4 (. ^ <• /L<; <>...» H^ /- /A-^' 4'0 uM //t/r/^

13. What do you view are the primary objectives and goals of the Pasadena Rental Housing i'l^t nfiUA^ ^^^< /^ ^ /^<5J^7 ^^-^ry^r ^ ^ I/ Board? p tl.-'f-J (c' f "~!J^^^.\1^ .•".•^•lc^. c^-tf /A^^/f;^" ^,//^/•('/~^^ i'i.(.(j^~ -•^ ^i,-f^-,^.l/I-v ^0'.•{(' C.^Jri../ 7 14. How would you help to achieve these objectives and goals? ^-^t '1-^ ^ 4/ ^9^^-T^ <:
y .Sc>'^<
•-^ ' " ^^1 ?^' ^/y
you neip to acnieve tnese 01 •^ u.ff ^ U/ ,;/ ^.fu^ '^-^- ^ f • /^ ^ ^ ^-^t ^ ^ 4/ {,Ql('L\ /•-f'<y^i-,1\ ,'^^'A ^)^i. '^•"y^< rC^ ^<-w'f Hs^/ <-?4 .&cl.- I, ^"C l-i^'-cf LU •^>1 c^y'if ^^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 /^ /'L day of /^7<- / _, 20 ?^.

Signed: ^''7-C- 7 .^ /^^<-^^
PrintedName: ft-^lu'-^ LO_St^fY^J^
^^rf% ^^]if CITf 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 (Charter Article XVIII). 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. ^ of the City of PasadenaI reside s CA £i l)r^~ (zip code)^^
Signed:
(street), Pasadena,
A 3 ^^-X
Printed Name: ft^^J LO s^^-rc^r'

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

Change of Address Confirmation by the U.S. Postal ServiceProperty 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, employeror 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, ora 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.
.^r^s^
^ "^^
^ ^m
i»l I!
^
m

Instructions: The Pasadena Fair and Equitable Housing Charter Amendment (Charter Article XVIII) 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 andtheir Extended Family's interests and dealings in rental properties in Los Angeles County in thethree (3) years before submitting an application. The City is adopting the Fair Political PracticesCommission's Form 700 for this purpose, but City Charter provisions in Article XVIII requires information about interests in rental property in Los Angeles County for three years, not the oneyear the FPPC Form otherwise uses. Under City Charter Section 1811(b), these documents are public records; they will not be confidential.

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 otherrental property rented or offered for rent for residential purposes, whether or not such unitspossess a valid Certificate of Occupancy for use as rental housing, together with all housingservices 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
l, ^c-k^'cf ^ -y^^'vu ?•/ (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 A; day of A<7^/ / _, 20 Z-5^
Signed: /?LA] ^ i.'L.-L^*--'^-
Printed Name: /^.Cll^ C.J Ai-(A-^//
^f^. CITY OF PASADENA
^D Affidavit of Tenancy - MANDATORY for Tenant Board ^S^ffl and Tenant Alternate Seats (Form RHB-003)
I, (printed name), declare under penalty of perjury under the law of the State of California that the foregoing is true and correct:

1. lama 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 fc' day of /^^.-/ /
r"
,20 '^S.

Signed: /^2<-} ^^^
Printed Name: K'.cLc4-^ t^ ^^^.1^
Richard W. Stan-att
Pasadena, California 91105
email i
Work Experience Commercial Brokers International Broker Associate.

Responsible for securing listing agreements for the sale and leasingofmulti-family, industrial, office, and retail properties. Analysis ofcurrent market conditions and valuations of acquisitions anddispositions for clientsMacVaugh & Co. Associate. Responsible for securing listing agreements for the sale and leasing of multi-family, industrial,office, and retail properties. Analysis of cuiTent market conditionsand valuations of acquisitions and dispositions for clients.

Significant transactions included Cardinal Equities, Wait DisneyStores and Powell Electrical Systems.

Doerken Real Estate Services, Project Maiiager. Responsible for business development, underwriting loans and joint ventiire projects, loan administration, customer service and support, investment reports for a $20 Million Mezzanine Loan portfolio.ColIiers-Seeley, Vice President. Responsible for securing listingagreements for the sale ofmulti-family, industrial, office, and retail properties. Analysis of current market conditions and valuations ofacquisitions and dispositions for clients. Developed new company wide procedures for the targeting of multi- family asset sales.

Cushman & Wakefield, Sales Associate. Responsible for
preparation of marketing material including flyers and offering memoranda for the sale of office, industrial, retail, and multi- familyassets. Most significant were Town Center Business Park, a 450,000square feet mixed use indusfarial park in Santa Fe Springs and Desert Crossing, a 515,000 square feet retail power center in Palm Desert.Total Investment Real Estate Brokers, Sales Associate.

Responsible for the marketing and sale of multi-family and retailassets for various clients. Fifteen closed transactions in first two years worth a total of over $12,000,000
W. H. Latimer Trust, General Manager. Managed privately held mixed-use real estate portfolio including office, retail, cominercial,agricultural, and multi- family assets. Main asset was 500-acre citrusranch in Riverside, CA. Exported citrus to Hong Kong, Singapore, Malaysia, and Taiwan.

Education Bachelor of Arts, Claremont McKenna College, Claremont, California. International Relations MajorKing's College, Taunton, Somerset, England. Passed two "A" level exams on year abroad exchange.

Phillips Academy, Andover, M.assachusetts.

Military
Affiliations
1st Lieutenant, United States Marine Corps. Communications Officer. Stationed in Okinawa, Japan and Pan-is Island, South Carolina.Citrus Insurance Trust, Chainnaii. CIT was a managementcontrolled employee health plan for workers in the citrus industry.

The Board of Directors set investment policy and implementation, Plan Benefits, Pricing, and Eligibility.Rose Institute for State and Local Government, ClaremontMcKenna College, Board of Governors. The Rose Institute produces publicly useful information through its faculty directed undergraduate research teanis. The Board of Governors sets policy and directs the faculty and staff.

Rotai-y Club of Ontario, CA. President 1994-95
Gage Canal Company, Riverside, CA. Director. The Gage Canal Company is an over 1 OO-yeai'-old irrigation delivery system inRiverside, CA servicing the citrus industry.

San Antonio Community Hospital Foundation, Upland, CA
Director The Board of Directors oftliie Foundation is responsible for setting policy concerning investment, ftind raising, staffing, andsupport for the San Antonio Community Hospital.

CALIFORNIA FORM7QO

FAIR POLITICAL PRACTICES COMMISSION

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE

A PUBLIC DOCUMENT RECEIVED
Date initial Filing Received
Fl'i'lS OSCfcf Usa 0:;ly
Please type or print in ink.
"n"" •:/•:-, , . NAME OF RLER (LAST)
^•^r^^r^
(FIRST)
R^UC-CC^- •ffiiDGLEr n 14 -7^!n::)fi ^e^.^:;'"'"

1. Office, Agency, or Court ary OF ^^B^A
Agency Name (Do not use acroyyasf) C.' W- ^)^- j^^
Division, Bq^rd, Department, District, if applicable Your Position p^^Ae^^ ^'z&^.kl -^^s^ -^(^.
>• If filing for multiple positions, list below or on an attachment. (Bo not use acronyms) Agency: _ Position:
^

2. Jurisdiction of Office (Check at least one box)
a State
D Multi-County
8'City of P't^ A. (?L<^>-
\Z\ Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction)
^County of i-0 ^ A^/^S
D Other

3. Type of Statement fc/ieck at /eas( one box)
Q Annual: The period covered is January 1, 2024, through December 31, 2024.
•or.

The period covered is / / _, through
December 31, 2024.

D Leaving Office: Date Left . / /
</ ^ ^.i>2-<
(Check one circle below.)
D The period covered is January 1,2024, through the date of leaving office.
•orAssuming Office: Date assumed D The period covered is the date of leaving office.
@. Candidate: Date of Election /v'v>.^— and office sought, if different than Part 1:. / / through
"y"

4. Schedule Summary (required)
Schedules attached
> Total number of pages including this cover page: Z-,
Schedule A-1 - Investments - schedule attached
Q Schedule A-2 • Investments - schedule attached
Q Schedule B - Real Property - schedule attached
-or- D None • No reportable interests on any schedule
Schedule C - Income, Loans, & Business Positions - schedule attached Q Schedule D - Income - Gifts - schedule attached
D Schedule E - Income - Gifts - Travel Payments - schedule attached

5. Verification

MAILING ADDRESS STREET
(Business or Asencv Mdress Recommended - PuMc DocumenlJ CITY" STATE ZIP CODE
/ < ,'/ '^acb^ C.^ clHO^

DAYTIME TELEPHONE NUMBER
T
f / /
—(-

EMAIL ADDRESS
/ /
I
I have used all reasonable diligence in preparing this statement I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a public document.

I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date Signed ^//l0/^t) Signature
^4;' ^6<^-^>
(monlft, day yev) ^ (Rle the orfginally signal paper statement iii(1) your tKng olSdal.j FPPC Form 700 -Cover Page (2024/Z025)
adulce6lfppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 6

SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
CALIFORNIA FORM 700

FAIR POLITICAL PRACTICES COMMISSION
Name
/^-Ar^tt^^^^\
\> 1. INCOIUE RECEIVED

NAME OF SOURCE OF INCOME
^h^-cJ^ i)^A^^^^ Pi^'f
ADDRESS (Business Address Acceptable)

BUSINESS ACTIVITY, IF ANY, OF SOURCE
^_
^Dc^c-i'^ c^ ^^^ ^cMfSQ
YOUR BUSINESS POSITION r
:- C-^i.^-^-^
GROSS INCOME RECEIVED Q No Income - Business Position Only Q $500 - $1,000 @$1,001 - $10,000Q (10,001 - $100,000 n OVER $100,000

YOUR BUSINESS POSITION
GROSS INCOME RECEIVED Q No Income - Business Position Only Q $500 - $1,000 Q $1,001-»10,000Q $10,001 - $100,000 Q OVER $100,000

CONSIDERATION FOR WHICH INCOME WAS RECEIVED
II Salary |] Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.)
D Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.)
Q Sale of
(Real property, car. boat, etc.)
I[ Loan repayment
II Commission or || Rental Income, list each source of {10.000 or more (Describal
Q Other
(Describe)
\> 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD You are not required to report loans from a commercial lending institution, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows:

NAME OF LENDER'ADDRESS (Business Address Acceptable)

INTEREST RATE
-% Q None
TERM (Manths/Years)

BUSINESS ACTIVITY, IF ANY, OF LENDER

SECURITY FOR LOAN
II None ]| Personal residence

HIGHEST BALANCE DURING REPORTING PERIOD
Q $500-$1,000Q $1,001 -$IO,QOOQ (10,001 - $ioo.oooQ OVER $100,000 Q Real Property Streat addrsss
cay
[~] Guarantor
Q Other
(Describe)
Comments:

FPPC Form 700 - Schedule C (2024/2025)
advlcelSfppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page -14
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RECFiVED
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CITY OF PASADENA
Pasadena Rental hlousing Board

CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THE

Applicant Name:Home Address:

Mailing Address:

Email Address:

Business Phone:Home Phone:
($/^/4VL WF.^^ B^-e.^y
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.- 'P/-lSftO£-/YiA, (} ft ^l}0 c>
"'^t\c£. P\&^ /-^p., r; A ^ lioj
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Date Available to Start: <9'/2/ /^SCell Phone:

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

S £ 6- /^/^('•/y'^- /^) /^<$; S' ^) /t-t /t-
Education - Include professional or vocational licenses or certificates.

See ^ /-//4: <- ^e-o -'p. e s k /•<•( £?

1. Have you ever worked for the City of Pasadena? (If yes, please list dates/department) YES DNO

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

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
D
NO
NO
DEl

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
NONO
D
DNO
NO
D
1Extended Family: any spouse, whether by marriage or not. domestic partner, parent, child, sibling, grandparenl, aunl or uncle, niece or nephew, grandchikl, or cousin (Charter Section 1803(g)).

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

10. Can you, upon appointment, provide proof of identity and proof YES of eligibility to work in the United States, as required by Federal law?
El NO
NO
D
D

12. How would you add value to th,e Pasadena Rental Housing Board? Se ^ ff^-'^C^c^ f\ic^! ^••^^•i-S

13. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board? S .e- € C'J-(-CiC i'U?^ (\5(^Cf ^^^ S

14. How would you help to achieve these objectives and goals? S^-e ff^c-l-ie^ l^oc-u ^^^\ t-, ^^/4/ il[!^V~l/l ^ / f (printed name), declare under penalty of perjury under the law of the State of/Catifbrnia that the information reported in this Form RHB-001 is true, accurate, and complete.

Signed this /^ day of p ^1\ on/ . 20 ^.
^" -;
Signed: ^: /"7r
Printed Name: F^h lu (M^^^ ^ ^ r
T
^
1^'^M^
^•^B/

CITY OF PASADENA
Residency Verification - MANDATORY
;;as-S=>t>"
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 (Charter Article XVIII). 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. (j(7 of the City of Pasadena I reside at ,
CA ^1/0^ (zipcode)7
Signed:
(street), Pasadena,
y.
-i
..<—
^ ^_^c
~?r
Printed Name: /r//^t^ \A)^vu ^ PJ

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 postsecondary 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 VotersProof 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 • Caiifornia Certificate of \/ehic.!e 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 abirth 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 tracingdocument due to a name change (for example, marriage, divorce, or courtorder), name change documentation is required.

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 (Charter Article XVIII) 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 City Charter provisions in Article XVIII requiresinformation about interests in rental property in Los Angeles County for three years, not the oneyear the FPPC Form otherwise uses. Under City Charter Section 1811(b), these documents arepublic records; they will not be confidential.

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 unitspossess 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
1^ f^^/ /Lf (/^crH Ir?-^ ft'") (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 /4/?//'/ _, 20 2T.

Signed: (y^
Printed Name: L^t ^ 'l/l/^^ ^ f 1
IQ^
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 t\^^itSigned; -^ f.
_,20^
/

6. /
Printed Name: ^f-^r/^ ^r^^V/

RECEIVED
Emily Wernberg
Pasadena Rental Housing Board Application for Appointment to the Pasadena Rental, Housing Board . CiTYOF %BFNA Cil; C-Ei-i;T\

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

I am currently a tenant as well as a landlord in the city of Pasadena. Long ago, I also worked fora Property Management company as a Leasing Agent, Property lyianager and Corporate Trainer.

I have owned/managed my fourplex in Pasadena since 2013, and I lived on the property formany years as well, before becoming a tenant at my current address. I consider myself a Pro-tenant landlord and continually strive to be an excellent landlord and go above and beyond for my residents.

I have a firm grasp of fair housing law in California and have been doing my utmost to stay informed of the changes brought by Measure H and the ongoing activity of the rental board.

12. How would you add value to the Pasadena Rental Housing Board? I believe I would be a very moderate voice on the board. I understand the perspective of the landlord community and feel I can add insight into the logistics, rising costs and business side of property management that is not always taken into account when making decisions. I am also familiar with Fair Housing laws and their application and am always the first to tell my friends and acquaintances when their landlord is breaking the law. Lastly, as this board is quite new, I believe my diverse experience working in a startup, a public company and for a governmentcontractor would be valuable in informing the future development of the board.

13. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
I believe the goals of the Pasadena Rental Housing Board are as the charter states. To promote neighborhood and community stability, healthy housing conditions and affordability by enforcing existing fair housing laws. The charter also states while ensuring Landlords a fair return on their investment and guaranteeing fair protections for renters, homeowners, and businesses. I feel the perspective of the landlords has taken a bit of a backseat thus far. Understandably, with the fragmented nature of the landlord population and only one Landlord on the board, there isn't a lot of this perspective being disseminated during meetings. I would like to stand for the position to add this perspective.

14. How would you help to achieve these objectives and goals? As a renter and a landlord, I feel I am uniquely situated to offer insight from both sides. I hope toserve in a mediator/moderator role and help the Rental Board gain support from all sides withthe goal of improving the quality of life for all Pasadena Residents. I don't think families shouldbe displaced to make room for temporary rentals or be pushed out by bad actors or corporateinvestors with limitless resources. It is heartbreaking that many hard working families can't even afford a two bedroom apartment in Pasadena.

EMILY WERNBERG
SR. FEDERAL & HEALTHCARE PROGRAM PROFESSIONAL• Pasadena. California • ^^ . - . ^ Dedicated federal program director with 7+ years of experience overseeing medical care system developments, project lifecycle management deliveries, quality control strategies, and improvement methods across healthcare, non-profit, and start-up industries. Broad background has encompassed solution service integration, grouncl-up SOP constmction, data-driven population health efforts, leading key business partnerships, and merger & acquisition (M&A) transitions for mu1ti-mil1ion dollar institutions. Looking to leverage these skill sets within a program director position in an institution that min-ors complimentary ethics, goals, and values.

AREAS OF EXPERTISE
Project Lifecycle Management & Prograin DeliveryHealthcare System Integrations & Clinical Analysis Care Advocacies & Patient Development StrategiesChronic Disease, Illness & Mental Health Initiatives Stakeholders, C-LeveIs, Vendor & Clinical Partners
Quality Assurances, Risk Mitigations & Best Practices
Data Research, KPI Forecasting & Impact Assessment
Government, Federal, Multi-State & Legal ComplianceProcess Improvement, HEDIS & Change Management Contractmg, Negotiation, RFP & Scope Methodologies

TECHNOLOGIES
V Software: SharePointERP, Salesforce CRM, Concur, Extensity, Google Analytics, Google Docs, MS Office 365 (Word, Excel, Powerpoint, Outlook), Social Media Applications, MailChimp, Survey Monkey, OneDrive, Dropbox, WordPress, Zoom

EDUCATION BACKGROUND
V Bachelor of Science (BS), Journalism, University of Idaho, Moscow, Idaho V Certification: Human Resources Management CHRM) Certificate, California Polytechnic State University V Volunteering: Friends in Deed- Food Drive, Community Support; Mt. Baldy, Ski Patrol Volunteer Member; Child Education Center, Program Support

PROFESSIONAL EXPERIENCE
ASSOCIATE DIRECTOR- FEDERAL DIVISION 2017 - 2019
HBAI.TH SERVICES ADVISORY GROUP, INC. (HSAG) / Gj-.ENDAr-R, CAJ.IFORNJA (2012 - 2019) Leads state-wide objectives through program management and improvement initiatives related to Medicare quality (QIO), hospital quality (HQIC), end-stage renaJ disease (ESRD) networks, and healthcare policy and quality measurement solutions (HPQM). Supports a diverse 11+ team of 7 California, 2 Arizona, and 2 Ohio health informatics specialists and coordinators focused on Medicaid external quality review (BQR), data science reporting, advanced analytic KPIs, and survey outcomes. Creates weekly, monthly, quarterly, and annual roadmaps in efforts tofui-ther the company's mission in assisting centers with Medicare and Medicaid Services (CMS) in delivering agency goals in compliance with best practices and strategic goal setting. • Noted for supporting CA, FL, OH, and AZ-based clinicians aligned with federal QA reporting requirements and processes for over 1 OK graduated practices from the TCPT program. • Tracked, coordinated, planned and facilitated educational sessions fur over 2.5k diabetic and pre-diabetic patients. • Integrated key SOP improvements and best practice methodologies that catapulted KPI improvements in blood pressure management by 26%. • Spearheaded improvement in cancer screening and immunization measures by 750%. with an original target of 25%. • Moved from the Project Manager II position into the Associate Director role after showcasing successful KPI performances. • Mitigated operadng costs (OpEx), integradng innovation and data-driven population health efforts through convened Learning & Action Network (LANs).

PROJECT MANAGER II- FEDERAL DIVISION 2014 - 2017
Partnered with cross-functional State of California departments within private and public endties to collaborate on direcdves to improve healthcare for all Medicare beneficiaries. Worked with health infonnatics specialists to strategize on process improvement implementations, spec clarifications, change management, request submittals. and troubleshooting analysis to meet project timelines. Administered in-depth plaaning covering budget requirements, update preparation, proposal specs, assessment data, and team performance governance. • Co-led the organizadon's customer relationship management (CRM) workgroup to leverage leadership, hands-on team training, and mentorship attributes.

PROFESSIONAL EXPERIENCE CONTINUED.....

Pasadena. California
PROFESSIONAL EXPERIENCE CONTINUED.....

PROJECT MANAGER I- FEDERAL DIVISION 2013 - 2014
HEALTH SERVICES ADVISORY GROUP, INC. (HSAG) / GLENDALE, CALIFORNIA (2012 - 2019) Supervised federal division projects fociised on Centers for Medicare & Medicaid Sei-vices (CMS), Quality Improvement Organization (QIO), and 10th scope of work (SOW) activities. Managed all tasks that meet program deliverables by coordinadngand implenienting collaborative and community initiatives among private and piiblic entities. Collected various data to further company objectives through critical contract deliveries, vendor coordination, best practice strategies, report accuracies, andprocessing of policy docuinentatiou in a timely manner. • Provided new hire training and guidance on process compliances, SOP integration, tailored job duty expectations, federal operations, and culture-driving missions.
• Supported the Transforming Clinical Practices Initiative (TCPI) that graduated 904 practices.• Primary liaison between business partners and eligible providers that were recruited tor the I Oth SOW physician quality reporting program system (PQRS) and the cardiac learning and action network (LAN). • Quickly promoted from the Project Coordinator position in less than 1 year after spearheading customer management systems and project improvements.
• Oversaw confidential information, critical action-related communications, and deadline-driven material only seen by C-level executives and program directors.

PROJECT COORDINATOR 2012 - 2013Assessed project productions to ensure continuous improvement (CI) by managing task schedules, identified opportunities to improve processes and further quality management (QMS) outcomes. Leveraged capabilities to maintain communication workflows, ensure agile methods, assess trend data, and integrate change management efforts based on client expectations. • Facilitated and orchestrated all executive meetings, team schedules, and various gatherings of business partners, vendors, and newly hired staff.
• Noted for decreasing operating and process times with the elimination of redundant steps to orchestrate. and condense functions into one cohesive and cross-tunctional process.
• Improved training effectiveness by conducting extensive training needs assessments based on data-intensive methodologies.

TECHNICAL PROJECT MANAGER 2008 - 2012USA TODAY / Los ANGELES, CALIFORNIAPipelined technical project management through complex program integration, digital resource capabilities for live entertainmentproduction, remote communications, and digital broadcasting. Produced change management pl>mning that improved large technicalproject completion, increased productivity, niitigated processes, and reduced overhead production costs. • Acted as a corporate trainer and hirmg manager overseeing the talent acquisition and system implementation of remote video conferencing capabilities between the Los Angeles and Virginia corporate offices. • Orchestrated M&A activities to merge all business functions, including ROI development, travel team delegation, human resource (HR) processes, aiid accounts payable functioiis.

OFFICE MANAGER 2006 - 2009BNQT MEDIA GROUP / LOS ANGELES, CAUFORNIAOrganized in-house operations for a start-up dedicated to providing advertising, techiiology, aiid content solutions and to provideinsight into how it effectively reaches the 12-34-year-old market. Funneled daily administrative duties to handle incoming calls,emails, documentadon, and 3rd party needs to ensure proper communication needed for insurance authorizations, payments, servicearrangements, calendar schedules, and customer inquiries. • Main mentoring expert for onboarding and training newly hired accounting and administrative assistants on process education, operational alignments, and company expectations.
• Curated the HR departinent from scratch, including prograin planning, SOP development, compliaiice researching, and launch implementation across all company facets.
• Served as the employee relations and accounting manager for accounts payable (AP) functions and resolved payment issues.• Designated to be the main point of contact (PoC) for pipelining communication between the VC's.

CORPORA.TE TRAINER 2005 - 2006STR^YTUS REAL ESTATE / WOODLAND HILLS, CAUFORNIAOffered hands-on mstructional, educational, and corporate-led training events for new hires, maiiagement, and cross-functionalemployees to align on company mission, objectives, policies, and employee relations across Hawaii, Arizona, and California states. • Contributed to the construction of the comiTiunity onsite manual by proofreading 300+ pages of content that was distributed across all property portfolios.
• Pioneered Stratus's lil ever open-house hiring event that catapulted brand awiu'euess, new business developments, referral opportunities, aiid overall ROI growth.

Kimberly Ryan
Los Angeles, CA 90042
To Whom it may Concern,
I am writing to recommend Emily Wemberg for a position on the Pasadena Rental Housing Board. The board needs representation when it comes to experienced property managers and Emily can fiilfill that need.

Emily was my landlord from February 2016 through July 2023. During a time when the rental market was saturated and I was having ti'ouble finding a home for me and my 2 daughters, Emily offered us a wonderful place in Pasadena that we could afford. I was denied access to numerous other rentals based on my low income and the fact that I needed a 1-bedroom dwelling for 3 people. Emily told me that none of that mattered to her and that the important things were that I would pay my rent on time and take good cai-e of the property. When I assured her that those were my top priorities, she immediately approved my application.

Diiring the 7 Vi years when Emily was my landlord, she only raised the rent one time because she understood that I was a hard-workmg preschool teacher and single mom on a strict budget. She responded immediately to any requests for repairs, took care of the appliances, and provided any resources we might need related to the COVID pandemic. Additionally, Emily paid for all the repairs. Although I came to regard Emily as a dear friend, our relationship was veiy professional and she always gave me appropriate notice ifanytliing unusual was required ofnie, such as needing access to my imit for any reason.

Emily has a firm grasp of the housing ecosystem in Pasadena and conviction for tenant rights and fair housing enforcement. She would be an asset to the Pasadena Rental Housing Board.

Sincerely,
Kimberly Ryan
April 15, 2025
To whom it may concern,
I was fortunate to be a tenant of Emily's from August 2019 through the end of this last year. Without a doubt, this was the best rental situation I have ever had. She was kind and professional, & always responded to any concern I might have with immediacy & clarity.If I ever had a concern with maintenance, it was addressed very quickly- and often Emily would check on things herself if the gardener or maintenance man were not available. She was very fair with any increase in rent, and made sure everything was up to the current standard- being sure to explain and provide any documentation. It put me at ease to know I wasn't going to be surprised at any point.

I know I am not the only tenant that feels grateful to have her. The other tenants who I met over the years were not shy about agreeing that we tucked out with her! I remember some damage to the property occurred during another tenants' move in with a moving truck, & I know this particular person was mortified at the impression this made. Emily had the damage fixed immediately, & to my understanding was incredibly understanding about the whole ordeal. One of the manytimes she handled a situation with genuine concern & grace for her tenants.

All this to say, I appreciated Emily as a Landlord & when it came time to move out, I was very nervous to leave what I knew was a great situation. Anyone would be lucky to have her as a landlord, and I believe her professionalism there speaks volumes for how she carries herself in other capacities as well. -David Lepor
CALIFORNIA FORM 700

FAIR POLITICAL PRACTICES COMMISSION
SCHEDULE A-1
Investments
Stocks, Bonds, and Other Interests US"
(Ownership Interest is Less Than 10%) | ^7 iif_^, . _ „ ,' Investments must be itemized. I L- t'1
Do not attach brokerage or financial statements.
> NAME OF BUSINESS ENTITY
O'j}r\b^\^ ^C)-S

GENERAL DESCRIPTION OF THIS BUSINESS
'g^l/V^-

FAIR MARKET VALUE
[~[ $2,000 - $10,000D $100,001 - $1,000,000

NATURE OF INVESTMENT
Stock ^ Other
< $10,001 -$100,000
[_ Over $1,000,000
^
(Describe) [_] Partnership D Income Received of $0 - S499 n Income Received of $500 or More {Rapoit on Schedule C) IF APPLICABLE, LIST DATE:

J. J24.

ACQUIRED
J. J2A.

DISPOSED
> NAME OF BUSINESS ENTIH'

GENERAL DESCRIPTION OF THIS BUSINESS
FAIRMARKETWLUE"
n $2,000 - $10,000 \~ $10.001 - $100,000Q $100,001 - $1,000,000 [^_ Over $1,000.000

NATURE OF INVESTMENT
n Stock n Other
(Describe) I] Partnership Q Income Received of $0 - $499 D Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE:

J. _/24_

ACQUIRED
y. J24.

DISPOSED
> NAME OF BUSINESS ENTIPl'

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
Q $2,000 - $10,000n $100,001 -$1,000,000

NATURE OF INVESTMENT
Q Stock [^ Other
[^ $10,001 - $100,000 F~ Over $1,000,000
(Describe) r^ Partnership D Income Received of $0 - S499 H Income Received of $500 or More fReporf on Schedule C) IF APPLICABLE, LIST DATE:
_/. J24-

ACQUIRED
_/_ J24-

DISPOSED
>• NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THTS-BU S I MESS"

FAIR MARKET VALUE
Q $2,000-$10,000n $100,001 - $1,000,000

NATURE OF INVESTMENT
Q Stock Q Other
[^ S10.001 - $100,000|— Over $1,000,000
ler
(085cribe) n Partnership D Income Received of $0 - $499 D Income Received of $500 or More IReport on Sdiedu/e c; IF APPLICABLE, LIST DATE:
_/_ J24-

ACQUIRED
y. J24-

DISPOSED
> NAME OF BUSINESS ENTITY

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
n $2,000 - S 10,000Q »100.001 -(1.000,000

NATURE OF INVESTMENT
Q Stock [^ Other
n $10,001 - si oo.oooQ Over $1.000,000
(Descnbe) r~| Partnership D Income Received of $0 - $499 D Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE:
_/_ /24

ACQUIRED
./_ /24

DISPOSED
> NAME OF BUSINESS ENTITY

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
n $2,000-$10,000
Q $100.001 - $1,000,000

NATURE OF INVESTMENT
Q Stock Q Other
\"~ S10,001 -$100,000
[^ Over $1,000,000
(Uescnba) n Partnership D Income Received of (0 - S493 Q Income Received of $500 or More (Report an Schedule C) IF APPLICABLE, LIST DATE:

J_ -724-

ACQUIRED
J_ J2A.

DISPOSED
Comments:

FPPC Form 700 - Schedule A-l (2024/2025)
[email protected] ' 866-275-3772 • wivw.fppc.ca.gov
Page - 8
CALIFORNIA FORM 7 00

FAIR POLITICAL PRACTICES COMMISSION
Date Initial Filing Received
Fifny Olfcial Use Orfy
Please type or print in ink.

STATEMENT OF ECONOMIC INTERESTS

COVERPAGE RECEIVP-H
/\ PUBLIC DOCUMENT
^4;-T? n PM -.00

NAME OF FILER (LAST) (FIRST)
^f^ S(-e.^. ^AilcAA
(MIDDLE)
/">.'
^';v -:; :.-..-;?(<;

1. Office, Agency, or Court / ...•;" ;".- ;;'"^A
Agency Name fDo not use acronyms) ^/'/ V 6' f' ^(.s- ^ /3 6^ A Division, Board, Department, District, if applicable Your Position ^^ 4 /^ e/y /) f^ CN -r^^ /-h^s.'/^ 6 /? ^/4/eo A-/- 4?£'c:,^ Bo^^b M's ^16^^ »- If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: —__ Position:

2. Jurisdiction of Office fc/ieck a( least one box)
n State
D Multi-Counly
;ityof /^ >/-)/)£Nfi
II Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction)
a County of
D Other

3. Type of Statement (Check at leas( one box)
P Annual: The period covered is January 1, 2024, through December 31, 2024.
-orThe period covered is / / _, through
December 31, 2024.
r Leaving Office: Date Left J_ _/_
L. Assuming Office: Data assumed _/_ J_
the date of leaving office.

K' Candidate: Date of Election /V 6 N Gr and office sought, if different than Part 1:. (Check one circle below.)
L The period covered is Januai-y 1, 2024, through the date of leaving office.
-or-
[^ The period covered is / / _, through
i4. Schedule Summary (required)
Schedules attached
> Total number of pages including this cover page: {^;5 [y1 Schedule A-1 • Investments - schedule attached
f^] Schedule A-2 - Investments - schedule attached
^} Schedule B - Real Property- schedule attached
"or- n None • No reportable interests on any schedule
[)(_ Schedule C - Income, Loans, & Business Positions - schedule attached |_ Schedule D - /ncome - Gifts - schedule attached
F~ Schedule E - Income - Gifts - Travel Payments - schedule attached

5. Verification

MAIUNG ADDRESS STREET
ffguslness^sjr Aaenm Mdress Rsmmmended - Public Documenl) cirr STATE a p CODE

DAYTIME TELEPHONE NUMBER
( )

EMAIL ADDRESS
P^ftD^A,^, 6/^ Tt^l
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a public document.

I certify under penalty of perjury under the laws of the State of California that the foregoing is (rujDate Signed ^l[(£lt5 [month. Signature correct.
^
{File She origiaally slgneii ilamcnt u/lh yow liling olSclal.) FPPC Form 700 -Cover Page (2024/202S)
[email protected] • 866-275-3772 • www.fppc.ca.gov
Paee - 6
SCHEDULE A-2
Investments, Income, and Assets
of Business Entities/Trusts
(Ownership Interest is 10% or Greater)

I CALIFORNIA FORM
FAIR POLITICAL PRACTICES COMNItSSION

6. ^s^^t^)
> 1. BUSINESS ENTITY OR TRUST >• 1. BUSINESS ENTITY OR TRUST Name
. •^f^tt-^C^'l"'l
Address (Business Address Acceptable)
Check one
P Trust, go to 2 |% Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF THIS BUSINESS f'hh^e'lW/-^ ei /)i'.v^r-^t ffW^d' b'-.l ^fl'li^Y y
IF APPLICABLE, LIST DATE:
7—J24-

ACQUIRED
J—J2^-.

DISPOSED

FAIR MARKET VALUE
\~_ $0-S1,999I $2.000 - $10,000[~ $10,001 - $100,000 j^. $100,001 -$1,000,000 ', Over $1,000,000 NATURE OF INVESTMENT[__ Partnership [^ Sole Proprietorship S.

YOUR BUSINESS POSITION ^'i I-^G- M^^'t^ r'/^U W^ J
Other
NameAddress (Business Address Acceptable)
Check one
f~ Trust, go to 2 D Business Entity, complete the box, then go to 2

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
^_ $0-$1,999 I S2.000 - $10,000^ $10,001 - $100,000 ] $100.001 - S1,000.000 \~~ Over $1.000,000
IF APPLICABLE. LIST DATE:

J24-

ACQUIRED
J-^24_

DISPOSED
NATURE OF INVESTMENTQ Partnership Q Sole Proprietorship [^ Other

YOUR BUSINESS POSITION
> 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATAB^ 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RAT/ SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) • SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) B S10,001 - $100,000n OVER $100,000
1Z $0 - S499C $500-$1,000
|— $1,001 - $10,000
> 3. UST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE lAllacli a Enparalc nhcot If nonusary.) INone or Rd Names listed below
^"v/o (.epc-'R-e yi-i i h i'i K i-i S'W '/ -/i, f.Jf^shti D-e peif o To «-? <>\/re ii; s f:-/ > 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR

LEASED BY THE BUSINESS ENTITY OR TRUST
Check one box;
\~ INVESTMENT [?('REAL PROPERTY
Name of Business Entity, if Investment, flr Assessor's Parcel Number or Street Address of Real Property (t •?- :? (5-0 ^ ^rc'/ 7 .- ^/^-^ ^/ ^^^ ^ r Description of Business Activity or City or Other Precise Location of Real Property C S10,001 - $100,000|— OVER $100,000
E $0 - $499C S500-$1,000
n $1,001 - $10.000
> 3. UST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF
INCOME Op $10,000 OR MORE (Atlach a scpaialn shod il nccossaii.) I None or | | Names listed below

FAIR MARKET VALUE
$2,000 - $10,000
$10.001 -5100,000$100,001 -$1,000,000 [^'Over $1,000,000

NATURE OF INTEREST
'roperty Ownership/Deed of Trust
IF APPLICABLE, LIST DATE:

J24_
ACQUIRED ^—y24_ DISPOSED
[^ Stock Q Partnership
[^ Leasehold
Yrs. remaining [^ Other
ICheck box If additional schedules reporting investments or real property are attached Comments: ^ee a-4^cwrf
>• 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED B^^HE BUSINESS ENTITY OR TRUST
ChecK one box:

D INVESTMENT ^ REAL PROPERTY
^
Name of Business Entity, if Investment, er Assessor's Parcel Number or Street Address of Real Property Description of Business Activity of
City or Other Precise Location of Real PropertyFAIR MARKET VALUE Q $2.000-$10,000
$10,001 - $100,000$100.001 - $1,000,000Over (1.000,000
NATURE OF INTERESTII Property Ownership/Deed of Trust
IF APPLICABLE. LIST DATE:

ACQUIRED DISPOSED
[^ Stock Q Partnership
Q Leasehold
Yrs. remaining [^ Other
["} Check box K additional schedules reporting Investments or real property are attached FPPC Form 700 - Schedule A-2 (2024/2025)
[email protected] • 866-275-3772 • www.fppc.ca.gov
Page. 10

CALIFORNIA FORM

SCHEDULE B
Interests in Real Property
(Including Rental Income)
700

FAIR POLITICAL PRACTICES COMMISSION
Name^. 0'£^/s/'.5^/fc76
> ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
^-^co-z ^/f-,^^/^^..

CITY
-^
T^^M^i^
FAIR ^4ARKET VALUE
n $2,000 - S10,000Q 110,001 - $ioo,ooo
D $100,001 -(1,000,000[^'Ovsr $1,000,000

NATURE OF INTEREST
f-^ Ownershlp/Deed of Trust
n Leasehold
IF APPLICABLE, LIST DATE:
j /24

ACQUIRED
IEasement
^24_

DISPOSED
Yre. remaining Other

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
I I $0-$499 | $500-$1,000 | $1,001 - $10.000\^[ $10,001 - $100,000 f— OVER $100,000 SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source ofincome of $10,000 or more.

None
bA\i'i^ L'p>^ C7 lift M tl ^ t'1 S't'l.t (4-L i
Ut'(4'">^'fv bK?>?(.?ii
'Tut-h <:Yf^,,u--4-:.(
a
>- ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY

FAIR MARKET VALUE
D $2,000 - $10,000Q tio,ooi - $100,000
n (100.001 -$1.000,000Q Over $1,000.000
NATURE OF INTERESTII Ownershlp/Deed of Trust
n Leasehold
Yrs. remaining
IF APPLICABLE, LIST DATE:

ACQUIRED DISPOSED
I Easement
r.

Olhnr

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
I I $0 - $499n $10,001 - 1100,000
$500-$1,000 I $1,001 - $10,000
OVER $100,000
SOURCES OF RENTAL INCOME: If you own a 10% or greater
interest, list the name of each tenant that is a single source ofincome of $10,000 or more.

None
You are not required to report loans from a commercial lending institution made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows:

NAME OF LENDER*ADDRESS (Business Address Accaptabla)

BUSINESS ACTIVITY, IF ANY, OF LENDERINTEREST RATE
-%
TERM tMonths/Years)
None

HIGHEST BALANCE DURING REPORTING PERIOD
D $500 - S1.000 |— $1,001 - $10,000n $10,001 - ¥100,000 r~ OVER $100,000[_| Guarantor, If applicable NAME OF LENDER*
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY. IF ANY, OF LENDER

INTEREST RATE
-% n None
TERM (Months/Years)

HIGHEST BALANCE DURING REPORTING PERIOD
n i5oo - ?i,ooo n $1,001 - $10,000f-] $10,001 - S100.000 n OVER $100,000[_] Guarantor, H applicable Comments: ^^^ O^Aci^d^
FPPC Form 700 - Schedule B (2024/2025)
[email protected] « 866-275-3772 • www.fppc.ca.gov
Page-12
Attachment California Form 700 - Emily Wernberg
I own a four unit rental property in Pasadena, with the addresses of: . -, and Pasadena, CA 91104.

This property is held in the Emily Wernberg Living Trust.

Emily Wernberg, as Trustee of the Emily Wernberg Living Trust has granted those units, which constitute real property, to .

Those units are the only assets held by

SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)

CALIFORNIA FORM

FAIR POLITICAL PRACTICES COMMISSION
Name
^.[^tLN&<.li^

1. INCOME RECEIVEDNAME OF SOURCE OF INCOME
6^C!
ADDRESS (Business Address Acceptable)
. n^u^.r/i £'iifply
BUSINESS ACTIVITY, IF ANY. OF SOURCE
Pl'^ f £ t ••{-•J ^Id'rLA.^ tl-^ k+

YOUR BUSINESS POSITION
^ 'i t'1.^ Ik M€-|t-Y fee'W / ^».^N (•\£ve-{L
GROSS INCOME RECEIVED [—] No Income - Business Position Only D $500-$1.000 Q $1,001 - $10,000
@ $10,001 - $100,000 LJ OVER $100,000

CONSIDERATION FOR WHICH INCOME WAS RECEIVED
^ Salary || Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) [~\ Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.) Q Sale of
(Real property, car. boat, etc.)
I Loan repayment
II Commission or Rental Income, list each source oFSIQ.OOO or more, S'iiAtl^t-, ^(;fi.,. bivviaLco^t-.'TDtK ^K^fc; CK-^t ^Oes 4- roesmlsj n Other
(Descnbe)
^ 1. INCOME RECEIVED

NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)

BUSINESS ACTIVITY, IF ANY, OF SOURCEYOUR BUSINESS POSITION GROSS INCOME RECEIVED (-| No Income - Business Position Only C S500 - $1,000 Q $1,001 - $10.000
[^ $10,001 - S100,000 d OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED[~ Salary [— Spousa's or registered domestic partner's income (For self-employed use Schedule A-2.) \~ Partnership (Less than 10% ownership. For 10% or greater use Schedule Ar2.) I
'•I
F_ Sale of
(Rea( property, ear. boat. ate.)
II Loan repayment
ICommission or | Rental Income, Csl each source o/1(0,000 or mom (Describe)
P Other
(Describe)
> 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD You are not required to report loans from a commercial lending institution, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your ofTicial status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows:

NAME OF LENDER'
ADDRESS (Business Addrass Acceptable)

INTEREST RATE
-% Q None
TERM (Months/Years)

BUSINESS ACTIVITY, IF ANY, OF LENDER

SECURITY FOR LOAN
[^ None ~] Personal residence

HIGHEST BALANCE DURING REPORTING PERIOD
D $500-31,000n $1.001-$10,000
Q $10,001 - 5100,000
Q OVER 5100,000
[^ Real Property Slraet address
G'ly
D Guarantor
[^ Other
Comments: <;s^le /r/^c^'J
(Descffbe)
FPPC Form 700 - Schedule C (2024/2025)
advlce(?fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page-14
District 7 & At Large
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RECEiVED
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CETi/OFPAS,^£NA
Pasadena Rental Housing Board
,,^3£??>, ^^%. til
v.y

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 thePasadena 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 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 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: pf;'t)C)'f/'Lh i^'i
^1
J--\ ^•-/T
Home Address:

Mailing Address: ^^<;L4)U/ (^ ^h-l-^)
/
Cd.

A I
Email Address:

Business Phone:

Home Phone:

I
(/•
•^ T J
Date Available to Start: j ft] nudl(^i"€y
Cell 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 ire currently serwng or have served, offices held and m what pity, .— i ^^ff • ire currently sen/ing or have served, ^^li^ ^W ^)^n &^^f^6J4%M^ ^:() K/ /•I fcd ^^R v/:iT n &ji^^fr^(^4^M^^)y R^^^t- ,, yV^)^/-!^ 'f^^iWT^^1^ ^^d. ^U.^l^^ Employment - Title and duties, current and past (acceptable to attach resume as an alternative). .. .. ^
'Q-LL' fl^n^U/L fJi^^^O
Education - Include professional or vocational licenses or certificates. BA- TiMr.h - dSi^ ^& ff^<l^^'^^ F^ur ^ wl^ 7l IK^'t^t^^^tlSy4

1. Have you ever worked for the City of Pasadena? (If yes, please YES list dates/depaftment) A()r^M^- '^M^.I fa7f..^ ^cmk^ Izvzs-.^zs} NO Q

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 giHs, 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 amember of the Rental Housing Board? (If yes, please indicate any potential conflicts)
YES
YES
D
NO
NO
D

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 NOE]
DNO
DNO
NO
D
1Extended Family: any spouse, whether by marriage or not. domestic partner, parent, child, sibling, grandparenl, 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 YES |^<J NO consecutive years as a member of the Pasadena RentalHousing Board?

10. Can you, upon appointment, provide proof of identity and proof YES |^J NO of eligibility to work in the United States, as required by Federallaw?

11. Describe your relevant life experience, professional training, and/or education in the following areas: Hoi^sing/Housing J^sttcelLan^ord Tenant Relationships/Real Estate:, -^4L^^fe^OA ^.^M^AJ/^^/^lMh/^ / f^^J.^^m.f-6 f^imll^. /-.
^/"•7
^
A^J 1.9
^fMsr^^a T/f-lp'^-^-^^ r.o^W^ Ti^ '^ 'Sx/im'c^
n^i^^^M^- p^crUm ¥^M ^-u/^^y

12.,How would you add value to the Pasadena Rental Housing Board? ^_ i _ ^. _ _ < ^Ti~\i^^^(\ ^t7)Prnb,r-r^"u}4z/(2^ X Jx^^ ^rvat^ ^,L ft? (ia\ /. {? D t'r-^ A,^ 7 )%Ir f^i^^^T^^r AW ^^^~ ^
^,L ft? (ia\ /. {? D t'r-^ A,^ 7 )%Ir f^i^^^T^^r AW ^^^~ ^n^^^T^L^^^A^^e^^m''^^ ^h/^ adds> ^ ]7z^ ^fW^Ki'!^4^/ ^f~<^^a^f^^rH pfT)p</r^ <,u^ ^^ ^/uj/

13. What do you view are the primary objectives and goals of the Pasadena Rental Housing 7^apT]^^f)^)^^v-^^flb/>fi^^^^/^
m 4-Pjf^t^J 4U 1MJ^ /
}^^u
^
4-^^^sssi ~^,^. 'k\ H\IS^(^ u^'w
/-V /
a/f^
[^r^.u^ a^U&lW^'.. Iw.'f^wf jfe- /( -p^Ah.! ^W ^.(\AAA7t7l^(U W^ ' >
fwft^ in
14_ How would you help to achieve these objectives and goals? T-^W^i ff.^U^injH |u//lf7J^,{ ]rif^m\Ld,6^7/bH^Uu^ '.fn'U.LVLU V T!) l^U IA^-1AAJ(1.{ f fin^\ {)'\^A- ^f}(1 V(^ft^ ^- /fO-(-/A-^ 4'()/)-^i/^'Q' 0^t'^/'^^.;^^1^- T~ ^A^^ /• "' " ~-' - >•'-••-' .-«— Tf "~ ,~ / /• - f '. .i S t „. : [^f}0 y^-jte ^, Jfr>-(n^ A^'^^1^ &fr^/'^^;^'?lt }^M<^..^7|7/w,^'n^^f^/-^'n/(^) ^ te ^-n^Ajy^s^h'^^n^ ^•/^/l^Lvli^- ^U^w a. -in e, ^^~FA I P^/bA^ ^v^i ^../^^.CL\^/}VIS (.. 2^45> ^ >s 1/H^
y ^^•V^J-^ f-n^' f]l/^^^/p W^/'l^'/l^ L'!iF>T ^^ 'thl. ^*i( ^f^^rif r^t-A/i^n-u^^, '.- 7?^H>^.^ b^^P the State of Californii that the ii'iformation the
complete.

Signed this

2. (printed name), declare under penalty of perjury under the law of formation reported in this Form RHB-001 is true, accurate, and 16^ day of A^// 20 ^"
Signed: .^\ /-S7^t-^/4/' ,<7f//^^-^
Printed Name: D-f^^Uh ^--/A/K
t^s^
m''^^^'Ap/ r^

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 (Charter Article XVIII). Proof ofresidency 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.
am a resident of District No. '-/ of the City of Pasadena I reside at -
CA ^ ft fi) (zip code).
2 (street), Pasadena,
7 Signed: _ I/ t/.Printed Name:h^hM/W/l ]}i)n.ih-1p

Please provide clear, readable copies of two (2) documents from the following list and attach tothis 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 cardInsurance 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 stateMortgage 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 postsecondary 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 PasadenaCalifornia 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.
^f
f .-fl
^
.^ i(( Cii
m
:%.. .^' ;'y^^'

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 (Charter ArticleXVIII) prohibits Tenant Board and Alternate Tenant Board members from having "MaterialInterests in Rental Property" (defined below) at the time of their appointment and during their sen/ice. 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 PracticesCommission's Form 700 for this purpose, but City Charter provisions in Article XVIII 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.

Rental Unit: any building, structure, or part thereof, or land appurtenant thereto, or any otherrental property rented or offered for rent for residential purposes, whether or not such unitspossess 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 arental housing agreement to the use or occupancy of any Rental Unit (Section 1803(aa)).

CITY OF PASADENA
Economic Interests Affidavit - MANDATORY
1, / V^T^T/'L^') IMA.^i rrfO (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 ///Signed:
^ day of _, 20^5:
/hr^t^u ^&€^t^^J
Printed Name: ']\^rfrY/l.^ l^JM.'Jfrp
^^T^fe
-^gir

CITY OF PASADENA
(d ^ i§| Affidavit of Tenancy - MANDATORY for Tenant Board %,%vy3 /^/ ^sy and Tenant Alternate Seats (Form RHB-003) I, j \{\ir)h'^(,[M j ^ ^'\, {.^"}D (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 ^f// Q j (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 /S'^/ day of /^-i^l^/.Signed: r'A/.^'^f^C-^^ (7^"^i^n. Printed Name: T).^^X^ hdp( Z?p ,20.25"
DEBORAH J. DUNLOP

PROFILE
Experienced, organized and detail-oriented Senior Real Estate Paralegal with 15+ years ofexperience performing title and survey reviews, and assisting with real estate closings ranging from large commercial multi-state portfolios to residential closings.

EXPERIENCE
BOARD MEMBER, PASADENA RENTAL HOUSING BOARD - 2023-CURRENT • Tenant Representative for District 7.• Member of Policy, Outreach, Relocation and Charter Amendment Ad Hoc Committees. • Bi-monthly meetings, discussions of Agenda items and voting on same. • Attend District 7 Commissioners' Meetings.

TITLE CURATIVE SPECIALIST, BOSTON NATIONAL TITLE - 2021-2022 • Review title to ensure all curative issues are identified and resolved. • Obtain payoffs for mortgages Judgments and liens on title for final clearance. • Confirm legal vesting, tax information, bankruptcy issues and subordinations.• Prepare Deeds, obtain surveys as required and finalize clear-to-close for all title requirements.

INDEPENDENT TITLE EXAMINER-20-19-2021
- Obtain property reports for residential properties.
• Perform title reviews to confirm chain of title and assess encumbrance issues for closings.
• Obtain documents from County Recorders, as requested. lasadenaCA91101
SENIOR PARALEGAL, EXCHANGERIGHT; PASADENA, CA - 2018-~20'I9 Perform title, ALTA survey, zoning reviews to assess issues for closings (with specialemphasis on multi-site, multi-state transactions).Review and sumnnarize commercial, retail and oil and gas leases; assist in preparation oflease amendments, assignments and termination agreements.Prepare UCC financing statements.

Prepare escrow instruction letters; assist with closing.

Conduct post-closing follow-up; review final title policies; prepare closing document portfolio indices and assemble closing binders; prepare transmittal of post-closing security documents to Lender Counsel.Prepare organizational documents for Corporations, Limited Liability Companies andLimited Partnerships and manage foreign registrations and filings for all with appropriatestates.

SENIOR PARALEGAL, GIBSON DUNN & CRUTCHER LLP; LOS ANGELES, CA - 2017-2018
Perform title, ALTA survey, zoning reviews to assess issues for closings (with specialemphasis on multi-site, multi-state transactions).Review and summarize commercial, retail and oil and gas leases; assist in preparation oflease amendments, assignments and termination agreements.

Obtain Good Standing and Legal Existence Certificates, as required, from all states.Order and review extensive due diligence search reports from all states and jurisdictions; prepare summaries for all searches.

Prepare UCC financing statements.

Prepare escrow instruction letters; assist with closing.

Conduct post-closing follow-up; review final title policies; prepare closing document portfolio indices and assemble closing binders; prepare transmittal of post-ctosingsecurity documents to Lender Counsel.

Prepare organizational documents for Corporations, Limited Liability Companies and Limited Partnerships and manage foreign registrations and filings for all with appropriatestates SENIOR PARALEGAL, SIDLEY AUSTIN LLP; LOS ANGELES, CA - 2014-2017 Perform title, ALTA survey, zoning reviews to assess issues for closings (with specialemphasis on multi-site, multi-state transactions).

Review and summarize commercial, retail and oil and gas leases; assist in preparation oflease amendments, assignments and termination agreements.Obtain Good Standing and Legal Existence Certificates, as required, from all states.Order and review extensive due diligence search reports from ait states and jurisdictions; prepare summaries for all searches.

Prepare UCC financing statements.Prepare escrow instruction letters; assist with closing.

Conduct post-closing follow-up; review final title policies; prepare closing documentportfolio indices and assemble closing binders; prepare transmittal of post-dosingsecurity documents to Lender Counsel.

Prepare organizational documents for Corporations, Limited Liability Companies and Limited Partnerships and manage foreign registrations and filings for all with appropriate states
SENIOR PARALEGAL, MUNGER TOLLES & OLSON LLP; LOS ANGELES, CA - 2013-2014
Perform title, ALTA survey, zoning reviews to assess issues for closings (with specialemphasis on multi-site, multi-state transactions).

Review and summarize commercial, retail and oil and gas teases; assist in preparation oflease amendments, assignments and termination agreements.

Obtain Good Standing and Legal Existence Certificates, as required, from all states.

Order and review extensive due diligence search reports from all states and jurisdictions; prepare summaries for all searches.

Prepare UCC financing statements.

Prepare escrow instruction letters; assist with closing.

Conduct post-closing follow-up; review final title policies; prepare closing documentportfolio indices and assemble closing binders; prepare transmittal of post-closingsecurity documents to Lender Counsel.Prepare organizational documents for Corporations, Limited Liability Companies andLimited Partnerships and manage foreign registrations and filings for all with appropriate states

EDUCATION

CALIFORNIA STATE UNIVERSITY, MORTHRIDGE, BA
SKILLS
Microsoft Office; iManage; Wintitle; Ramquest; ABC Conveyancing; Web Pacer; Summation

ASSOCIATIONS
Member of CA Paralegal Association

REFERENCES
Provided upon request.

CALIFORNIA FORIV1700

FAIR POLITICAL PRACTICES COMMISSION
Please type or print in ink.

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE

A PUBLIC DOCUMENT
Dste in'tial Fii'ng Received
Fui;'!; Ond,'.' u.si; Ori/

RECEIVED
NAME OF FILER (LAST) Don I ^p (FIRST) \^-fha^ IMIDDLET 7i!Z7TMi°7n 3 7UT-0:-T^ i-l:T.' :• r"; i.'

1. Office, Agency, or Court CiTY OF PASADENA
Agency Name fDo not use acronyms)
o-P Pt^arhMOt ^
Division,-Board,'Department, District, if applicable Your Position 'P^^l^iafe^l tt^^in^ BArd B^N Mw]^/7^4^4^ > If filing for multiple positions, list below or on an attachment. (Do not use acronyms) / Agency: Position:

2. Jurisdiction of Office (Check at least one box)
D State
D Multi-County
&Cityof P^^CliMfi
D Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction)
D County ofD Other
D Leaving Office: Date Left . _/_ J_

3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2024, through
December 31, 2024.
-orThe period covered is / / _, through
December 31, 2024.
-(S- Assuming Office: Date assumed --^1-2.^1 Z^2^^>5
the date of leaving office.
^g) Candidate: Date of Election /(/'/9/V/t~. and office sought, if different than Part 1:. (Check one circle below.)
D The period covered is January 1, 2024, through the date of leaving office.
-orQ The period covered is _/_ _/_ -, through

4. Schedule Summary (required)
Schedules attached
> Total number of pages including this cover page: /
Q Schedule A-1 • Investments - schedule attached[_] Schedule A-2 • Investments - schedule attached[_] Schedule B - Rea/ Property - schedule attached -or- g, None • No reportable interests on any schedule
Q Schedule C - Income, Loans, & Business Positions - schedule attachedQ Schedule D - Income - Gifts - schedule attached Schedule E - /ncome - Gifts - Travel Payments - schedule attached

5. Verification

MAILING ADDRESS STREET
fB"<;"a"" " Agency Address Recoirunended - Puyfc Document) -^ ' / ' / -

CITY STATE ZIP CODE
Q

DAYTIME TELEPHONE NUMBER
(
'ik^ae^a A4 £?«<t

EMAIL ADDRFRS
•±
I have used all reasonable diligence in preparing this statement I have reviewed this staWment and to the best of my Knowledge the iiiiuiiiiauui contained herein and in any attached schedules is true and complete. I acknowledge this is a public document.I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date Signed /)-^C^L1'/€'/^l D ^ S' ^W^^~^-?^A'^~^C-'^
/ tmonlh, aav, yeaif ~~ (Meineongmanyagneopapei (Re the (wgmaBya'gneif paper stalenient mlfi your Sing offidal.; FPPC Form 700 - Cover Paee (2024/202S)
[email protected] • B66-27S-3772 • www.fppc.ca.gov
Page - 6
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RECEIVED
^"^'4 ^n: 54
^!V¥- CLERK
CiTYOH^AOENA
Pasadena Rental Housing Board
;?. 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 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 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 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:
^
e^^-e^•^ ^1_
•^ _^_._ .-B^NO, Gt^ ^ (10^
-t-- I
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):

1. Have you ever worked for the City of Pasadena? f/f yes, p/ease YES | | list dates/department) NO

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)

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 anypotential conflicts) YES
YES
0D
NO
NO
D

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 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?
NO
D
YES [3 NO @
a NO
NO
El
a
' 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 YES consecutive years as a member of the Pasadena RentalHousing Board?

10. Can you, upon appointment, provide proof of identity and proof YES of eligibility to work in the United States, as required by Federal law?
NO
D
E3 No D

11. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate: ^ <SL*^ Xn\»^'^^<a.j\b ^ ForrA4t«- Lor^i^w^ •fc*^^r»t""^ X AcwcejcpA^/tf^pt- e-»^pAy/<S-^Cjt- AA.vI ^oi+»'in<| ^vft-uA^- ^l^AULfli^Ai -

12. How would you add value to the Pasadena Rental Housing Board^ MV ^^-<Llk ^AC-^^A^auL^c! tl^ <>a^l<^.'it^< ^J^UKQ ^LtJ^r
,'it^q 'C^cttz^r^ +OCUAC-GIL frt^
i/ecj| Co^n^L^vLttGA , r^t'»<R»TC<?^
^ ^iu'Hl^^A \OV (li^LU/^A^Ve,
^^»n^t»VM_^Y ~+A ^iC^jS^SS. A'l \ lk»l«^.

13. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board? XY^ T<^\^^r ^p ^^LU/)^ ~st^-/l/^KS^ ^fr^f^rc^^ a^.<- ^e^^u^^jbil ,-^cj ih ^^^,1 M^S<^ ej-^h^h^^'6^^ f^^-^k Vui^^bl^ /rfft,^M^^ /-^ii^-f^ ^ ^-^M^^^- Az^y/^< ^e^^f ^IA^/C^^ <L At/^ ^f'-h^ • ^

14. How would you help to achieve these objectives and goals? Z U<',11 l^dvfc. -t^ ^Ql^U^'l C<L^y. ^- eAucs»JL ^K 'f<<^A^^ ^ 4^*<c4>^ ^^dv'.o^y-S ^Aau^- •M^. /-^^haJL bootrj 4: ^^1^ /'^yMiM^^lf t^ JA*. T^pu4/ <Z^V5( MAt<Z p^ioy-'h'-?^ tXif-y-<^» cL tJVCf}-^ /o '^(/ ^^(•^.»t.^(»,rs . 1, \6vt6oi tiuf)^ _ (printed name), declare under penalty of perjury under the law of the State
complete.
ia that the information reported in this Form RHB-001 is true, accurate, and Signed this f day of /)(T>f't
\^a^
,20,^iS-.

Signed:

Printed Name: l/aV£x.
~f~^ v^
/OL^a^ UoQle^ ^
^
&?!%, CITY OF PASADENA
^^JiJ Residency Verification - MANDATORY
All applicants must provide proof of residency in a City Council district under section 181 1(b) of The Pasadena Fair and Equitable Housing Charter Amendment (Charter Article XVIII). 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. f of the City of Pasadena I reside at
CA ^UOfc (zip code)"
Signed:
(street), Pasadena,
^A
Printed Name: 3CfiJi^O.^ L^uL/1^
•
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:

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 VotersProof of payment of resident tuition at a public institution of higher education inCalifornia 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 PasadenaCaiiforni-a Certificate ofVehicie or Vessel Titles or registration (i.e., a title to, ora 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 abirth certificate, marriage license, or domestic partner registration certificate to trace your relationship to the person whose name does appear on theresidency documentation.

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

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 (Charter Article XVIII) 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 theirservice. 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 thethree (3) years before submitting an application. The City is adopting the Fair Political Practices Commission's Form 700 for this purpose, but City Charter provisions in Article XVIII requires information about interests in rental property in Los Angeles County for three years, not the oneyear the FPPC Form otherwise uses. Under City Charter Section 1811 (b), these documents are public records; they will not be confidential.

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)).

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 unitspossess a valid Certificate of Occupancy for use as rental housing, together with all housingservices 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 law of the State'cff Califbrnia that the information provided and reported in this Form RHB-002 and theattached Form 700 is true, accurate, and complete. .-E
^ <<u <\
Signed this
Signed:

Printed Name:
''' day of ptPOL
: :
-, 20 ^-
ftl^Ad L/L)(

CITY OF PASADENA
|1 1§| Affidavit of Tenancy - MANDATORY for Tenant Board and Tenant Alternate Seats
(Form RHB-003)
I, ^printed name), declare under penalty of perjury under the law of the State of California that the foregoing is true and correct:

1. lama 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 ftp rn^ 20 2^
Signed: :£t^y
Printed Name: f^ ^>1^<ib) ^ ^^ ^?^'
Parag Gupta

SUMMARY
A seasoned professional with 15+ years of experience in financial technology development for underserved communitybanking.

WORK EXPERIENCE
Valor Financial Technology - Cross Border Payments Pasadena, CA Head of Product May 2022 - Present
• Building a cross-border payments platform for sending money to other countries from the US with no transacuon fees.
• Early Markets: India, Mexico, and the Philippines.

Wepay a JPMC co.-Payment Gateway for Platforms Redwood City, CAVP of Product - Payments Platform Aug 2019 - Mar 2022 * Responsible for building a payments platform that companies like GoFundMe used to process donadon payments.

Green Dot Bank-Mobile Bank Accounts & Debit Cards Pasadena, CA Product Lead Aug 2015-Jul 2019
• Launched the company's Hrst secured credit card, overseeing its development from initial concept to market introduction to help build credit.
• Launched a savings product that encouraged Americans to save money by winning monthly sweepstakes prizes.

Wells Fargo-Commercial R-eal Estate: Multifamily Capital Mclean, CABusiness Consultant Aug 2013 - Nov 2014 • Led the transition of cash flow product from paper-based to digital processes, resulting in significant resource efficiencies.

FDIC Washington, DC
Product Management Consultant
• Streamlined bank examination processes, significantly reducing the dme examiners needed to complete assessments, thereby improving operational efficiency.

Freddie Mac Mclean, VA
Product Management Consultant
• Established business reguladons that miugated risks and enhanced loan purchase quality, resuldng in substantial financial savings.

Fannie Mae Washington, DCProduct Management Consultant
* Collaborated with internal teams to integrate stakeholder requirements for securities accounting enhancements, ensuring comprehensive needs analysis and inclusion.

EDUCATION
Wayne State UniversityMS, Industrial Engineering

COMMUNITY ENGAGEMENT
Detroit, MI
Volunteer - Supported community education efforts around financial literacy and early childhood education.

Speaker & Panelist - Discussed tech's role in improving access to essendal services, including financisd tools.

SKULLS
Multilingual: English(Fluent), Hindi (Fluent), Punjabi(basic) & Spanish (basic) Strong public speaking, policyinterpretation, and stakeholder cngagenient skills Data-driven decision-making with a. human-centered approachExperienced in cross-sector collaboration (public, private, nonproHt) CALIFORNIA FORM700

FAIR POLITICAL PRACTICES COMMISSION
Please type or print in ink.

STATEMENT OF ECONOMIC INTERESTS
.,COVERPAG.E..... RECEIVED
Dats initial Filing Received
filing OScto! U5i> Onfy
/I PUBLIC DOCUMENT
?n^&FR (U &H 11^47

NAME OF R (LAST)
u
cy,or rt
(FIRST)
^cL\^a^
(MIDDLE)
C! i -f CLLRK
un r u?- r-.o-^uciNrt 1. Office, A;
not use acronyms) ^cktft.<^ t-wW HDUA'A^ ^<»<t*-ol
Board. Your Position
A+ ^^ <2- M^w'a^
> If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: Position:

2. Jurisdiction of Office (Check at least one box)
Q State
D Multi-County
B^'yof PAA^ ctoj^/2
D Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction)
D County of
D Other

3. Type of Statement fc/iec* at least one box)
Q Annual: The period covered is January 1, 2024, through December 31, 2024.
•orThe period covered is / /
December 31, 2024.

D Leaving Office; Date Left J. J_
through
(Check one circle below.)
D The period covered is January 1,2024, through the date of leaving office.

D Assuming Office: Date assumed _/. J.
•orQ The period covered is J_ J.

Candidate: Date of Election WOKC^
the date of leaw'ng office,
and office sought, if different than Part 1:.
through

4. Schedule Summary (required)
Schedules attached
> Total number of pages Including this cover page: ^
Schedule A-1 • Investments - schedule attached
Schedule A-2 ' Investments - schedule attached
ichedule B • Real Property - schedule attached
•or- D None • No reportable interests on any schedule
Q Schedule C - fncome, Loans, & Business Positions - schedule attached Schedule D • Income - Gifts - schedule attached
D Schedule E - Income - Gifts - Travel Payments - schedule attached

5. Verification

MAILING ADDRESS ' - STREET CITY
^^dtACK
STATE
CAZIP CODE
DAYTIME "ItLEPHONE^IUMBER
0 <>
EMAIL ADDRESS °{\\0\
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a public document.

I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct Date Signed Vb<y"yV- " Signature ^[^> ^v^ •
/ V"°""'. ifj^fe thyiifn paper sfafemenl wlfi your SSng olSdal.j FPPC Form 700 . Cover Paee (2024/2025)
adviceigfppc.ca.gov • 866-275-3772 • www.fppcca.gov
Page-6
1 CALIFORNIA FORM 700

SCHEDULE B
Interests in Real Property
(Including Rental Income)

FAIR POLITICAL PRACTICES COMMISSION
Name
> ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
^^t^Q2-^0^£f
CITY
P^A^V^

FAIR MARKET VALUE
Q $2,000 - (10,000Q $10.001 - $ioo,ooo
'$100,001 -$1,000,000
Q Over $1.000,000
NATyftE OF INTEREST
@/&v.',",ership,'Desd of Trus!
IF APPLICABLE, LIST DATE:

Q Leasehold
Yrs. remaining
724_

ACQUIRED
]] Easement
D7_^24_ DISPOSED
Other
IF RENTAL PROPERTY. GROSS INCOME RECEIVED
Q $0 - $499 Q $500 - $1.000 Q^1-001 - $10,000Q $10,001-$100,000 Q OVER $100,000 SOURCES OF RENTAL INCOME: If you own a 10% or greaterInterest, list the name of each tenant that is a single source of income of $10,000 or more.

D None
> ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY

FAIR MARKET VALUE
Q $2,000 - 110,000Q $10,001 - $ioo,oooQ $100,001 -$1.000,000Q Over $1,000.000 NATURE OF INTERESTI! "".'"ershJp.'Deed "f Trus!II Leasehold IF APPLICABLE, LIST DATE:

Yrs. remaining
J—12^

ACQUIRED
,t Easement
DJ2A- DISPOSED
Olhar

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
Q»0-$499 QtSOO-$1,000 Q »1,001 - $10.000Q $10,001 - $100,000 Q OVER $100,000 SOURCES OF RENTAL INCOME: If you own a 10% or greaterinterest, list the name of each tenant that is a single source ofincome of $10,000 or more.

Q Noneme
You are not required to report loans from a commercial lending institution made in the lender's regular course ofbusiness on terms available to members of the public without regard to your official status. Personal loans andloans received not in a lender's regular course of business must be disclosed as follows:

NAME OF LENDER'
T/ui,^ kx^Jk^
ADDRESS (Business Address Acceptable)
2-^ ^1i<«o^ J^^^bti^^^l It
BUSINESS ACTIVI'TY. IF ANY. OF LENDER IVI'TY.
z-^ Z^fS

INTEREST RATE
-% Q None
TERM (Months/^ears) .rfei

HIGHEST BALANCE DURING REPORTING PERIOD
Q$5oo-si,ooo Q $1,001^-110,000Q $10,001 - $100.000 (QP^ER $100.000 I] Guarantor, if applicable
NAME OF LENDER*
ADDRESS (Business Address Acceptable)BUSINESS ACTIVITY, IF ANY, OF LENDER

INTEREST RATE
-% Q None
TERM (Months/Years)

HIGHEST BALANCE DURING REPORTING PERIOD
Q $soo - $1,000 Q $1.001 - $10,000
Q $10.001 - »ioo,ooo Q OVER $100,000
II Guarantor, if applicable
Comments:

FPPC Form 700 - Schedule B (2024/2025)
[email protected] • 8G6-275-3772 • www.fppc.ca,(ov
Page -12
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RECEIVED
2025APH2! AH 10: 51
CiTY CLERK
CiT/ OF PASADENA
Pasadena Rental Housing Board
b? PAS?0.
y. '<•t-r
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<u ?6 5^ &TTO s

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 theCity 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:

Home Address:

Mailing Address:

Email Address:

Business Phone:

Home Phone:

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

1. Have you ever worked for the City;of^asadecia? (If yes, please list dates/department) f <
A-
. I • .
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2. Are you related to any employee, appointed or elected official of the City of Pasadena? (If yes, please indicate n^me and relationship) \ :i,
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3. Are you aware that financial disclosure is required annually? (e.g., sources of income, loans andgifis, 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 fronr».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 NO
YESDNO
YES
YESD
NO
NO
D

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 th|e 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 Pa^dena Rental Housing Board? ^

8. Are you aware of the time commitment necessary to fulfill the obligations of the Pasadena Rental lousing Board? ;),s,
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t
YES
YES
NO
NO
D
YESDNO

YES NO D
rtended Family: any spouse, whether by marriage or not. domestic partner, parent, chiM, sibling,'S'randparent, aunt o/»jnde, niece or nephew, grandchild, or cousin (Charter Section 1803(g)).

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

10. Can you, upon appointment, provide proof of identity and proof YES of eligibility to work in the United States, as required by Federallaw? NO Q
NO Q

11. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate:
^ WO^/A ^W(^

12. How would you add value to the Pasadena Rental Housing Board? S^ AU^lun'<lA9^

13. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board? 4^. A^/vlw. A AU^-

14. How would you help to achieve these objectives and goals? ^ /UAA^AA^W1, _UWl) T^ lWZZ(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 y^> day of ftPK\L
Signed: ^^J
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Printed Name: G-^S» T-^ VffW^
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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 (Charter Article XVIII). 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.

I reside at
CA €j^ (zipcode)-
Signed:
^
of the City of Pasadena
(street), Pasadena,
Printed Name: QWO T-U? ffl^T, S^.

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 § 1 5.01 (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 billRecords 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 cardInsurance 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 subdivr'sion 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/tandlord and the tenant/resident
School documents issued by a public or private primary, secondary, or postsecondary 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 StatesDeed 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 (Charter Article XVIII) prohibits Tenant Board and Alternate Tenant Board members from having "Material Interests in Rental Properi:y" (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 City Charter provisions in Article XVIII requiresinformation 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.

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)).

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, ^_>yr v v'^^ (V.^TI/ ( ^ l;t-(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
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Signed:rs] day of <iiL .20 WO i^
Printed Name: GUAO T-^ (Nr^
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
1, L--VWAI A v^ \r/f^((, f^rinted name), declare under penalty of perjury under the law of theState 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^P^ day of /WlL Lffi: .1 20^r Signed:.

Printed Name: C\W T^ 0^7;
CHADT-WPRATT,Sr.1
Pasadena, CA 91105
. Operations focused leader with 30+ years of experience in legal operations as well as performing as a respected trial attorney, leveraging extensive business and legal acumen and entrepreneurial experience to influence success. . Recognized for having extensive litigation experience including 25+ jury trials, and 10,000 UD (unlawful detainer) trials and successfully challenging major banks on Fraudulent and predatory loans safeguarding and protecting homeowners when others would not step up to do so.
. Pioneered and founded Bronco Advertising & Marketing, LLC as CEO a boutique ad firm that is disrupting the advertising space by placing ads on the sides of big rig trucks.
.Grafted a strategic business blueprint encompassing meticulous marketing and sales initiatives to bolster sales and company growth.
.Spearheaded the development of an inclusive app. Effectively utilizing the digital platform to bridge gaps in the community making resources quickly accessible.

RECEIVED
2025 APR 21 AH 10:51

CITY CLERK

CITY OF PASADENA
+ Strategic operations Leadership
+ Business Planning & Execution+ In -Depth Policies and Procedures+ Compliance and Regulations + Complex Contract Negotiations+ Partnership Building & Management + Creative "Out of the Box" Problem Solving
+ Project & Program Management+ Budget Management
+ Skilled Conflict Resolution
+ Entrepreneurial Business Initiatives
+ Legal Prowess & Social Impact
+ Technology Integration+ Resource Optimization
+ 34 Years of Local Community Outreach and Growth
1Presently retired from the practice of law.
1 Notable Cases
"Free & Clear" house Shantre vs T (Case # GC045358) lost on appeal. Jury verdict for tenant in possession & title (UD Case # 13U0076) Aurora Bank vs G (won 5 UDs row for same property) (UD#09H01594) Wrong lot foreclosed judgment for tenant and dismissal (UD Case # CIV D 1109076) Tenant victoiy/ wrong property (UD Case # 09U00120) Settlement for 20 tenants vs slumlord (Case #KCO 12892) Defeated "top trial attorney" attempt to mansionize property local zoning laws, Pasadena.CA. FULL REFUND security deposit house purchase no suit filed. Trials California: Los Angles, Orange, Riverside, San Diego, San Bernardino, San Francisco, Sacramento, Catalina Island. Counseled individuals, businesses, start-ups on legal & business issues.

Professional Experience: Litigation
Self employed litigator for hire for 33 years representing both plaintiffs and defendants in State & Federal courts, administrative hearings, tribunals et al. Counseled individuals, businesses, start-ups on legal & business issues.

Loyola Law School , adjunct professor "real estate law" SPRING 2013.

Real Estate Law Center, PC (RELC) lead litigator/senior partner of law firm with 1000's successful foreclosure settlements. [2011- 2013] Dennis P. Block & Associates, of counsel trial attorney UD. [1991-1995] Howard H. Hall, Inc., of counsel personal injury plaintiff law. [2000- 01] In house counsel Pacific Green Trucking, Inc. [2000- 2022] Lee Han & Pacioco,LLP "of counsel" litigator 2017-2022.

CRASH Mediator , LA courts 2000- 2010.
2000. Lecturer: Loyola Law school 2013, real estate seminars 2000, contractors' school 3 Addendum A
Pasadena RENTAL HOUSING BOARD- At Large Member
Form RHB-001

1. Community Service
St. Bede's Catholic Church Board of Directors 2006- 2009, Chair 2007 St. Bede's Catholic Church "usher" at mass 2022-present Knights of Columbus (Catholic men's volunteer organization ) 2023- present Assistant Pack Leader Troop 87 Cub Scouts 2013-2015
Assistant Scoutmaster Troop 507 Boy Scouts, 2017- 2018, Eagle Scout 1979 AYSO Referee 2015- 2017, Monitor of volunteer personnel 2018 , Pasadena AYSO Board of Directors Loyola Law School 2000-2002 Loyola Law School Adjunct Professor , Real Estate Law "unlawful detainer" 2013

2. Employment
Please See C.V. (four pages) attached hereto
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3. Education
Loyola Law SchoolSanta Clara University
Durham University (England)
Loyola High SchoolSt.Bede Grammar School
J.D. 1989
B A. Honors in History 1986Jr Year Abroad 1985
High School Diploma 1982
Grammar school 1978

11. I am a lifetime resident of the City of Pasadena 1963 to present date. I have owned real property, a single family residence in District 6, and I have recently downsized and now am a tenant of a condominium in district 7, so I see both sides of the issue(s).As a trial attorney I have litigated over ten thousand, YES ten-thousand UD (unlawful detainer) cases for both tenants and landlords. I have actual real-world , in the ti-enches experiences with all issues of landlord-tenant law. (I have done 10,000 as I worked with UD trial firms doing 300 trials per month for 5+ years and doing UD cases individually as well.). This includes court trials and jury trials.

Additionally, I have vast and multiple experience in quiet title and all such related realestate litigation, both bench and jury trials. I believe that I am the only candidate with such real-worid litigation experience on behalf of both landlords and tenants 2008- 2022.

12. I have been a resident of Pasadena for 61 years, I have been an owner and a tenant, and I have litigated 10,000 UD cases, and related quiet title litigation over real property. I have been head of household of a family of 4 (dad-mom and two kids) and after losing my beloved wife Lisa to brain cancer in 2018,1 know first hand the struggles of families in Pasadena to keep it all together. I will put all this experience to use on the PRHB to address the issues fairly, evenly, and properly for both landlords & tenants CALIFORNIA FORM70Q

FAIR POLITICAL PRACTICES COMMISSION
Please type or print in Ink.

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE

A PUBLIC DOCUMENT
Date Initial Filing Received
Filing OSdal ilss Only

RECEIVED
?R?54PR?i SM £;. NAME OF FILER (LAST) ^wrr (RRST) (2^AD (MIDDLE) -> r[\oH^^MtMM

1. Office, Agency, or Court <-11 YU^-PASADENA
Agency Name (Do not use acronyms) 'PAC40^/A>"(^A^ {WQfC (to^%b ^r ^^6.

Division, Board, Department, District, if applicable Your Position >• If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: _ Position:

2. Jurisdiction of Office (Check at least one box)
D State
MultWounty
^ City of pyfAOg/UA
D Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Junsdiction)
D County of
D Other

3. Type of Statement (Check a( feast one box)
Annual: The period covered is January 1, 2024, through
December 31, 2024.
•orThe period covered is / /
December 31, 2024.
\Z\ Leaving Office: Date Left , _/_ J_
through
D Assuming Office: Date assumed J_ J_
Candidate: Date of Election _Wiij/lo^boffice sought,
(Check one circle below.)
D The period covered is January 1,2024, through the date of leaving office. -or.

D The period covered is —I —I —, through
the date of leaving office.
if different than Parti:.

4. Schedule Summary (required)
Schedules attached
> Total number of pages including this cover page: ^
Q Schedule A-1 • Investments - schedule attached
[_] Schedule A-2 • Investments - schedule attached[_j Schedule B • Rea/ Property - schedule attached Schedule C • Income, Loans, & Business Positions - schedule attached [_) Schedule D • Income - Gifts - schedule attached
D Schedule E • Income - Gifts - Travel Payments - schedule attached or- B| None - No reportable interests on any schedule
^

5. Verification PAS^^M^ dA ^<(0;

MAILING ADDRESS STREET
(Business or Agency Address Recommended - Public Dowment)

CITY STATE ZIP CODE
DAYTIMF TFi FpHOME "'.".'.SF^
t -
EMAIL ADORES^ ,
I have used all reasonable diligence in preparing this statement I have reviewed this statement and to the best of my knowledge the information conwined herein and in any attached schedules is true and complete. I acknowledge this is a public doqifpent.I certify under penalty of perjury under the laws of the State of California that th( Date Signed 4 1<^) I l^ Signature
or e and o
(monm.vay.yea) (Rfe the origiaalyagned paper statement wth yourffing alWal.) FPPC Form 700 -Cover Page (2024/2025)
[email protected] • 866-275-3772 • www.fppc.ca.gov
Page - 6

CALIFORNIA FORM

FAIR POLITICAL PRACTICES COMMISSION

I AMENDMENT
STATEMENT OF ECONOMIC INTERESTS Date Initial Filing Received Filing Ofllcial Usa Oilly

COVER PAGE
Please type or print In Ink.

REC£n/£o
cn.-ir- i

NAME OF FILER (LAST) (FIRST)
P^ATT Gl^O
^nr^2 t^^^
ri-.-\..T»^l^

1. Office, Agency, or Court cm ^^^.,Jl
Agency Name (Do not use acronyms) P/^WM ^WTAL UOVWfi (3d^D >;~1 /n LM6f^ Division, Board, Department, District, if applicable Your Position >- If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: -- Position:

2. Jurisdiction of Office (check at least one box)
Q State
D Multi-County.

I City of. w^)^}^
D Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction)
D County of
D Other.

3. Type of Statement (check at least one box)
Q Annual: The period covered is January 1, 2024, through December 31, 2024.
•orThe period covered is / / _, through
December 31, 2024.

D Leaving Office: Date Left J_ J_
D Assuming Office: Date assumed J- J_
(Check one circle below.)
D The period covered is January 1, 2024, through the date of leaving office.
-orD The period covered is / / _, through
^ the date of leaving office. C^ Candidate: Date of Election ^{^/<V7 and office sought, if different than Part 1:. r^

4. Schedule Summary (required)
Schedules attached
> Total number of pages including this cover page:
-orSchedule A-1 - Investments ~ schedule attached D Schedule A-2 - Investments - schedule attached Schedule B - Rea/ Property - schedule attached Q None - No reportable interests on any schedule
Q Schedule C - Income, Loans, & Business Positions - schedule attached Schedule D - Income - Gfffs - schedule attached
[~\ Schedule E • /ncome - Gifts - Travel Payments - schedule attached

5. Verification ^

MAILING ADDRESS STREET
(Business or Agency Address Recommended - Public Document) CITC
-•l>»—I G^ r^t

STATE ZIP CODE

DAHIME TELEPHONE NUMBER
(

E-MAIL ADDRESS
Ihff - usea all reasonable diliglnce in preparing this statement. I have reviewed this statement and to the bes^f my knowledge the information containedherein and in any attached schedules is true and complete. I acknowledge this is a public document.I certify under penalty of perjury under the laws of the State of California that the/^reg^ig Is true an^l correct.

Date Signed. /^
(ffloni
^
Signature,
(month, day, yeai) (Fto the originsSy signed paper slatemenl with your llllng olSdal.) FPPC Form 700 (2024/ZOZ5)
[email protected] • 866-275-3772 • www.fppc.ca.gov

SCHEDULE B
Interests in Real Property
(Including Rental Income)
CALIFORNIA FORM700

FAIR POLITICAL PRACTICES COMMISSION
Name
>- ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY< ^ u ^! (7<(ai<. 64 ?(o?a

FAIR MARKET VALUE
Q $2,000 - $10,000
Q $10,001 - $ioo,ooo
KT $100,001-$1,000,000
1_^0ver $1,000,000

NATURE OF INTEREST
II Ownership/Deed of Trust[_] Leasehold
IF APPLICABLE, LIST DATE:
7__J24_ / /24 ACQUIRED DISPOSED
II Easement
Yre. remaining
D.

Other

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
$0-$499 Q $500-$1,000 Q $1,001 - $10,000
Q $10,001 - $100,000 Q OVER $100,000
SOURCES OF RENTAL INCOME: If you Own a 10% or greater interest, list the name of each tenant that is a single source of Income of $10,000 or more.

D None
5^ ^WW

ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
ciri'

FAIR MARKET VALUE
Q $2,000 - $10,000Q $10,001 - $ioo,oooQ $100,001 - $1,000,000 Q Over $1,000,000

NATURE OF INTEREST
Q Ownership/Deed of Trust
IF APPLICABLE, LIST DATE:
7—^4_ ^__^4_

ACQUIRED DISPOSED
[_] Easement
Q Leasehold
Yre. remaining
D.

Other

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
Q $0 - $499 Q $500 - $1,000 Q $1,001 - $10,000Q $10,001 • $100,000 Q OVER $100,000 SOURCES OF RENTAL INCOME: If you Own a 10% OF greater interest, list the name of each tenant that is a single source ofIncome of $10,000 or more.

D None
* You are not required to report loans from a commercial lending institution made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows:

NAME OF LENDER*
ADDRESS (Business Address Acceptable)

BUSINESS ACTIVITY, IF ANY, OF LENDER

INTEREST RATE
-% D None
TERM (Months/Years)

HIGHEST BALANCE DURING REPORTING PERIOD
Q »soo - (1,000 Q $1,001 - $10,000
Q $10,001 - $ioo,ooo [_] OVER $100,000
II Guarantor, if applicable
NAME OF LENDER*
ADDRESS (Business Address Acceptable)

BUSINESS ACTIVITY, IF ANY, OF LENDER
INTEREST RATE TERM (Monlhs/Years)
-% Q None

HIGHEST BALANCE DURING REPORTING PERIOD
Q $500 - $1,000 Q $1.001 - $10,000
Q $10,001 - $100,000 Q OVER (100,000
[~| Guarantor, If applicable
Comments:

FPPC Form 700 - Schedule B (2024/2025)
[email protected] • 866-275-3772 • www.fppc.ca.gov
Page-12
Schedule B - Real Property
Attachment to Cal Form 700
My two adult brothers, Todd P-G Pratt & Chancy R-L Pratt own real property located at / Pasadena, CA., 91030.

I declare under penalty of perjury under the laws of the State of California that the above-stated answer is true and con'ect of my own personal knowledge.

Res
DATED: APRIL 21st. 2025
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CHAD T-W PRATT, SR.
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CITY OF PASADENA

APPLICATION FOR APPOINTMENT TO THE

Applicant Name:

Home Address:

Mailing Address:Email Address:

Business Phone:

Home Phone:
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J ^J Date Available to Start: \^fJ^
./^ Cell Phone: ^-
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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. or nave, servea, orrices neia ana in wnai city. ^\A\^<Cr^ (AP^ \^^ S?r^c^; \K^^^^ co^pW ^6C)ct'-.\^\^ ^'\c^ V\os^Vj^v^Vu^^^ >o\A- ^o\^; Employment - Title and duties, current and past (acceptable to attach resume as analternative). \}'^^^(^c^^p(\^f,Ce^^ fye. ^^or^Drt-y^^ ^^^e.^6^^^W^^5<\^^^oy^^)OC) ^(\^\ c^ r^oM ^(^\-TC?,!^^ <'^c.^\r< ^a(\^pf\\ro^^(\te.^(^)?A'cre^ 9.\sc\\i^:^ ^orufA^.oA^k^eqJLte^^ \/o.r\Q^^»^ I/l^viSi<^^f'^5f^L^£1^ ^ V^r^o^-^reJervt-. Aev/elc^^ O^c r^:^jta>^eAt^<\Tco\\ q^oT^K^^^ (^(VC^ 4^ rn ^
Education - Include professional or vocational licenses or qertificates. \2). S. NV',c(oV>tO^ *^^^a()6^, N\6\f?c.\<\r GS^QC^LS-UC.^-/ ^ PV\'.\r^s6^ '-{)r^
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1. Have you ever worked for the City of Pasadena? (If yes, please YES || NO list date.s/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
B

3. Are you aware that financial disclosure is required annually? (e.g., sources of income, loans and gifts, investments, interests inreal 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
a
NONO
DB

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 extendedfamily, 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 || NO
YES || NO
YES NO
YES NO
D
(tended FamHy: any spouse, whether by marriage or not, dcmestfc partner, parent, child, sibling, grandparent, aunt or unde, 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 NO
D

10. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/LandIord Tenant Relationships/Real Estate: ^ A^n^ ^ l-0<. Aft(^S Jjof <?yer ^ \jP^^,"Y-1^ 6^<o^'^(MA ^ r^??<r\Vs <3?teMt(1(1 \1T> fU\ Hft(^PA<^ -V=hT UW< cj^ \/^w.\i.v,-v^ e^p^ \<;n\.<tA, ^y. ci\ a s-\^A-V.yoo^ ^f<'AQ<rjp.<\A^f^\\^^L ^ y/h.r^ ^ CQ<AVA^^\4^ y\P.^ ^P PRO ^ A ^/ v^fS-^aAj ;^ fl-? ^a<\4 --b^ o^ C^\W^5 . Q ^1 A\^ ^ .^ r .. ^ - t .A^ —^. A-l*hl.-l /I— -*- A—/•I1
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11. How would you add value to the Pasadena Rental Housing (IP,, ^^
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12. What do you view are the primary objectives and goals of the Pasadena Rental Housing ~\p^^S(^ ^ o^i\ P^\AQ r^\, pfGv^^m ^(\(^ e^po^C ^^^^^^ ^O^.^dfe ^ o^l\ P^-^^Q t-^. p^^f^ ^\\W, ^)^pr\<\^ FA V\MV\^ aA , ^, (>7 f
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13. How would you help to achieve these objectives and goals? ; ^^| W^\l ^/^^ ;M\ 'W^'^.S W\ ^..^ (\^[^: ^|. C..^,w^ ^ViW<^^\M ^0<{A^M~(\^ ^(\^^,'~V;'A wpjiJ a ^^f^oV^ &
^ / \ ^U" V—^f c^}! OMfp^^rA,^£\r ^ck,C^^M ^<\JOJ(N^ ^A\°{^S ^y?on+ QQjL ^. \yf. —'»-\» ' *-' ^ ^^^y\ 1^^ ^ "^ v^ — -• =\J: C^^ ?^^fp^> ^^\\^\e_ pA'\r>_\ Q.fP M^^O'I ^^e^^^\^ \ 1, LO ^ \ \^j,a(\Q^{ (printed name) declare under penalty of perjury under the law o the State of CaliforftA that the information reported in this Form RHB-001 is true, accurate, and complete.

Signed this <-^ day ofV)prft^\V)^r , 20 5M.
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Signed
Printed Name:
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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 resident of District No.~L
»
of the City of Pasadena
<
I reside at \ -
CA ^([F)(^ ^ip code). r
•V
/ (street), Pasadena,
Signed.A^,^ ^^2^^
Printed Name:: L^, v^< ^ 6\OS\
^

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 anyinstitution 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 billEmployment 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 StatesDeed or title to residential real property Voter registration confirmation letter or postcard issued by the CaliforniaSecretary of State or the Los Angeles County Registrar of VotersProof of payment of resident tuition at a public institution of higher education inCalifornia 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 PasadenaCalifornia Certificate of Vehicle or Vessel Titles or registration (i.e., a title to, ora DMV registration for, a boat, truck or car) A DMV No Fee Identification Card Eligibility Verification (DL 933) form, compieted and signedIf your name does not appear on any residency documents, you may present abirth 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 (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(1)).

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
I, /^o^S ^^(JQ^of the State of Calffcu^iia that (printed name), declare under penalty of perjury under the law of the State of Calffcu^iia that the information provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete.

Signed this
^
day ofD^cm^er
Signed: ^\J^(kU 'Uk-J-
- Printed Name: Z_C\;t ^
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
, LS)^\\ ^Go lo S< (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. r

3. I reside at the following address
I ^
Pasadena, California cl j{ 0 \o (zip code)
J_ (street),
•>.

OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat.

Signed this 1 day of V3&C€M\3^r , 20 ^\ .

Signed-4 / ^^{//L^iPrinted Name: 2
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Out { ^(\jn(65l
CALIFORNIA FORM700

FAIR POLITICAL PRACTICES COMMISSION
Date Initial Filing Received
Filing OICclal Use Only
P/ease type or print in ink.

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE

A PUBLIC DOCUMENT
?^n^-9 fiuin.cRECEIVED

NAME OF FILER (LAST)
^\^0^>y (F.IRST) ^ .ou^5 (MIDDLE) ^\C<(^&5CL£RKt \- • ^ \J

1. Office, Agency, or Court ^iYOr^CADENA
Agency Name (Do not use acronyms) \>ci<sC\rkc^c\ J^<\i ^ \\\^^\c\w^ ^^r Division, Board, Department, District, if applicable Your Position >- If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: ^C^A^H^ Position:

2. Jurisdiction of Office (Check at least one box)
D State
D Multi-County
S city of ^>a<so(j^iT\(A
D Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jun'sdiction)
F] County of
D Other

3. Type of Statement (Check at least one box)
D Annual: The period covered is January 1, 2023, through December 31, 2023.
•orThe period covered is / / _, through
December 31, 2023.

F] Leaving Office: Date Left , _/_ J_
(Check one circle.)
D The period covered is January 1,2023, through the date of leaving office.

D Assuming Office: Date assumed
[g Candidate: Date of Election
_/_ J_
•orD The period covered is J_ _/_
the date of leaving office,
and office sought, if different than Part 1:.
through

4. Schedule Summary (required)
Schedules attached ^ Total number of pages including this cover page: "^ j^ Schedule A-1 - Investments - schedule attached
Schedule A-2 - Investments - schedule attached
Q Schedule B • Real Property - schedule attached
•or- C] None • No reportable interests on any schedule
|^ Schedule C - /ncome, Loans, & Business Positions - schedule attached Q Schedule D - /ncome - Gifts - schedule attached D Schedule E - /ncome - Gffls - Travel Payments - schedule attached

5. Verification

MAILING ADDRESS
/filK?/^"" — '• -
STREET
~ ,yfc.
^T<. ^) -,.^^ ffflME TlLEPHONE NUMBER
CITY
-t— '-)
STATE OPCODE, >-vkiAA. CA^OC
EMAIL^DDRESS ^ I ^ • I DAY
I have used all reasonable diligence in preparing this statement I have reviewed ...- oia(8(n6nt and to the BSst of rjiy knowledge the informah'on contained herein and in any attached schedules is true and complete. I acknowledge this is a public document.

I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct Date Signed v^l^.^ Signature '. <f)- ^ / \i 1L^<^^ (raeBieoifgfnaly) statement wfh your Sang olSdal.j FPPC Form 700 -Cover Page (2023/20Z4)
[email protected] • 8GS-27S-3772 • www.fppc.ca.gov
Page-5
SCHEDULE A-1
Investments
Stocks, Bonds, and Other Interests
(Ownership Interest is Less Than 10%)
Investments must be itemized.

Do not attach brokerage or financial statements.

CALIFORNIA FORM 70'0

FAIR POLITICAL PRACTICES COMMISSION
Name L^\ \^^{
> NWE OF BUSINESS 6NTITY N^fi4E 'C^TJ;'" P..0

GENERAL DESCRIPTION OF THIS-BUSI&E
)0(; ^

FAIR MARKET VALUE
NK $2,000-$10,000
$100,001 -$1,000,000

NATURE OF INVESTMENT
^ Stock I | Other
' Partnership
f ^
$10,001 - $100,000
Over $1,000,000
(Describe)
Income Received of $0 - $499
i ) Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE:
/ /23 J_ J23_

ACQUIRED DISPOSED
^ NAME OF BUSINESS ENTITY ^.. ^.^^L...^

GENERAL DESCRIPTION OF THIS'BUSINESS
i?r
FAIR MARKET VAL<UE ARKET VAL<UE
'*><• $2,000-$10,000
! $100,001 -$1.000,000

NATURE OF INVESTMENT
^<- Stock Other
$10.001 - $100,000
Over $1,000,000
(Describe)
Partnership ; Income Received of $0 - $499 Income Received of $500 or More (Report on Schedule C} IF APPLICABLE, LIST DATE:

J_ J23.

ACQUIRED,
J_ J23_

DISPOSED
>- NAM^fiF BUSINESS ENT1 '"N\FMcsT^EX ^0\[

GENERAL DESCRIPTION OF THIS BUSINESS
^
cbvfMrxiVpc ^
FAIR MARKET VALUEJ^
' $2,000 - $10,000
X; $100,001 -$1,000,000

NATURE OF INVESTMENT
'S< Stock Other
' $10,001 - $100,000
Over $1,000,000
(Describe)
Partnership ; Income Received of $0 - $499
: Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE:

J_ J23_

ACQUIRED
J_ ^23-

DISPOSED
-TftFS BUSINESS
^\^ a? S\G^ ^ ^uAopA ^¥ Wl^
> .NAME OF BUSINESS EIKT1T) 'T&^
GENERAL DESCRIPTION OP-TftFS

FAIR MARKET VALUE
^<~$2,000 - $10,000
$100,001 -$1,000,000

NATURE OF INVESTMENT
'^< Stock : Other
$10.001 - $100,000
; Over $1,000,000
(Describe)
Partnership : Income Received of $0 - $499 Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE:
_/_ J22_

ACQUIRED
J_ -^3.

DISPOSED
^ NA^IE OF BUSINESS ENTITY
>VS<\^
GENERAL DESCRIPTIOI^OF THIS BUSINESS 31^/C
f ^r^\\\^S\^

FAIR MARKET VALUE
$2,000 - $10,000 ?<^$10,001 - $100,000
$100,001 - $1,000.000 ; ; Over $1,000,000

NATURE OF INVESTMENT
Stock i ~i Other
(Describe)
Partnership Income Received of $0 - $499 ; Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE:
_/_ J23-

ACQUIRED
y_ J23-

DISPOSED
>• NAME OF BUSINESS ENTITY

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
$2,000 - $10,000
; $100,001 -$1,000,000

NATURE OF INVESTMENT
Stack Other
$10,001 -$100,000
Over $1,000,000
"(DescribeT
Partnership .^ ! Income Received of $0 - $499 ! Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE:

J_^23_ / J23_

ACQUIRED DISPOSED
Comments:

FPPC Form 700 . Schedule A-l (2023/2024)
[email protected] • 866-275-3772 • www.fppc.ca.gov
Page-7

SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)

CALIFORNIA FORM

FAIR POLITICAL PRACTICES COMMISSION
Name , ^/-(?JS \^GnloSl
> 1. INCOME RECEIVED

NAME OF SOURCE OF INCOME
^^, \\\.^A\ ^d \^\^^c^
jA,,C^W^^/ ADDRESS'VSusmess-/lddnsssAccejp(ab/e^ » . _ 1 . - —^—^s-'. _^- ISINESS ACTIVITY. IF ANV^OF Spq C<~^^-s URGE <U(\£_

YOUR BUSINESS POSITION
<=><,^r\l<\:SovT L\l£^
<EIE RECEIVED Q No Income - Business Position Only
Q $500-$1,000 Q $1,001-$10,000
$10,001 - $100,000 Q OVER $100,000

CONSIDERATION FOR WHICH INCOME WAS RECEIVED
^ Salary Q Spouse's or registered domesbc partner's income (For self-employed use Schedule A-2.) Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.) Q Sale of
(Real property, car, boat, etc.1
Loan repaymentCommission or Q Rental Income, /ls( eacft source of $10,000 or more (Describe)
Q Other.
(Describe)
> 1. INCOME RECEIVED

NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)

BUSINESS ACTIVITY, IF ANY, OF SOURCE

YOUR BUSINESS POSITION
GROSS INCOME RECEIVED Q No Income - Business Position Only $500-$1,000 Q $1,001-$10,000
Q $10,001 - $100,000 Q OVER $100,000

CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Q Salary Q Spouse's or registered domestic partner's Income (For self-employed use Schedule A-2.) Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.)
Sale of
II Loan repayment
[_] Commission or
(Real property, car, boat, etc.)
Rental Income, list each source ot (10,000 or mons
(Describe)
D Other.
(Describe)
^ 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD * You are not required to report loans from a commercial lending institution, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows:

NAME OF LENDER*
ADDRESS (Business Address Acceptable)

INTEREST RATE
-% Q None
TERM (Months^eara)

BUSINESS ACTIVITY, IF ANY, OF LENDER
SECURITY FOR LOANII None || Personal residence

HIGHEST BALANCE DURING REPORTING PERIOD
Q $500-$1,000
(1,001 - $10,000
[~j $10,001 - $100,000Q OVER $100,000
n Real Property S(ree( acfcfress
City
[—| Guarantor
Q Other.
(Describe)
Comments:

FPPC Form 700 - Schedule C (2023/2024)
advlceiafppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page-13

Pasadena City CouncilMay 19, 2025

Pasadena City Council
May 19, 2025