Cities Index.
AR 21 ATTACHMENT B

Pasadena City Council
May 11, 2026

Document
AR 21 ATTACHMENT B
Meeting
May 11, 2026
Body
Pasadena City Council
Original file
56.9 MB
Text extracted from the city's file for reading and search. Open the original on ww2.cityofpasadena.net. That file is the official record.

ATTACHMENTS

REDACTED APPLICATIONS FORPROSPECTIVE PRHB MEMBERS

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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 certified by the City Clerk as eligible forappointment shall remain valid for use towards future vacancies for a period of up to on© year from certification. In the event of a vacancy, if the applicant has not been appointed to the Rental Housing Board and still desires to be considered for appointment, they may submit an updated application, or may advise the City Clerk's Office in writing that the information contained on the original application is still current. For example, if an application is certified on February 21, 2025 as eligible, saidapplication will continue to be qualified subject to written confirmation by the applicant to the City Clerk's Office through February 21. 2026.

Applicant Name: .U.^.'^LcAi.^c^. <^fc
Home Address:

Mailing Address:

Email Address:Business Phone: ts,\ ^ !\
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Home Phone: ^A
Date Available to Start: L\ \D o'^ .r_L^t _u_^A ^
Cell Phone: 5
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-targe IVIember (4 seats, open to any Pasadena resident without respect to tenancy or Council District)
alternate Tenant Member (1 seat, resen/ed for tenants)
\/r Alternate At-large Member (1 seat, open to any Pasadena resident without respect to tenancy or Council District)
Community Sewjce - List boards, commissions, committees, and organizations on which you are currently serving or have
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are currently serving or ha ve served, offices held and in what city. 2-.o, s •^S\^_K .v ^Vv< AS " 5LO \ ^> 'Z-nvar 4^A< ^ ^ !^h^<-1 ^^ ^<- r •^
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1. Have you ever worked for the City of Pasadena? (If yes, please YES || NO list dates/dlepartment)

2. Are you related to any employee, appointed or elected official of YES Q NO the City of Pasadena? (If yea. please mdicate name and relationship)3. Are you aware that financial disclosure is required annually? YES @ NO || fe.gi., sources of income, loans andgifis, investments, interests in real property)

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

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? \^v^-^ A-< ^ c-Y& »^

6. Do you have a Material Interest In 4 or more units of Rental Property within the City of Pasadena? (If yes, please read the "Note" on the Supplement to Statement of Economic Interest Form (Form RHB-002) regarding property owners with interest in 4 or more rental units, attached to this application) YESYES
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7. Do you reside at a property owned or managed by a member of YES j 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 stakein said property? YES [~~] NO ^1
YES ^f NO Q
YES^TNO D

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

9. Are you aware of the time commitment necessary to fulfill the obligations of the Pasadena Rental Housing Board?

10.Are you aware that you may serve no more than eight
consecutive years as a member of the Pasadena RentalHousing Board? 11 .Can you, upon appointment, provide proof of identity and proof YES ?<^ NO [_] of eligibility to work in the United States?

12. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/ReaI Estate:
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13. How would you add value to the Pasadena Rental Housing Board? /Z>^J^^ c^

14.What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
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15. How would you help to achieve these objectives and goals? -±=^~ ^»x<
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he State of CaliforrMa t(
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the
complete.Signed thi
Signed;
(printed name), declare under penalty of perjury under the law c that the information reported in this Form RHB-001 is true, accurate, and .day of £A "c^" ..20^_.

Printed Name:\)<gl'^u\.<^-i>--11r^v\.
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CITY OF PASADENA
Residency Verification *- MANDATORY
All applicants must provide proof of reslcfency in a City Council district under section 1811(b) of The Pasadena Fair and Equitabte Housing Charter Amendment. 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.

I am a resident of District No.I reside at _ _ _
C/\ C\\\^r (zipcodel .

Signed:

Printed
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of the City of Pasadena
(street), Pasadena,
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2.If you are not a registered voter, please provide clear, readable copies of 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 fdlowing 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 jnstituflon or entity that has issued a credit card
Insurance documents, including medical, dental, vision, life, home, rental or vehicleMedical 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 postsecondary institution, college, or university that Includes the applicant's date ofbirth. 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, employeror 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, 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 tracingdocument due to a name change (for example, marriage, divorce, or courtorder), name change documentation is required. •
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CITY OF PASADENA
Supplement to Statement of Economic
Interest (FPPC Form 700)
(Form RHB-002)
Ad 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 (City Charter Article XVIII) prohjbits 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 apptication. The City is adopting the Fair Political Practices Commission's Form 700 for this purpose. When completing Form 700 to report such interests and dealings in rental property, please note that City Charter Article XVIII requires Enformation 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.

City Charter Article XVIII Definitions:

Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grandparent, aunt or unde, 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 oftheir 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)). Please acknowledge you have read the following:

Note: White the City Charter is pQrmissive in alfowing At-large members to own rental property, California's Con ff let of Interest regulations for public oftlcials contain separate standards. As a result, Board members who are property owners with interest in 4 or more rental units^mjth^dty afLPasaden^ might not be abte to free!y pai'tloipate in all matters that come before the Pasadena Rent&l Housing Board. Interested appliGants in such a posWon should consult with legal coiinsel prior to submitting an appl/c^tion. ••V
/ acknowledge I have read the foregoing Note \7^o/fe/s) Rental Unit: any buiiding, struGtuTe, or part thereof, or land appurtenant thereto, or any otherrental 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 arental housing agreement to the use or occupancy of any Rental Unit (Section 1803(aa)).

CITY OF PASADENA
Economic Interests Affidavit - MANDATORY
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)f the State of C^iiforn
1, _S:dA^j-^=A—L»_ (printed name), declare under penalty of perjury under the law of the State of CdiJfornia that the information provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete.

Signed this ^Ml day of ^^^ ^_--^ Signed:, J'U-W., ..^ .20 y i, 0" •< Printed Name? .l.t^—-SA.
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
1, A^.*:<A *tf\^4\-^ A •-, (printed name), declare under penalty of perjury under the law of the State of California tFhat 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: (street), Pasadena, California c-^ < ^cs-yfzip code) OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat. . day of TLAlx^C^ . 202L.. T5~ Signed
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Printed Name-?Q<'_^t\ u&AJ^-^X^.
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City of Pasadena-Application for appointment to the Pasadena rental housing board Form RHB-001- Attachment

12. Describe your relative life experience, professional training, or education in the following areas: Housing/HousingJustice/Landlord Tenant Retationships/Real Estate:

Housing ~ I have been a mortgage banker for 20 + years, expertise working with first time home buyers and low-moderate income home buyers. I have lead sates teams educatingand enabling them to be successful in these markets. I am a homeowner in the City ofPasadena and have been a rental property owner in the City of Los Angeles since 2000. I have my NMLS license however it is inactive at the present time.

Housing Justice -1 have been an advocate for safe and high-quality housing for my entiremortgage banking career. 1 have been a board member of 2 housing non-profits, East LA Community Corporation and Los Angeles Neighborhood Housing Services. When there was a Neighborhood Housing Services office in Pasadena, I was an active partner and speaker for their home ownership workshops. I am a member of the NationalAssociation of Hispanic Real Estate Professionals (NAHREP), past Western Region co-chairandfounding director for the Montebello East LA Chapter and past president.

Landlord Tenant Relationships -1 have been a property owner since 2000; I currentlyown 4 units in the City of Los Angeles. I am in good standing with the City of Los Angeles Housing Authority for adhering to all rent stabilization ordinances (RSO). I also have a good, professional relationships with all of the tenants living in my rental properties. As an example, I have very low turnover. One of my tenants has been jn their homes for 17 years, the other 22 years. I consider myself a very reasonable property owner. I keep up with the care of all my properties. My tenants know that they can always rely on me to make sure all repairs', requested work is done in a timely and workman like manner, t pride myself onbeing an exemplary small business property owner and contributing to attractive housing in the neighborhoods of my rental properties.Real Estate -lama big proponent of "respecting" all property, real estate. It is an honorand a privilege to own real estate. ( am proactive on being aware of the environmentsurrounding all my properties by visiting my properties at least once a week, going onlineto view neighborhood news, and understanding the latest rental ordinances.

13. How would you add value to the Pasadena Rental Housing Board? I would know and understand The City of Pasadena Charter, Articles 18,1 land any other Article that would be vital to the position of director. My corporate managerial training hasgiven me skills to collaborate with colleagues, communicate effectively, listen and understand what the need is to find the best solution for all parties. My experience as a "small property" owner has given me real life challenges and real-tife reasonablesolutions for both parties, tenant and owner. I am committed to always finding a solution to improve quality of life matters for all citizens equally.

14. What do you view are the primary objectives and goals forthe Pasadena Rental Housing Board?
Ensure that all citizens of The City of Pasadena have excellent housing. This begins withknowing and understanding the current rental laws and ordnances, Article 18. From there, work and strive to understand if there are areas where the City of Pasadena can advancefor the betterment of their citizens and The City of Pasadena's long-term prosperity.

15. How would you help to achieve these objectives and goals? As a new board member, I would become familiar and understand the present needs of the Rental Housing Board and the needs of Pasadena's citizens. I would then work with the board to prioritize those needs. If necessary, reach out to city's leadership to vaUdate the board's priority list. Simultaneously, become acquainted with each board member and strive to have a professional relationship with each member.

Desolina Avila
Pasadena, CA • •
Mortgage & Community Lending Professional! CRA Strategy | Affordable Housing Partnerships | Leadership
Summary
Mortgage lending expert with 20+ years in mortgage banking driving growth through CRA strategy, affordable lending, and hlgh-impact partnerships. Expert at launching and scaling portfolio, conventional, FHA/VA, bond, and down payment assistance programs; building reciprocal nonprofit, realtor and builder alliances; and developing sales talent. Trusted industry voice and community connector known for operational rigor, compliance alignment, and consistently exceeding goals.

Core Strengths- CRA strategy and execution
- Affordable lending: bond & DPA programs
- FHA/VA and conventional lending- Sales leadership, coaching, enablement- Housing nonprofit, realtor, builder, partnerships- Market development in LMI and multicultural segments - Training design and delivery (in-person/virtual)- Cross-functional collaboratiion with Community Relations/Compliance" Public speaking and stakeholder engagement Professional Experience
U.S. Bank — Business Development Manager, West Retail Jan 2023-Sep 2024- Coordinated loan officer submissions for bond and down payment programs to ensure accuracy and speed to decision.
- Advised senior regional leaders and sales teams on CRA portfolio, conventional, FHA/VA, bond, and DPA programs—guidelines, positioning, and sales execution." Partnered with CRA leadership to review documentation aligned to exam readiness and ratings.
- Built and delivered training clarifying LMI tract vs. LMI borrower qualifications, improved sales and compliance alignment.
" Developed sourdng strategies leveraging realtors, builders, nonprofits, and trade groups to expand referral channels,
- Led educational events/webinars with realtors, GSEs, builders, NAHREP, AREAA,NAREB. - Frequently requested internal/external presenter on CRA and affordable products.
- Maintained proactive cadence with VIP partners; completed training and reporting ahead of deadlines.

Citibank — Business Development Officer, LA & Ventura Oct 2019-1an 2023 - Subject matter expert to sales leaders on CRA/affordable products, from guidelines to go-to-market.
- Built and managed relationships with nonprofits, housing authorities, and HFAs to expand LMI and minority homeownership.
- Engaged affordable housing developers in LMI and majority-minority tracts to increase program awareness and utilization. - Collaborated with Community Relations to meet CRA goals across the market. " Sourced volume-generating relatlonshjps with real estate professionals and associations (NAREB, NAHREP, AREAA).
- Advised recruiting on strategic placement of multicultural mortgage professionals.
- Founding member, Citi LatinX employee network.

Wells Fargo — Regional Diverse Segments Manager LA Oct 2000-Sep 2019 - Led strategy for minority lending, first-time homebuyers, and LMI purchase lending across LA County. - Co-created annual sales goals and built the LA County CRA plan; partnered crossfunctionaliy on CRA activities and reporting. - Forged long-term partnerships with realtor boards, trade orgs, nonprofits, and community stakehotders.
"Trained and mentored sales teams to maximize internal programs, driving performance and retention. "Regular speaker/panelist at national and local industry events on diversity lending, FTHB, IM\. and multicultural segments.
- Drove Initiatives with military and union program leaders to expand access and awareness.

Industry Leadership & Affiliations
- East LA Community Corporation (ELACC): Board of Directors (2002-2019) " LA Neighborhood Housing Services: Past Board Member
- NAHREP: Director, Southwest Region (2022-2023), Founding Director/Past President, Montebello SE LA Chapter (2008-2010)
- AREAA: Founding Director, Los Angeles Chapter; Advisor (2010-2019}- NAREB: Past Director, Consolidated Chapter of Los Angeles Community Involvement
" Pasadena Humane Society: Volunteer (2024-Present)
- Pasadena Meals on Wheels: Director and Driver (2016-2022) " Pasadena Little League: Director and Coach (2011-2016) Awards
- Wells Fargo President's Club (2005,2009)- NAHREP South Bay: Affiliate of the Year(2016) Education
- California State University, Dominguez Hills — BA, Interdisciplinary Studies - Languages: Spanish (fluent)
- NMLS ID available upon request
CALIFORNIA FORM 700
FAIR POUTIGAt. PRACTICES COMMISSION

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE

A PUBLIC DOCUMENT
Date tnltta! Filing Received
Wnf OOidaI Use Only
Pfsase tyf>a or print in Ink

RECEIVED
NAME OF FU-6Q (LAST)
AAME OF FU-6Q (t ^:Jk\' imsTi ^C^ \)€-^\s PO%FE824 SH 2 t"s<- 1. Office, Agency, or Court 'un i i/i-r.i\)'\- CITY of: ?^y'^^ Agency Name fDo no? use yynyms) (L\ ^-M C-^c ts^^S<-&€^'- Div'^jon, Board, Dep^tnent, DistricJ,, if applicabie I 'yaur Poslb'on>- If filing for muttEple psltions. list below or on an attaetimen^, (Oo not use\sronyms) ^
Agency; Position;

2. Juriseiiction of Office (check at least MS box)
H State
DMuN-Couin^.
>^city°fJ/^>^<;;*Y.(.^
[_] Judge (Supreme, Appellate, Superior Court), Retired Judge, pro Tern Judge, or Coui^Commlssiony (Statewide Jurisdicdon) %?^f ^ U<J^-V^ACS D Other \^3

3. Type of Statement (Chwk at least one box)
[_ Annual: The period cowred Is January 1, 2025, through December 31, 2025,
•orThe period covered is / / „„„„„,., through
December 31,2025,
D Leaving Office: Date Left , J_ J.
(Check one cirsie below.}
D The period covered Is Januaiy 1, Z02S, through the date of leaving offire,
n Assuming Office; Date assumed J-. J-
-or"
a The period covered Is J. J.

MCandidate; Date of EtecBon t^hv^<-^ the date of leaving office. and office sought, if different ftan Part 1:, through 4, Schedule Summary (required) i- Total number of pages InGluding this ewer page:
^
Schedules attached
^ Schedufe A-1 • Investmwts ~ sAeduls attached
[_] Schedule A-2 • Invsstments - siAedule attached
^..Sehedute B • Rsa/ Pfoperty ~ siAeduls attadied
Q Attachment 700.P«Prospecffve EmploymQfit (87200 FIIQFS Only)" schedule attached "or" D None" No reportable interests on any sGhedule
[_] Schedule C »ifneome, toa/is, & Bt/smess Portions - sehedute attachedD Schedule D. fncome - Gifts - schedule attacheda Schedule E- tnwne -Gifts - Travel Payments - schedule attached

5. Verification
MAB.INS ADDRESS STREET
ffluansss of ^lancyAlldFsss FSwmvwi«t*i< - PiiMfe n<miHMnn DAfnME TELEPH(»iE NSiM^R'
cny STATE
EAAiLADDRESS'"
ZIP COOl
I have ussd all reasonable diligence in preparing this statement. I have rewewed this statement andjp the best of my knowledge the information contained herein and In any attached schedulss is true and complete. I acknowledge »iis is a public dogxtiehi I certity under penalty of psijury under the laws of the State of California that ttie'^Joinfi^ true and correct.

Dale Signed t^Z-Z-^'AJ.-^ _ Signature _^-^ fnwi(/iiday,y«9r) <L iya^eiaitefiaS^lpwl.imwSMwiwt Nfi yw a/i; (iffiefBl.j fWS.fOtmfW -CBwrSage (202S/20Z6)
Types of Statements
Assuming Office Statement:
if you are a newly appointed official or are newly employed in a position designated, or that will be designated, in a state orfocal agency's conflict of interest code, your assuming officedate is the date you were sworn in or otherwise authorized toserve In the position. If you are a newly elected official, your assuming office date is the date you were sworn in.

Report: Investments, interests in real property, andbusiness positions heid on the date you assumed the office or position must be reported. In addition, income(including loans, gifts, and travel payments) received during the 12 months prior to the date you assumed the
office orposition,
For positions subject to confirmation by the State Senate or the Commission on Judicial Appointments, your assumingoffice date is the date you were appointed or nominated tothe position.

Example; Maria Lopez was nominated by the Governor
to serve on a state agency board that is subject to state Senate confirmation. The assuming office date is the
date Maria's nomination Is submitted to the Senate.Maria must report investments, interests in real property, and business positions Maria holds on that date, andincome (including loans, gifts, and travel payments) received during the 12 months prior to that date.

If your office or position has been added to a newly adopted or newly amended conflict of interest code, use the effective date of the code or amendment, whichever is applicable.

Report; Investments, interests in real property, andbusiness positions held on the effective date of the codeor amendment must be reported. In addition, income (including loans, gifts, and travel payments) receivedduring the 12 months prior to the effective date of the code or amendment.

Annual Statement:

Generally, the period covered is January 1, 2025, throughDecember 31, 2025. If the period covered by the statementis different than January 1, 2025, through December 31, 2025, (for example, you assumed office between October
11 2024, and December 31, 2024 or you are combining
statements), you must specify the period covered.

Investments, interests in real property, business
positions held, and income (including loans, gifts, andtravel payments) received during the period coveredby the statement must be reported. Do not change thepreprinted dates on Schedules A-1, A-2, and B unless you are required to report the acquisition or disposition ofan interest that did not occur in 2025, * if your disclosure category changes during a reporting period, disclose under the old category until the effective date of the conflict of Interest code amendment anddisclose under the new disclosure category through theend of the reporting period.

Leaving Office Statement:Generally, the period covered is January 1, 2025, through the date you stopped performing the duties ofyour position. If the period covered differs from January 11 2025, through the date you stopped performing the
duties of your position (for example, you assumed officebetween October 1, 2024, and December 31, 2024, oryou are combining statements), the period covered mustbe specified. The reporting period can cover parts of two calendar years.

Report: Investments, interests in real property, business positions held, and income (including loans, gifts, andtravel payments) received during the period covered by the statement. Do not change the preprinted dates onSchedules A-1, A-2, and B unless you are required toreport the acqursition or disposition ofgn interest thatdid not occur in 2025.

Candidate Statement:

If you are filing a statement in connection with yourcandidacy for state or local office, investments, interestsin real property, and business positions held on the date of filing your declaration of candidacy must be reported, In addition, income (including loans, gifts, and travel payments) received during the 12 months pnor to the date of filing your declaration of candidacy is reportable. Do not change the preprinted dates on Schedules A-1, A-2, and B.

Candidates running for local etective offices (e.g., countysheriffs, city clerks, school board trustees, or water district board members) must file candidate statements,as required by the conflict of interest code for the electedposition. The code may be obtained from the agency ofthe elected position.

Amendments:
if you discover errors or omissions on any statement, file an amendment as soon as possible. You are only required to amend the schedule that needs to be revised; it is not necessary to refile the entire form. Obtain amendment
schedules from the FPPC website at www.fppc.ca.gov.

Note: Once you file your statement, you may not withdraw it. All changes must be noted on amendment schedules.Expanded Statement:If you hold multiple positions subject to reportingrequirements, you may be able to file an expandedstatement for each position, rather than a separate and distinct statement for each position. The expandedstatement must cover all reportable interests for all jurisdictions and list all positions on the Form 700 or on an attachment for which it is filed. The rules and processes governing the filing of an expanded statement are set forthin Regulation 18723.1. ift/in ^^^i-^ff/fttt>"*<"t
SCHEDULE A"1
Investments
Stocks, Bonds, and Other Interests
(Ownership Interest is Less Than 10%)
InvQstments must be Itemizecf.

Do not attach brokerage or finmciat stataments.

CALIFORNIA FORM 7QO

FAIR POUTICAL PRACTICES COMMISSION
»• NAME OF BUSINESS ENTin
GENERAL DESCRIPTIO!U*: THiS
>c.«-<-\S <\,i-t,^,. FAIR MARKET VALUE
D$2,000-S'tO,OQO "' g $10,001-jliaO.QOO a < 100,001 - d ,GOO,OOQ Q over $1 .oao.ooo _N^.TURE OF INVESTMENT ]^,. Stock D Other
iDescribaj Q Partnership Q Income RsceivBd of SO • $499 [] Income RecatvBd of SSOQ or More (Repot on Sdiadula c) IF APPLICA.BLEJ.IST DATe;
ZLK>c>^
]__JS_ f

ACQUIRED
J2&.

DISPOSED
>» NAME OF BUSINESS ENTITY

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
C3 S2,flQO • S10.0SO
Q $100.001 .»i,ooo,oos

NATURE OF INVESTMENT
n stock n ouiw
[j S10.001 . $100,000 [j Over $1,000,000
(D&sieribe) Q Partnership Q tncoine ReGalvad of $0 - S499 Q Income Received cf $500 or Mom (Rapart on Se/istfuto ci (F APPLICABLE, LIST DATE;
J. J25-

ACQUIRED
A J25-

DISPOSED
>» NAME OF BUSINESS ENTITT

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKFT VALUE
[3 $2,000-$10,000[j $100,001 .$1.000,000

NATURE OF INVESTMENT
Q Stock [_} OtHer
1~~| SIO.OOI - tlOO.OOO~! Over (l.OOO.OQO
(uescfionj [) Partnership n tnc»me Received of 50 * $499 Q Income Received of $500 or More (Rsport on Schedule d IF APPUCABIE. LIST DATE;
J- J2&.

ACflUIRED
J_ J25_

DISPOSED
jame B°-L\,
r NAME OF BUSINESS ENTITC

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
D sz.oao. 110,000
Q 8100,001 .tl.OOOiOOO

NATURE OF IMVESTMENT
H Sta<* H Other
Q tio.ooi - sioo.aooC Over tl,aoo,ooa
(DBscriba)
Partnership Q Income Raceivgd of SO - $499 LJ Income Recelred of S5QO or More (Raport on Sc/iaduh a) IF APPUCABLE, LIST DATE:
t 125 _ I J25-

ACQUIRED DISPOSED
^ NAME OF BUSINESS ENTIW
GENERAL DESCRIPTION OF THIS BUSINESS"

FAIR MARKET VALUE
Q S2.000 . SW.OOO
D $100,001 - $1,000,000

NATURE OF INVESTMENT
Q Stock Q Othar
Q $10,001 - sioo,ooQ
C Over $1,000,000
(Otsefiha]
(_^ Partnefship Q Incaame Received of to - $499 Q Income Received of tsoo or More jpapgrf on ScAaa'ufo C; IF APPLICABLE, LIST DATE;
-/-. J25-

ACQUIRED
j_ J25-
Dtsposeo
>>. NAME OF BUSINESS ENTITr

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
Q $2,000-$10,000Qsioa.OQi .ti.ooo.ooo

NATURE OF INVESTMENT
D s<°* D cnto
Csio.ooi .$100^100Q Over Sl.000,000
^uascn&Q) I' Partnership C Income Received of SO • $493 Q Income Received of ?5QO or Mom (Rapart on Schedule S) IF APPLICABLE. LIST DATE:
-/. J25-
AcayiREo
/- J2SDiSPOSEO
Commetite:

FPPC Form 700 -SchBliifeA-l (202S/2026|
Instructions
Cover Page
Enter your name, mailing address, and daytime telephone number In the spaces provided. Because the Form 700 Is a public document, you may listyour 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 orcourt. Consultants must enter the public agency name rather than 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 Council Member; Staff Seroices 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 each agency. 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 fiie an expanded statement for multiple positions,enter the name of each agency with which you are required to fiie and your position title with each agencyin the space provided. Do not use acronyms. Attach anadditional sheet if necessary. Complete one statement disclosing all reportable interests for ati 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 ssparats statement, For example, a city council member who assumes a position with a county special district after the April annual filing deadline must file a separateassuming office statement. In subsequent years, the citycouncil member may expand their annual filing to include both positionsExample:

Brian Bourne is a city council member for the City of Lincoln and 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 alt reportable interests for both offlces and list both positions on the CoverPage, Brian will file the expanded statement with each the City and the District as directed by Reguiation 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 14, 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 the county or city in which the agency has jurisdiction.

Example:

This filer is a member of a water district board with jurisdictionin portions of Yuba and Sutler Counties.

I. OIBeo, Agoncy, or Court
Agtn^^iWi (Oft rt^t i*ie AMWyftl^
!?e.-ii)^rf Kis'cr (mii;^t»dtt Di'stric'L
Owi^, fliwfd. Oott.iiffl-w', OwWto^ l( apf^fif
N'A
ufPEWWl
^yitfd MritttlKf
fflfCf.
))h<g tor fmjfftrt* Bcwicw.

N/A
b-hirgfWiNtNlodmw*, ffito ncf >w» xwymtf
I?. iJyrftfitEetlftn of O^ett (C^sir *< *i<i* «i« 'to'tf QW.
• Mdtnrtl Yiil" &Sn."e't-'i!!!l»!SL
QUfof0 AXtpi y C&rt C()iwiiti*iw<r RtWS(»rt» Jhrnd.dwn) ac.^.'. a0"'' Part3. Type of Statement
Check at loast one box. The period covered by a statementis determineci by the type of statement you are filing. If you are completing a 2025 annual statement, do not change thepre-printecl dates to reflect 2026. Your annual stetement is used for reporting the previous year's economic interests,Economic interests for your annual filing covering January 1, 2026, through December 31, 2026, will be disclosed on yourstatement filed in 2027. See Reference Pamphlet, page 4,Combining Statements: Certain types of statements for thesame position may be combined, For example, if you leaveofdce after January 1, but before the deadline for filing yourannual statement, you may combine your annual and leavingoffice statements. File by the earliest deadline. Consultyourfiling 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 completed pagos including 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.

PartS. VerificationComplete the venfication by signing the statement andentering the date signed. Each statement must have anoriginal "wet" signature unless filed with a secure electronicsignature. (See page 4 above.) All statements must be signedunder penalty of perjury and be verified by the filer pursuant toGovernment 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 auUiority to sign the statement. An unsigned statementis not considered filed and you may be subject to late filingpenalties.

SCHEDULE B
Interests in Real Property
(Including Rental Income)

CALIFORNIA FORIW

FAIR POLITICAL PRACTICES COMMISSION
700
Name
^
t «—
> ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
it
cirr
\>^, U^ ^cc^<

FAIR MARKET VALUE
Q $2,000 . S10.QOOQS10.001 .$•(00,000
[~] $100,001 -$1,000,000
.Over $1,000,000

NATURE OF INTEREST
wrshlp/Desd of Trust
Q leasshold
LIST DATE: •Z-oOt^"
/ 1^ I /25

ACQUIRED DISPOSED
n Easenient
aYr». wmalnlng Othsr
IF RENTAL PROPERTf, GROSS INCOME RECEIVED
a »0 - $4B9 [^ SSOO . S1,000 Q tl.OOI - $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 sf each tenant that is a single source of Income of $10,000 or more.
a None

I- ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
"»,•
OTY
€^y^A

FAIR MARKET VALUE
Q $2,000 . SIO.OOQ
F1 tio,ooi»$100,000
H $100,001 -$iiOoo,aQa
{W $1,000,000
IF APPLICABLE, LIST DATE:
^^&^-J^ACQUIRED DISPOSED
N/yURE OF INTEREST
'^'•j^Swmrahip/Dead of Trust [_j Easement
c LeasBbold
Yra, fWnafntns Other
IF RENTAL PROPERTY, GROSS INCOME RECEfVEO
r;JSO-S488 Q $300-$1,000 ^|1,001 . S10,000
[3 51Q.QQ1 . $100,000 H OVER $100,000
SOURCES OF RENTAL INCOME: If you own 8 10% Or greater
interest, list the name of each tenant that Is a smgle source ofincome of $10,000 or more.

D Nona
*
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 tender's regular course of business must be disclosed as follows; NAME OF LENDER*
<^\A.r^c--<<
ADDRESS (BusimaS'Adtdfass^wtablB)
BUSiNESS ACTIVITY, IF ANY, OF LENDbR
-...'J

INTEREST RATE
^fcAS. cNona TERM (Manths/Yeara) ^^..hf !J1AHIGHEST BALANCE DURING REPORTING PERIQD D <S80 - $1.000 C.<1>Q01 - 510,000Q $10,001 - t100,000 CS»jPVER SWQ.MQ [I Qyarantor, If Bpplicable
NAME OF LENDER* m\u.^•^s-d^
ADDRESS (BuainSss AMrwaa^watitatite)
BUSINESS ACTIVITY, IF ANY^OF LENDER
IhTTERESTRATE '~5Lllllfllllllil TER.M(Monthsn'eSfSS
fc^SiL^. a Non« a»^ r'>.

HIGHEST &ALANCE DURING REPORTING PERIOD
Q $500 - SI.OOO Q f,1,001 . $10,000
Q $10,001 . S100,000 'Q((IVER $100,000
Q Guarantor, if applicable
Comments:

FPPCftarmTOO .SdieduteB (N2S/20MI
Instructions - Schedule A-2
Investments, Income, and Assets of Business Entities/Trusts Use Schedule A-2 to report investments in a business
entity (including a consulting, business or otherindependent contracting business) or trust (including a living trust) in which you, your spouse or registered domestic partner, and your dependent children, together or separately, had a 10% or greater interest, totaling $2,000 or more, during the reporting period and which is locatedin, doing business in, planning to do business in, or which has done business during the previous two years in your agency's jurisdiction. (See Reference Pamphlet, page

14.) A trust located outside your agency's jurisdiction is reportable If it holds assets that are located in or doing business in the jurisdiction. Do not report a trust that contains non-reportable interests. For example, a trustcontaining only your personal residence not used in whole or in part as a business, your savings account, and some municipal bonds, is not reportable.

Also report on Schedule A-2 investments and real property held by that entity or trust if your pro rata share of theinvestment or real property interest was $2,000 or moreduring the reporting period.

To Complete Schedule A-2:

Part 1. Disclose the name and address of the business
entity or trust. If you are reporting an interest in a businessentity, check "Business Entity" and complete the box as follows:
• Provide a general description of the business activity of the entity.
• Check the box indicating the highest fair market value of your investment during the reporting period.
• If you initially acquired or entirely disposed of this Interest during the reporting period, enter the date
acquired or disposed,
• Identity the nature of your investment.• Disclose the job title or business position you held with the entity, if any (i.e., if you were a director, officer,partner, trustee, employee, or held any position ofmanagement), A business position held by your spouseis not reportable, Part 2. Check the box Indicating your pro rata shareof the gross income received by the business entity or trust. This amount includes your pro rata share of thegross income from the business entity or trust, as weilas your community property interest in your spouse's orregistered domestic partner's share. Gross income is thetotal amount of income before deducting expenses, losses, or taxes.

Part 3. Disclose the name of each source of income that is located in, doing business in, planning to do business in,or that has done business during the previous two years inyour agency's jurisdictton, as follows:

Disclose each source of income and outstanding loan
to the business entity or trust identified in Part 1 if your pro rata share of the gross income (inctudingyour community property interest in your spouse's orregistered domestic partner's share) to the business entity or trust from that source was $10,000 or more
during the reporting period. (See Reference Pamphlet,page 12, for examples.) Income from governmentalsources may be reportable if not considered salary.See Regulation 18232. Loans from commercial lendinginstitutions made in the lender's regular course of business on terms available to members of the public
without regard to your official status are not reportable.

Disclose each individual or entity that was a source
of comnnission income of $10,000 or more during thereporting period through the business entity identified in Part 1. (See Reference Pamphlet, page 9.)
You may be required to disclose sources of income locatedoutside your jurisdiction. For example, you may have a client who resides outside your jurisdiction who does business on a regular basis with you. Such a client, if a reportable source of $10,000 or more, must be disclosed,Mark "None" if you do not have any reportabte $10,000 sources of income to disclose. Phrases such as
"various clients" or "not disclosing sources pursuant to attomey-dient privilege" are not adequate disclosure.
(See Reference Pamphlet, page 15, for information onprocedures to request an exemption from disclosing privileged information.)Part 4. Report any investments or interests in real property held or leased by the entity or trust identified inPart 1 if your pro rata share of the interest held was $2,000or more during the reporting period. Attach additions! schedules or use FPPC's Form 700 Excel spreadsheet ifneeded, Check the applicable box identifying the interest held as real property or an investmentIf investment, provide the name and description of the business entity.
• If real property, report the precise location (e.g., an assessor's parcel number or address).
• Check the box indicating the highest fair market value of your interest in the real property or investment duringthe reporting period. (Report the fair market value of theportion of your residence claimed as a tax deduction ifyou are utilizing your residence for business purposes.) • Identify the nature of your interest.• Enter the date acquired or disposed only if you initially acquired or entirely disposed of your interest in theproperty or investment during the reporting period.

FPPCForm?00 (ZOZS/20Z6)

CALIFORNIA FORM

SCHEDULE B
Interests in Real Property
((ncluding Rental Income)
FAIR POI.mCAl. PRACTICES COMMISSION
Name ?i..K.;\.
»> ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
ClTf
X_k,C^^oo(\<

FAIR MARKET VALUE
Q $2,000-tlQ.OOOD $10,001 - (100,000D (100,001 . (1,000.000 <er S1.000.000

NATURE OF IKTEREST
mership/Deed of Trust
a Leasehold
IF APPLICABLE. LIST DOTE:

Z^s^_ 7—fiiC" __y_j2S_

ACQUIRED DISPOSED
Q Easement
D.

Yr». ramatning Other

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
[3 $0 . $493 Q $SOO . $1,000 Q $1,001 . $10,000
$10,001 • $100,000 Q OVER $100,000
SOURCES OF RENTAL INCOME: If you own e 10% or greater
Interest, list the nams of each tenant that is a single source of income of $10,000 or more.

Q None
> ASSESSOR'S PARC^i NUMBER OR STREET ADDRESS
,1
cin
L^/^^ocAl '-iFAIR MARKET VALUE
D $2,000 * $10.000
Q $10,001 • $ioo,ooo
n,$ioo,ooi. $1,000,000'*@ Over <1,000.000

NATURE OF INTEREST
Ownership/Deed of Trust
Q Leasehold
IF APPLICABLE, LIST DATE;
'Z-sy-'J? -=:^=3&5_ _^_^2SACQUIRED DISPOSED
[_] Easement
aVn. remaining OBw
(F RENTAL PROPERTY, GROSS INCOME RECEIVED
Q$0-t493 QtSOO. $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 ths name of each tenant that is a single sours» 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. Persona! loans and loans received not in a lender's regular course of business must be cfisclosed as follows:

NAME OF lENDER*
<\AlX A^^^-c
WDRESS (Buslnaas^ddress A<<S^^^
BUSINESS ACTIVfrY. IF ANY, OF LENDER ^ t;^0^^, ^ \52^ " ^ SZ INTEhSSf RXfE
4fc3^«
^
Q None
TERM (Months/Years)
SOy^

HIGHEST BALANCE DURING REPORTING PERIOD
Q $soo - d.ooo Q ^1,001 . (10,000
Q (10.001 . $100,000 rg(gVER $100,000
Guarantor, X applicable

NAME OF LENDEF
^ \\ ^ ..^e.<^ <-
AOORESS (BtisiMS\Ailclress^ep^6)
JSINESS A5%ir<'IF^N^ OF JLENDiR'
?^^..rJ^
INTEREST RATi ^
^A$% C3 None
l<52^b~-^tS^
TERM (Manths/Yaars)
^^.wt^ S^J
HIGHEST BALANCE DURING REPORT1NQ PERIOO
Q $500 - $1,QOQ Q $1,001 - $10,000
[~] 110,001 . $100.000 ^|rOVER $100,000
Q Guarantor, If applicable
Comments:

FPPC Farm 700 .SchaduleB (Z02S/ZBZ6)
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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 the CityCouncil in its evaluation of your application. Applications certified by the City Clerk as eligible for appointment shall remain valid for use towards future vacancies for a period of up to one year fromcertification. In the event of a vacancy, if the applicant has not been appointed to the Rental hlousingBoard and still desires to be considered for appointment, they may submit an updated application, ormay advise the City Clerk's Office in writing that the information contained on the original applicationis still current. For example, if an application is certified on February 21, 2025 as eligible, said application will continue to be qualified subject to written confirmation by the applicant to the City Clerk's Office through February 21, 2026.

Applicant Name: nqodig D^ AMJQ
hlome Address:Mailing Address:

Email Address:Business Phone:Home Phone:
?gsad&nc\ CP^^^a LPr 1180!
u
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):

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 youare currently sen/ing or have served, offices held and in what city. lUl^
Employment - Title and duties, current and past (acceptable to attach resume as an alternative).

WtL Aje^i^v^
Education - Include professional or vocational licenses or certificates. ^^ VVA fl^V^+^Viy^*^^/ F^L^,^^ ft^ t/Y^Vl^4'<m

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

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? YES (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 and voting on matters in which they may have a direct orindirect financial interest. Are you aware of any potentialconflicts of interest which may develop from your occupation, or economic holdings, in relation to your responsibilities as amember of the Rental Housing Board? (If yes, please indicate any potential conflicts)
NO
D 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 have a Material Interest in 4 or more units of Rental YES Property within the City of Pasadena? (If yes, please read the "Note" on the Supplement to Statement of Economic Interest Form (Form RhtB-002) regarding property owners with interest in 4 ormore rental units, attached to this application) D NO
NO
QExtended 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)).

7. 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?

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

9. Are you aware of the time commitment necessary to fulfill the obligations of the Pasadena Rental Housing Board?

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

11. Can you, upon appointment, provide proof of identity and proof of eligibility to work in the United States?
YES
'I
DNO Ef
YES
DNO
YES 1^/1 NO
YES
YES
NO
NO
D

12. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant Relationships/Real Estate:
t{'^ j^l^ y\ 4^^-^^ -4^1^ ^^ <A^i:^? ^0^^ WLrt^-^(( P'Ud l-PrK-t;, CWV^r^^, u^yt^ t<A~ C^(«^A a^ ^) ftyJ/wu^ -hs A/4,''i- i?- CB^lit'a^^' <^ty^frw^^ ^-^^T^t-^M.t c<w»w;^

13. How would you add value to the Pasadena Rental Housing Board? vi'l^\ J^A^'C^L 1A/J ^i9{^S ^- (it^CU^t^^ ^'^V^U.^'C^ ci^ £^-i^( M^J ^ 6\\ M^VKVU? ti- Jr^\ fi-)A^VT»^.<^' iJ^K a^ J> ^Ml^*c'<4~(?^^ ~u~

14.What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
^A^-MA^V^ a ir»J^v-t^ .i-^o-e^N- Uv^^b fiUAJilflt^lAs^Jo. ^r^\'&^-ii,w^ J-v. 1 fvaAV.J<J4:/v^^' JL<AA-'^ /^"a^L- A^-^ts^r' A^^/'-.^^®^

15. How would you help to achieve these objectives and goals? C.^V-l'/y^i-t -Jb <^|Y<?^A^ ^-^^^ 8A/\ J^A-^A^t^w H'^ CA ^tA^ t^-ei*^^<3^\A t^\- I, CUiCt 0& P(VYi^
C-fc-^yw^^^v-^ Lw^JU^V) 1^ ^^*/6h'^tv/(If^fey/!
(printed name), declare under penalty of perjury under the law o the State of California that the information reported in this Form RHB-001 is true, accurate, andcomplete.

Signed this ^v^ day of ^\ _, 2QZif .

Signed:

Printed Name: U^^W De h^l\
b'F PAS?0
^
^
?
<0
so
%

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. 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. Z. of the City of PasadenaI reside at .. ^ „ .

CA ^U0~l (zip code).

Signed
(street), Pasadena,
: c
Printed Name: U(XdA^ 0^. A^A^i

2. If you are not a registered voter, please provide clear, readable copies of 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 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 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 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 CaliforniaAn original copy of an approved Claim for Homeowners' Property Tax Exemption (BOE-266) form filed with the Los Angeles County AssessorCourt 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.
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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 (City Charter ArticleXVIII) 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 sen/ice. Ail 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. When completing Form 700 to report such interests anddealings in rental property, please note that City Charter 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.

City Charter Article XVIII 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 ExtendedFamily owned, managed, or had a 5% or greater ownership stake in Rental Units in the county ofLos Angeles in the past three (3) years (Section 1803(i)). Please acknowledge you have read the following:

Note: While the City Charter is permissive in allowing At-large members to own rental property, California's Conflict of Interest regulations for public officials contain separate standards. As a result, Board members who are property owners with interest in 4 or morerental units in the City of Pasadena might not be able to freely participate in all matters thatcome before the Pasadena Rental Housing Board. Interested applicants in such a position should consult with legal counsel prior to submitting an application. / acknowledge I have read the foregoing Note {-v" (initials) 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
l, C\^^(\ De A^^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 theattached Form 700 is true, accurate, and complete.

Signed this M.rtM^ day of ^T^] _, 20 Z<^ .

Signed:

Printed Name: C[o\i^Q P^> A^vd^
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Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
i, CjftcU 0^ Aw A<^ _(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 <^Ut?1 (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 OL\ day of ^Ac^cJ^
Signed:

Printed Name: GlflJ^ D-^ AV^^I
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CLAUDIA
DE ANDA Los Angeles County, CA | linkedin.com/in/cdeanda8811 ^.•^.•—."^Z^S^r^^r^^.'-.Si'SSt-sa.:^ .~&^^fc.:.?^SJ^^;^^^?^;^^!^»!^a3!W»,.SZSffi^^ !:.S21.:K^ME".3,-;it The backbone for Audit Services and Institute Compliance (ASIC); confident, adaptive, strong organizational and multi-tasking abilities, time management skills, and highly effective verbal and written communication skills.

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AUDIT

EXPERIENCE
ADMINISTRATIVE ASSISTANT TO THE AVP, INSTITUTE CHIEF COhflPLIANCE OFFICER FOR

SERVICES AND INSTITUTE COMPLIANCE (ASIC)
California Institute of Technology | Pasadena, CA
2019-PRESENT
Facilitates regulatory change implementation; monitors developments related to Institute operations; works withdepartment management, reviews processes and maintains a centralized location forASIC's policies andproceduresDevelops and implements audit quality controls; performs quality control review of audit reports; ensures clarity,logic, and adherence to internal and government accounting standards.Nurtures functional relationships with Institute departments facilitating audit activities for management andauditors,Serves as the Audit Liaison; coordinates external activities with regulatory agencies and other organizations as directed or required; responds to requests for data by obtaining, evaluating, and presenting data to requesting parties; responds to inquiries on data provided.Coordinates with IMSS on upgrades and maintenance ofASIC's software and hardware ecosystem.Ensured transfer of institutional knowledge to successor including insights, and critical information. ati=!S£';£'i<R2:-i asi^K'-'^gB^s^ S.S^^C^-.-.^S.IEKe 'XL-S^.'^a^SS-S^-'tSEK^ SR. EXECUTIVE ASSISTANT
211 LA County, a 501(c)(3) organization | San Gabriel,
CA2017-2019

CLERICAL ASSISTANT II - SUPERINTENDENT'S
OFFICE
Monrovia Unified School District | Monrovia, CA
2016-2017
Ensured timely and service-oriented administration Researched cost-effective marketing companies,support for the City of Los Angeles Request for Proposal; negotiated with, and arranged service agreements inreviewed contracts and service agreements to ensure compliance with federal funding requirements.accuracy, compliance with internal controls; reviewedand prepared organization-wide travel expenses. ^.•:,-,sK»-3-;...;.,,r*?x=r-,5;i3ra

EDUCATION

BACHELOR OF ARTS IN ANTHROPOLOGY
University of California, Santa Cruz
Be^^^a^isa^'gi.sa^scr^-sass^fflKEmsaa'ssEE^^
SKILLS
Microsoft Office Suite
Fiscal Systems Management: OBI, Concur
Compliance, Financial, and Control Oversight
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INFORMATION TECHNOLOGY CERTIFICATE OFACHIEVEMENT
Citrus College
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Exceptional communicationFluent in Spanish
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CALIFORNIA FORM7QO

FAIR POLITICAL PRACTICES COMMISSION
ate Initial Fliing Received
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STATEMENT OF ECONOMIC INTERESTS

COVER PAGE
A PUBLIC DOCUMENT RECE^^£D
Please type or print in ink. . CQ
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NAME OF FILER (LAST)
Ck P^ct
(FIRST)
Cl^iA (MIDDL^J^i^ZI V i""'t

1. Office, Agency, or Court crn OF WSAOENA
Agency Name fDo no( use acronymsj i 9^.8) J^^^^^^^^ H^s;^ to ^1 1^ 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)
State Judge (Supreme, Appellate, Superior Court), Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction) •County
^ityof P£t$A^it1(?L
VCounty of JJ& A^CiCltJ
Other

3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2025, through
December 31, 2025.
•or"
The period covered is / / _, throughDecember 31, 2025.

Leaving Office: Date Left J_ J_
•or.
(Check one circle below.)
The period covered is January 1, 2025, through the date of leaving office,
Assuming Office: Date assumed J_ _/. The period covered is J_ J_ through Y, Candidate: Date of Election N&At
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
Schedule A-2 - Investments - schedule attachedSchedule B • Rea/ Property - schedule attached Schedule C • Income, Loans, & Business Positions - schedule attachedSchedule D • Income - Gifts - schedule attached Schedule E • Income - Gifts - Travel Payments - schedule attached Attachment 700-P - Prospective Employment (87200 Filers Only) - schedule attached "Or-\ None • No reportable interests on any schedule

5. Verification

MAILING ADDRESS STREET
(Business or Agency Address Recommended - Public Document) CITY
?0j^^^
DAYTIME TEL^i i luiic IMUIVIBCK
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STATE
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ZIP CODE
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EMAIL ADDRESS
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I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knoi.^uy^ u^ iiiiuii.iuuuii 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 X(M\^AV ^1 i '2-0'2^> Signature
(File Ihs'Vriginally signed pap^sfafemenf wlh your filing alficial.) FPPC Form 700 - Cover Page (ZOZ5/2026)
[email protected] * 866-275-3772 • www.fppc.ca.gov
Page - 6
Types of Statements
Assuming Office Statement:

If you are a newly appointed official or are newly employed in a position designated, or that will be designated, in a state orlocal agency's conflict of interest code, your assuming office date is the date you were sworn in or otherwise authorized toserve in the position. If you are a newly elected official, your assuming office date is the date you were sworn in.

Report: Investments, interests in real property, and
business positions held on the date you assumed theoffice or position must be reported. In addition, income(including loans, gifts, and travel payments) receivedduring the 12 months prior to the date you assumed the office or position.

For positions subject to confirmation by the State Senate or the Commission on Judicial Appointments, your assumingoffice date is the date you were appointed or nominated tothe position.

Example: Maria Lopez was nominated by the Governor
to serve on a state agency board that is subject to stateSenate confirmation. The assuming office date is thedate Maria's nomination is submitted to the Senate.

Maria must report investments, interests in real property, and business positions Maria holds on that date, and
income (including loans, gifts, and travel payments)received during the 12 months prior to that date.

If your office or position has been added to a newly adoptedor newly amended conflict of interest code, use the effectivedate of the code or amendment, whichever is applicable.

Report: investments, interests in real property, and
business positions held on the effective date of the code or amendment must be reported. In addition, income(inciuding loans, gifts, and travel payments) receivedduring the 12 months prior to the effective date of thecode or amendment.

Annual Statement:

Generally, the period covered is January 1, 2025, throughDecember 31, 2025. If the period covered by the statementis different than January 1 , 2025, through December 31,2025, (for example, you assumed office between October 1, 2024, and December 31, 2024 or you are combining
statements), you must specify the period covered.

Investments, interests in real property, business
positions held, and income (including loans, gifts, and travel payments) received during the period covered
by the statement must be reported. Do not change the
preprinted dates on Schedules A-1, A-2, and B unless
you are required to report the acquisition or disposition ofan interest that did not occur in 2025.

If your disclosure category changes during a reportingperiod, disclose under the old category until the effective date of the conflict of interest code amendment anddisclose under the new disclosure category through theend of the reporting period.

Leaving Office Statement:

Generally, the period covered is January 1, 2025,
through the date you stopped performing the duties ofyour position. If the period covered differs from January1, 2025, through the date you stopped performing the duties of your position (for example, you assumed officebetween October 1, 2024, and December 31, 2024, or you are combining statements), the period covered must
be specified. The reporting period can cover parts of two calendar years.
• Report: Investments, interests in real property, business positions held, and income (including loans, gifts, andtravel payments) received during the period covered bythe statement. Do not change the preprinted dates on Schedules A-1, A-2, and B unless you are required toreport the acquisition or disposition of an interest that did not occur in 2025.

Candidate Statement:If you are filing a statement in connection with your candidacy for state or local office, investments, interestsin real property, and business positions held on the dateof filing your declaration of candidacy must be reported.In addition, income (including loans, gifts, and travelpayments) received during the 12 months prior to the date of filing your declaration of candidacy is reportable. Do notchange the preprinted dates on Schedules A-1, A-2, and B.Candidates running for local elective offices (e.g., countysheriffs, city clerks, school board trustees, or water district board members) must file candidate statements, as required by the conflict of interest code for the elected position. The code may be obtained from the agency of
the elected position.Amendments:

If you discover errors or omissions on any statement, file an amendment as soon as possible. You are only required to amend the schedule that needs to be revised; it is notnecessary to refile the entire form. Obtain amendmentschedules from the FPPC website at www.fppc.ca.gov.Note: Once you file your statement, you may not withdrawit. All changes must be noted on amendment schedules.

Expanded Statement:If you hold multiple positions subject to reporting requirements, you may be able to file an expandedstatement for each position, rather than a separate and distinct statement for each position. The expanded
statement must cover all reportable interests for all
jurisdictions and list all positions on the Form 700 or on an attachment for which it is filed. The rules and processes governing the filing of an expanded statement are set forth in Regulation 18723.1.

FPPC Form 700 (2025/2026)
[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 wilt 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 the City Council in its evaluation of your application. Applications certified by the City Clerk as eligible forappointment shall remain valid for use towards future vacancies for a period of up to one year from certification. In the event of a vacancy, if the appiicant has not been appointed to the Rental Housing Board and still desires to be considered for appointment, they may submit an updated application, or may advise the City Clerk's Office in writing that the information contained on the original application is still current. For example, If an application is certified on February 21, 2025 as eligible, saidapplication will continue to be qualified subject to written confirmation by the applicant to the City Clerk's Office through February 21 ,2026.

Applicant Name: E/l \ ?i la U. A-^^^<^^
Home Address: -+ ^^M^]pl
Mailing Address:

Email Address:

Business Phone:Home Phone:
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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):

Tenant IVlember (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)
Communitv Service ~ List boards, commissions, committees, and organizations on which you are currently serving orl^ave served, offices held and in what city. \G{ifkit£tvy\^-^ ioQ&S - M?-4^£^
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EmDlovment- Title and duties, current andpsist (acceptable to attach resume as an altematiye). ft^LtWlc-"t <>^.LtJ / fl/e^sy. ^^ 4^-f^^e^-^. t
Education - Include professional or vocational licenses or CQrttflcates. A^^A^^-h^ " (^Sd.po^m^^cA |^(L<

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

2. Are you related to any employee, appointed or elected official of the City of Pasadena? f//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
D

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

6. Do you have a IVIaterial Interest in 4 or more units of Rental Property within the City of Pasadena? (If yes, please read the "Note" on the Supplement to Statement of Economfc Interest Form (Form RHB-002) regarding property owners with interest In 4 or more rental units, attached to this application) YES |~"~| NO
YES D NO J2

7. 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 stakein said property?

8. Have there been, or are there now, any personal or business circumstances which might reflect adversely on the proprietyof your serving as a member of the Pasadena Renta! HousingBoard?

9. Are you aware of the time commitment necessary to fulfill the obligations of the Pasadena Rental Housing Board?

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

11. Can you, upon appointment, provide proof of identity and proof of eligibility to work in the United States?

YES Q NO
YES
DNO
YES
YESYES
NO Q
No D
NO
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12. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/LandIord Tenant Relationships/Real Estate:

13. How would you add value to the Pasadena Rental Housing Board? , , ^^^l^^ti^V^^ML^ i^-^^^i^^^ ix^MUi^^^-Lfi'^^t>^^ ^^ ^'-T'&n^iiJ ^i ^<^(!,^=^—^JjQ^-^Q^sM

14.What do you view are the primary objectives and goals of the Pasadena Rental Housing Board? x_^<^^i3^^lL'^^_o^pA&^^ //l^ ^^^Ll-^0^3S^J^7^JC^^^ s.Howwo&ft vouihifl^otoachieve these objectives and
^^—fev^-^U3-
y^uihietptoachieve these objectives and goals? 5e^.n^ ^(r'l<4\/R« ^^A ^^J^ ^QL^J^UL^—M-^^ 4p^ls^^^l^-^k^J—^^x^(^ 1, & li's.'la J^<^»4^ ^-v (printed name) declare under penalty of perjury under the law c the State of California that the information reported in this Form RHB-001 is true, accurate, and complete.

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Residency Verification ~ IVIANDATORY
All applicants must provide proof of residency in s City Council district under section 1811(b) of The Pasadena Fair gnd Equitable Housing Charter Amendment. 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 verily your signature on file with the Los Angeles County Registrar of Voters.

I am a resident of District No
I reside at
CA^^of (zip code).

Signed:
._! of the City of Pasadena
•I.
(street), Pasadena,
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Printed Name: Bll^la ^^^me/r1

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

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

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 authortty governing over a country, state, county, city. municipatity, distrld, 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 tease agreement with the signature of the owner/landlord and the tenant/residentSchool 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 dQCument. it must be sealed by the school and S*^.^l* o^JJ^. ^ ^t*^.A^..^^.«..-^L^ -^JCAl-..«. ^-..^.li^^.^.JL .^.A !.:(-..- .--.,- At,-, ...I 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 organjzation, employeror 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 abiri;h 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. »
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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 (City Charter Article XVIII) prohibits Tenant Board and Alternate Tenant Board members from having "Material Interests En 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. When completing Form 700 to report such interests and dealings in rental property, please note that City Charter 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.

City Charter Article XVIII Definitions:

Extended Family: any spouse, whether by marriage or not, domestic partner, parent, child, sibling, grartdparent, 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)). Please acknowledge you have read the following:

Note: While the City Charter is permissive in atfowing At'-farge members to own rental property, California's Conflict oflntQrest regulations forpubfic officials contain separate standards. As a result, Board members who are property owners with interest in 4 or more rentaf units in the City ofpQsadena might not be able to freely participate in sit matters that come before the Pasadena Rental Housing Board. Interested applicants in such a position should consult with legal counsel prior to siibmltting an application.

I acknowledge I have read the foregoing Note(j, \ ^initials) 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 Jnterests Affidavit - MANDATORY
I, te^ V t ?i l^ hA. ^r/<%^ w e-f> (printed name), declare under penalty of perjury under the law of the State of California that the jnformation provided and reported in this Form RHB-002 and the attached Form 700 is true, accurate, and complete.

Signed this ,,H day ofJ^lfawOj
Signed: C^i^,t
Printed Name: ^\\^^ U. ^-'OiPvne^
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CITY OF PASADENA
Affidavit of Tenancy - IVIANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
[> J£44S.^<21 ^a^^^.'^ (printed name), declare under penalty of perjury under the law of the State of California that the 'foregoing is tme 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) namedjn^a rental housing ^gTeement)Dr lease, or b) have provided proof of a relationship to a person named In a rental'agreePnent that entitles me the rights of a tenant.

3. I reside at the following address: Pasadena, California ^ 110 ( (zip code) (street), OR
This form is not applicable to my application as I am not seekEng a Tenant Board or Tenant Alternate Seat.

Signed this^ A"1 da^f V'e^O^Qn^ . 20 2-fo.

Signed:

J
Printed Name: ^/ \ \-s [a^ra 0 rW&'P
Elista M. Farmer
Pasadena, CA 91101

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Work Experience
»
Pasadena Tournament of Roses Association
^4embe^ & Public Services Assistant
5/2023-12/2025
Assist in the administrative and operational aspects of the Membership services department.

Point of contact for public information regarding Rose Parade matters.

Provide information to the Association's 935 Tournament members and committees.

Serve as staff liaison to the Assodat'on's operating committees, as assigned.

Provide support for marketing, communications & membership-related events and activities. •
Swenson Corporation - CPA corporation
Enrolled Agent, Federal #88413, August 2007
11/2005-2008
Advise, represent, and prepare tax returns for individuals, partnerships, corporations, estates,trusts, tax-exempt organizations, and other entities with tax reporting requirements.

Prepare tax planning projections.Research tax law for tax preparation, collection, and representation matters.Proficient in preparing and reviewing Jndividuat, business, fiduciary and corporate tax returns to determine correct federal tax liabilities.

Clients include savvy investors, netAGI $500K -$12M, corporate stockholders and shareholders, and those who engage In complex business transactions.Demetriou, Montana & AssociatesCA Tax Preparer/Staff Prepared individual, business and payro!) income tax returns.Researched tax laws.

Conducted client interviews.

Prepared financials for coliection matters.NordstromCustomer Service Specialist • Managed more than 50 temporary staff in telecommunication center. 08/2002-11/2005
12/96 "8/2002
Education
• Bachelor of Science, Business Administration, Accounting concentration California State University, Dominguez Hills, August 1990 Farmer, Elisia M.

Additional Information
Can effectively Interact with a broad range of individuals, accountants, legal and other busjness-related professionals.

Able to plan, organize, and prioritize work.

Effectively able to communieate both orally and in writing.

Volunteer Experience
Friends-in-Deed, food bank 2017 - current
t am a regular volunteer each Saturday stocking shelves and accepting donations which allows me to have meaningful interactions with the community. As a person of the community, I strive to makeeveryone that comes to donate aware that their donation is greatly appreciated. For those who come for help, I take extra steps to provide food and information to make their lives a little easier. This is so important for the work we do at Friends tn Deed-Pasadena. I've also volunteered at the main office filing, sorting, and data input. In 2022, there was a turkey shortage. I initiated phone calls to ensure that FID would receive turkeys.

Pasadena Sister Cities Committee, member since ZOIS, Treasurer 2021" 2023 As Treasurer, I keep and maintain, or cause to be kept and maintained, adequate and correet books and accounts of the Pasadena Sister Cites committee's properties and transactions. I also deposit or cause to be deposited all monies and disburse funds as required.

TOR White Suiter, since 2021, co-Chair Emergency Operations 2022; Chair Emergency Operations 2023 In this role, I coordinated with Float Fest volunteers to document and report events through the days i.e.,lost phones, wallets, keys, lost child or family members; trips and falls; breach of barricades; defusesituations when required; use handset and cellphone to cotnmunicate with Vice President. Maintained apresence in the Emergency operations center; keeping a watchful eye on the monitor, and consistently walking Float Fest to taik with other White Suiters and visitors.

So Cat Women's Conference, 2022, 2021 and 2020 Community Engagement; Coordinated and prepared Swag Bags for more than 500 attendees. Attended various events to promote the SCWC throughout the year.Women in Leadership Vital Voices, since 2020; Volunteer AssistantJohn J. Kennedy, District 3, Volunteer Assistant • Campaigned 2023; Phone Banked, door to door canvasing neighborhoods, • Texted constituents and addressed mailers.

Assisted with the 2019 Holiday vpany,
• Turkey Giveaways 2021 and 2022, Thanksgiving and Christmas, Mayor Terry Tornek, 2020
* Campaigned, phone banked, door to door canvasing neighborhoods, speaking with residents, and addressed mailers.

U.S. Senator Raphael Warnock 2020
Phone Bank for then Georgia Pastor/MinisterWarnock.
"Get Out the Vote" Campaigns - ongoing.
• Computer assistance in various states: Texas, Virginia, and California Tree Planting, City of Pasadena 2021 and 2022
• Volunteered to replace dead or install new trees in the Sunset Oaks and the W.D.Edson Neighborhoods.

Black History Parade 2022 and 2023
Represented the Senegal Sister Cities parade route.Pre and Post parade J. K. Kennedy Memorial set up.

First AME Church-Pasadena 2019 During Covid, Ordered, picked up and delivered meals three days a week to COVIO volunteers, who selected restaurants and meals of their choice.

Hosted Information Table:

Atkebu-lan Cultural Center-Art Night Pasadena Sister Cities Chris Holden annual Block Party, Pasadena Sister Cities and So Cat Women's Conference Councitman Tyron Hampton, Pasadena Sister Cites and So Cal Women's Conference Altadena Home tour-Pasadena Sister Cities
Holiday Turkey Giveaway-- 2021 and 2022 Jlohn I. Kennedy, District 3 • Delivered frozen turkeys to Pasadena resident's homes.* Delivered turkeys on behalf of District 3 to various organizations.

Helped to coordinate, placing volunteers in strategic positions, i.e., unloading, unpacking, and distributing positions.Organized, picked up lunch and snacks for the various volunteers.

CALIFORNIA FORM 7 00

FAIR POUTICAL PRACTICES COMMISSION

SWEMENT OF ECONOMIC INTERESTS

COVER RAGE
A PL/Bl/C DOCUMENT
Date Initial Filing Received Rliny OIEcSal Use Onl/
Please type or print fn Ink.(WM£ OF FILER ffJW)
^^e^
fftRST)
£lis/^_
pfioat.e)
y4

1. Office, Agency, or Court
Agency Name (Do mt use awfjyns)
Division, Boartf, DeparffTient, District, if applicable I"-
Your Position
J:3L t-3e»
(e, £e^l -f+0^^ ^l3k/ ^W/i^^ sj IK- If filing for multiple positions, list below w on an attachment. (Oo'hA? use scmt/ms) Agency: Position:
1T
""1
^ m
^ ^ <
m
XX
%c
pi
^^ r= [:T

2. Jurisdiction of Office (check at least one box)
a State
-z~>
wc,>
D MuN-County
'Btityof ^r^A^ff
C] Judge (Supreme, Appellate, Superior Court), Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdictioni pfCwnt^ of 4 tf^ ^r!q€./6s
D Other
3, Type of Statement (ChecK st feast one box)
Q Annual: The period wverad is January 1, 2025, through DecsfflbSf 31, 2025,
"orThe period covered Is.: ,.„„/„„„„„„ L
December 31, 2025.

D Leavtns Office: DatBLeft. J. Jthrough (Check one circle bslow.) D The period covered is January 1.2025, through the date of leaving office.

Q Assuming Office: Date assunied J-
^ Candidate: Date of Election /VffiV^
J_
'•or*
a The period covered is _/_ J_
the date of leaving office.
and office sought, if different than Part 1:.
through

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

Q Schedule A-1" /wesfmeflfe" schedule attached
D Schedulo A-2 • Investments - sdieduls attached
jg'Schedute B • fiea/ Properly ~ schedule attached
Q Schectule C • /ncoms, Loans, & Business Positions - schedule attached Lj Schedule D • Income ^ Gifts- sdiedule attached
;_j Schedule E • Incxvne - Gi&s - Travel Payments ~ schedule attadied [-] Machment 700-P»Pfospsctive Emptoyment (8720Q R/e/s Oft/yj - scheduls sttachetl •or ' None • No ivportable interests on any schedule

5. Verification
MAiLINQ ADDRESS STREET
(Busiaassor^sMyMdnss Raconifflwicfsd" Fu Docuimnn

DWDME TELEPHONE NUMBER
! )
ciTv
"^^sofc^
EMAIL ADORES^
STATE
6-fi
zipcooe
^tlot
I have used all reasonable dillgen® in preparing this statement. 1 have reviewed this statement a® tc(Ae best of my knowledge the information contained herein and in any attached schedules Is tnje and complete, I acknowledge this Is a public document t certity under pen^t^of parjury under Uiie laws of the State of Califar Date Signed /y,^4(^ ^ G^'/^/2^?£"^ ?^^ft&±-^ l^
arjury under Uie laws of the State of California that the foptgOtngJe.true and •Signature
<^^y^»9wl3inallys fl Wl '/uurlSyMdSIJ'
/ } irmW .Cover Page (WZS/ZOM}
Types of Statements
Assuming Office Statement:
(f you are a newly appointed official or are newly employed ina position designatect, or that will be designated, in a state orlocal agency's conflict of interest code, your assuming office date is the date you were sworn in or otherwise authorized toserve in the position. If you are a newly elected official, your assuming office date is the date you were sworn in.

Report; Investments, interests in real property, and
business positions held on the date you assumed the
office or position must be reported. In addition, income (including loans, gifts, and travel payments) received
during the 12 months prior to the date you assumed theoffice or position, For positions subject to confirmation by the State Senate orthe Commission on Judicial Appointments, your assuming office date is the date you were appointed or nominated tothe position.

Example: Maria Lopez was nominated by the Governor
to sen/e on a state agency board that is subject to state Senate confirmation. The assuming office date is the
date Maria's nomination is submitted to the Senate.Maria must report investments, interests in real property,and business positions Maria holds on that date, andincome (including loans, gifts, and travel payments) received during the 12 months prior to that date,
If your office or position has been added to a newly adopted or newly amended conflict of interest code, use the effectivedate of the code or amendment, whichever is applicable.

Report: Investments, interests in real property, andbusiness positions held on the effective date of the code or amendment must be reported. In addition, income
(including loans, gifts, and travel payments) received
during the 12 months prior to the effective date of thecode or amendment, Annual Statement:

Generally, the period covered is January 1, 2025, throughDecember 31, 2025. If the period covered by the statementis different than January 1, 2025, through December 31, 2025, (for example, you assumed office between October
1, 2024, and December 31, 2024 or you are combining
statements), you must specify the period covered.

Investments, irstere$ts in real property, businesspositions held, and income (including loans, gifts, and travel payments) received during the period coveredby the statement must be reported, Do not change the preprinted dates on Schedules A-1 , A-2, and B unlessyou are required to report the acquisition or disposition ofsn interest that did not occur in 2025. • If your disctosure category changes during a reporting period, disclose under the old category until the effective date of the conflict of interest code amendment anddisclose under the new disclosure category through theend of the reporting period.

Leaving Office Statement:Generally, the period covered is January 1,2025,through the date you stopped performing the duties ofyour position. If the period covered differs from January 1, 2025, through the date you stopped performing the
duties of your position (for example, you assumed office between October 1, 2024, and December 31, 2024, or
you are combining statements), the period covered must
be specified. The reporting period can cover parts of hvo calendar years.

Report: Investments, interests in real property, businesspositions held, and income (including loans, gifts, andtravel payments) received during the period covered by the statement. Do not change the preprinted dates onSchedules A-1. A-2, and B unless you are required toreport the acquisition or disposition of an interest that did not occur in 2025.

Candidate Statement:If you are filing a statement in connection with yourcandidacy for state or local office, investments, interestsin real property, and business positions held on the date of filing your declaration of candidacy must be reported.

In addition, income (including loans, gifts, and travelpayments) received during the 12 months @nortQ the date of filing your declaration of candidacy is reportable. Do notchange the preprinted dates on Schedules A-1, A-2, and B.Candidates running for local elective offices (e.g., county sheriffs, city clerks, school board trustees, or water
district board members) must file candidate statements,as required by the conflict of interest code for the electedposition. The code may be obtained from the agency ofthe elected position.Amendments:

If you discover errors or omissions on any statement, file an amendment as soon as possible. You are only requiredto amend the schedule that needs to be revised; it is not necessary to refile the entire form. Obtain amendment
schedules from the FPPC website at www. fppc.ca,gov,
Note: Once you file your statement, you may not withdraw it. All changes must be noted on amendment schedules.

Expanded Statement:If you hold multiple positions subject to reporting requirements, you may be able to file an expanded
statement for each position, rather than a separateand distinct statement for each position. The expanded statement must cover all reportable interests for all
jurisdictions and list all positions on the Form 700 or on anattachment for which it is filed. The rules and processes governing the filing of an expanded statement are set forth in Regulation 18723.1.
^.

Ctoft/- c~-'-^ tftrt /•trtic /trt-ict

SCHEDULE B
Interests in Real
R
700
I:.1

CALIFORNIA FORM
.FAIR POimCAL PRACTICES COMMISSION
Name
(Including Rental Income) 20% FEB P (j:53
>- ASSESSOR'S RARCEL MUMBER OR STREET ADDRgSS a
Cl
j^l
'^U^n €}lC£^

FAIR MARKET VALUE
Q $2,000-110,000
Q $10,001 .5100,900
Q $100,001. $1.000,000!^5 Over $1.000,000

NATURE OF INTEREST
Ownership/Deed of Trust
[j Leasehold
IPAPPLfCABLE, LIST DATE:

Yra, mmalning
J—J2SACQUIRED
r—| Eas&ment
D-
/ /25

DISPOSED
Other

IF RENTAL PROPERTY, GFIOSS INCOME RECEIVED
D SO • S493 Q $500 - $1,000 Q $1,001 . $10.000
Q (10.001. $iao,Qoo D OVER $100.000
SOURCES OF RENTAL INCOME; If you own a 10% or greater
tnterest, list the name of each tenant that Is a single source ofincome of $10,000 or more.

D None
HoiheCs €^i^^<^
»• ASSESSOR'S pn^pgL^U.iS18'?R,pri STREET ADORESS
CITf
FAIR MARKET VALUE—1$2,OQO-S10.000_J $10.001 . S100.000Q (100,001 -$1,000,000Q Over S1,000,000 IF APPLICABLE, LIST DATE:

NWURE OF INTEREST
Q Ownership/Oaed of Trust
!_] Leaseholcf
A5»

ACQUIRED
[_] Easement
D.
^_^2&-

DISPOSED
Yrs. remaining Othar

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
Q $0 . $499 Q $500 • $1,000 Q S1,001 . |i10,000
H $10,001 - $ioa,aoo Q OVER $100,000
SOURCES OF RENTAL INCOME: If you own fl •10'A or greater tnterest, list the name of each tenant ttat is a single source ofincome of $10,000 or more.

D None
You are not required to report loans from a commercial tending institutton 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 tender's regular course of business must be disclosed as foliows:

NAME OF LENOER*
ADDRESS (Bustmss Mrfmss Acsaptablej
BUSINESS ACTlVin, IF ANY, OF LENDER

INTEREST RATE
-% [_] Norw
TERM (Mcnths/Years)

HIGHEST BALANCE DURING REPORTING PERIOD
Q $500 . $1,000 Q $1,001 - (10,000
:Q sio,ooi * $100,000 Q OVER SioOiOoo
f.1 Guarantor, IF appllcabte
I
NAME OF LENDER*
ADDRESS (Business Atfdress Aoo9ptable}
BUSINESS ACTIVITY, IF ANY. OF LENDERINTEREST RATE
.% [l None
TERM (MontWfears)

HIGHEST BALANCE DURING REPORTING PERIOD
Q »500 . $1,000 Q $1,001 - $10,000Q $10.001. $iOQ,aoQ Q OVER si °0i0oo _] Guarantor, U applteabte
Comments:

Instructions - Schedule A-2
Investments, Income, and Assets of Business Entities/Trusts Use Schedu(eA-2 to report investments in a business
entity (including a consulting business or otherindependent contracting business) or trust (incluciing a living trust) in which you, your spouse or registereddomestic partner, and your dependent children, together orseparately, had a 10% or greatennterest, totaling $2,000 or more, during the reporting period and which is locatedin, doing business in, planning to do business in, or whichhas done business during the previous two years in your agency's jurisdiction. (See Reference Pamphlet, page

14.) Atrustfocated outside your agency's jurisdiction is reportabte if it holds assets that are located in or doingbusiness in the jurisdicSion. Do not report a trust thatcontains non-reportabie interests. For example, a trustcontaining only your personal residence not used in wholeor in part as a business, your savings account, and somemunicipal bonds, is not reportable.

Also report on Schedule A-2 investments and real property held by that entity or trust if your pro rata share of the investment or real property interest was $2,000 or more during the reporting period,To Complete Schedule A-2:

Part 1. Disclose the name and address of the business
entity or trust. If you are reporting an interest in a businessentity, check "Business Entity" and complete the box asfollows:
• Provide a general description of the business activity of the entity.
• Check the box indicating the highest fair market value of your investment during the reporting period.
• If you initially acquired or entirely disposed of this interest during the reporting period, enter the date
acquired or disposed.
• Identify the nature of your investment.
• Disclose the job titfe or business position you held with the entity, if any (i.e., if you were a director, officer,partner, trustee, employee, or held any position ofmanagement). A business position held by yourspouse is not reportable.

Part 2. Check the box indicating your pro rata share
of the gross income received by the business entity ortrust. This amount includes your pro rata share of the gross income from the business entity or trust, as well as your community property interest in your spouse's or registered domestic partner's share. Gross income is the total amount of Income before deducting expenses, losses, or taxes.

Part 3. Disclose the name of each source of income thatis located in, doing business in, planning to do business in, of that has done business during the previous two years inyour agency's jurisdiction, as follows:
• Disclose each source of income and outstanding loan
to the business entity or trust identified in Part 1 ifyour pro rata share of the gross income (induding your community property interest in your spouse's or
registered domestic partner's share) to the business
entity or trust from that source was S10,000 or moreduring the reporting period. (See Reference Pamphlet,pago 12, far examples.) Income from governmentalsources may be reportable if not considered salary.

See Regufation 18232, Loans from commercial (endinginstitutions made in the lender's regular course of business on terms available to members of the public
without regard to your official status are not reportable.

Disclose each individual or entity that was a source
of commission income of $1 0,000 or more during thereporting period through the business entity identified in Part 1. (See Reference Pamphlet, page 9.)
You may be required to disclose sources of income located outside your jurisdiction. For example, you may havea client who resides outside yourjunsdictt'on who does business on a regular basis with you. Such a client, if areportable source of S10,000 or more, must be disclosed.Mark "None" if you do not have any reportable $10,000 sources of income to disclose. Phrases such as
"various clients" or "not disclosing sources pursuant to attorney-dient privilege" are not adequate disclosure.(See Reference Pamphlet, page 15, for information on procedures to request an exemption from disclosing
privileged information.)Part 4. Report any investments or interests in realproperty held or leased by the entity or trust identified inPart 1 if your pro rata share of the interest held was $2,000 or more during the reporting period. Attach additionalschedules or use FPPC's Form 700 Excel spreadsheet ifneeded.• Check the applicable box identifying the interest held as real property or an investment.
* If Investment, provide the name and description of the business entity.
• tf real property, report the precise location (e.g., an assessor's parcel number or address).Check the box indicating the highest fair market valueof your interest in the real property or investment duringthe reporting period. (Report the fair market value of the portion of your residence claimed as a tax deduction if you are utilizing your residence for business purposes.) * Identify the nature of your interest.• Enter the date acquired or disposed only if you initially acquired or entirely disposed of your interest in theproperty or investment during the reporting period. co&i" Cn^m^nft f'>fti3ie/"»mifil

RECEIVED
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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 addjtiona! pages, a copy of your resume, or submit supplemental information which you feel may assist the CityCouncil in its evaluation of your application. Applications certified by the City Clerk as eligible for appointment shall remain valid for use towards future vacancies for a period of up to one year from eertification. In the event of a vacancy, if the applicant has not been appointed to the Rental Housing Board and still desires to be considered for appointment, they may submit an updated application, ormay advise the City Clerk's Office in writing that the information contained on the original application Is still current. For example, if an application is certified on February 21, 2025 as eligible, said application will continue to be qualified subject to written confirmation by the applicant to the City Clerk's Office through February 21, 2026.

Applicant Name: S^<^/ CTj'SSO^
Home Address: _^40F^ Cft, qi I Q-?
Mailing Address: __^f__AI°^EEmail Address:

Business Phone:Home Phone:

Date Available to Start: fnWDiATR/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 youare currently serving or have sen/ed, offices held and in what city.

CM&j—c^rTM^ ft^St^jcs e^vArto^. p^wv^ -vw>fW€ To QJIG^^ ^^ ^ CN a2^)'T U$T ^ ^yq^J//< Q2^i)(T "iWf </A/^y '2&2^ employment - Title and duties, current and past (acceptable to attach resume as an alternative). ^-r^N^- <5F ^T $NEyw0tO t^C . PW^^A^: /te^r^ ^»^y N /?^WM ^ Lf4 W€ftJy ffG^^ <y c^w(r/^a^ri<5A/^ WK TOP- W^ ryc^W^ cy^/r^t cH. c^ri^^S H^ffc^ u^^f . HW ^n/w^^5 ^^'-&?/€') JB^ycation,-- include professional or vocational licenses or certificates. 1?^ fti^f^ - Of4f\J€l^ny ^F ^a/e>ov MK^ uv/ve^'ip' iiW ^Mwe^) ^SST -m^ f^eWH - ^y^^-c ^fayu OF- r^^eHm/T

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

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

3. Are you aware that financial disclosure is required annually? YES (e.g., sources of income, loans end 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, (n relation to your responsibilities as a member of the Rental Housing Board? (If yes, please indicate any potential conflicts) ^\ ' A5 ^^ as)-o^!^- c?F /z ^w^ NO
NO
D
a
xA^-A^^, ' ( |^A/ HAV^ rQ> ft&^ss H^sn^ ^ ^hV ^f^c^in^c^S

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 have a Material Interest in 4 or more units of Rental Property within the City of Pasadena? (If yes, please read the "Note" on the Supplement to Statement of Economic Interest Form (Form RHB-002) regarding property owners with Interest in 4 or more rental unite, attached to this application) YES @ No D

YES NO Q
Sftended Fainlly: any tpouw, wh^Shaf by manlaga or n<X, dQinesBc pwinai". Rawnt, child. siWnn. flmsiioamnl. aunt nr unda. rilafla nr naBhnui. nBini-inhitil nn-ni .•to ifkii.iw C»-N— « »nw~u

7. Do you reside at a property owned or managed by a member of YES II 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 stakein said property?

8. 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

9. Are you aware of the timo commitment necessary to fulfill the obligations of the Pasadena Rental Housing Board?

10. Are you aware that you may serve no more than eight consecutive years as a member of the Pasadena Rental
Housing Board?
YES
0 NO
a
YES @ NO Q
11 .Can you, upon appointment, provide proof of identity and proof YES of eligibility to work in the United States?
NO

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

Ce^ A^TACM}l€K)r'

13. How would you add value to the Pasadena Rental Housing Board? <F£- A-TT^^-1 ^_f^T_

14.What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
<S&r A^n^^^^T

15. How would you help to achieve these objectives and goals? _^ee: ^Tr/^NMr^r
I, €\Hff^ dlBB^F (printed name), declare under penalty of perjury under the law c the State of California that the informatJon reported in this Form RHB-001 is true, accurate, and complete.

Signed this 2^- day of f^^U^A/ 20 Z<<.Signed:.

Printed Name: ^tH^ ^l^C^
o?
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CITY OF PASADENA
Residency Verification -- IVIANDATORY
All applicants must provide proof of residency in a City Council district under section 1611(b) of The Pasadena Fair and Equitabfe Housfng Charter Amendment. Proof of residency may be established by either of the foftowing:

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 Pasadena I reside at
CA Cllioy- (zip code). (street), Pasadena,
Signed.<h^^Printed Name: O^W ^BW^

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

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

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, rrtunicipatity. districS, agency, department, or any other political subdivision of a country or state Mortgage bill Employment documents Tax return (either Internal Revenue Sen/lce (IRS) or California Franchise Tax Board (FTB) Rental or lease agreement with the signature of the owner/landlord and the tenanVresidentSchool documents issued by a public or private primary, secondary, or post- secondary tnstitution, 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 Senu'ice 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) 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 courtorder), name change documentation is required.

CITY OF PASADENA
Economic Interests Affidavit "MANDATORY
l. €l^^ ^"IB^^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 7^ day of fW^f-^ 20^. Signed: _:^0j^l.

Printed Name: S!MMJ (^WCh^
^
of
^
^
?,
% 9h ^
Weo j

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 (City 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 ^ before submitting an application. The City Is adopting the Fair Political Practices Commission's Form 700 for this purpose. When completing Form 700 to report such interests and dealings in rental property, please note that City Charter Article XVIII requires information about interests in rental property in Los Angeles County for three years, not the one year the FPPCForm otherwise uses. Under City Charter Section 1811(b), these documents are public records; they will not be confidential.

City Charter Article XVIII 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 ifthey, 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 ExtendedFamily owned, managed, or had a 5% or greater ownership stake in Rental Units in the county ofLos Angeles in the past three (3) years (Section 1803(i)). Please acknowledge you have read the following:

Note: While the City Charter is permissive in allowing At'large members to own rental property, California's Conflict of Interest regulations for public officials contain separate standards. As a result. Board members who are property owners with interest in 4 or morerental units in the City of Pasadena might not be able to freely participate in all matters thatcome before the Pasadena Rental Housing Board. Interested applicants in such a position should consult with legal counsel prior to submitting an application. / acknowledge I have read the foregoing Note {initials) 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 andrecreational facJEIties 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)). ^&p
^
§
&;
^ ES
no

CITY OF PASADENA
Affidavit of Tenancy - IVtANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
1, ^H63N /^ (^P£PA/^ (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 c»de) (street),
^
OR
This form is not applicable to my application as I am not seeking a Tenant Board or Tenant Afternate Seat.

Signed this ^ da^ of $^4^/ ,d:'<^F^ -,20:2^ Signed
Printed Name: St^W €^ 0^5

SIMON GIBBONS
APPLICATION FOR PASADENA RENTAL HOUSING BOARD "SUPPLEMENTARY

8. Have there been, or might there be, any personal or business circumstances which might reflect adversely on the propriety of your serving as a member of the Pasadena Rental Housing Board? I was a plaintiff in the lawsuit about the legality of Measure H. Some people have expressed concern about my involvement in this. The courts ruled that some aspects of Measure H were indeed inappropriate, and the case has now been concluded by the plaintiffs.

Throughout the period since Measure H passed, I have respected and followed the law: Iimmediately carried out rent rollbacks at the end of 2022; I have followed all rules andregulattons set by the Rental Board; and I registered my rental units on tfrrie.

There is no disconnect between faithfully upholding the oath of office to fairly and impartially work for affordable housing, and exercising my constitutional right to express concerns.

12. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/HousingJustice/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 upgradesto infrastructure such as parking and utilities, and making sure that all maintenance and repairsare carried out quickly and effectively, I am also responsible for financial management for several Los Angeles rental properties owned by other people, and this includes working withtenants to set up payment plans, discounts, or other methods to try to keep residents in their homes. This expertise follows directly from my previous roles in credit risk management over 25 years, when I set up systems for fair repayment plans and debt forgiveness structures for major US and international banks.

A good example of working with tenants was during 2020, when I set up discounts for alt tenants from the start of the pandemic in March and April to help manage their finances duringthe uncertain period. As the businesses' own financial situation permitted, I offered further discounts during the second half of 2020. This helped to keep many tenants from building updebt during the eviction moratorium.I'm currently working to promote financial justice as a volunteer with CARE (Credit Abuse Resistance Education) to bring financial and credit advice to children and adults across LA County.

13. How would you add value to the Pasadena Rental Housing Board? I'd like to bring my own experience in rental property management and financial management to the Rent Board. I have been paying close attention to the Board's financial position, and Ihave attended the majority of meetings as a member of the public.

I will also treat the oath of office seriously. I will pay attention in meetings. I will comply withFPPC and City regutatJons, Just as I complied with complex regulatory requirements throughoutmy career in banking.

I

SIMON GIBBONS
APPLICATION FOR PASADENA RENTAL HOUSING BOARD "SUPPLEMENTARY

14. What do you view as the primary objectives and goals of the Pasadena Rental Housing Board? a) Adjudicate hearings from tenants and property owners in Pasadena in front of the Board for review to help provide effective and timely resolutions for disputes. b) Regulate rent levels in line with Measure H, and oversee the imptementation of Measure H which defines the obligations and requtrements of the Pasadena Rental Housfng Board andproperty owners in the city. cj Promote neighborhood stability and affordability in Pasadena. d) Provide oversight of the Rent Stabilization Department and its $5,6 million budget.

15. How would you help to achieve these objectives and goals? I intend to treat the Boarcl'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 expertise in property management and financial dispute resolution to make sure that alt sides are treated fairly,
I also want to use my financial experience to drive a more rigorous budget process and help the Board meet its obligations for regular and accurate reporting.

I will contribute to the balance of the Board by offering my experience as a rental propertymanager and owner, as well as a former renter in the USA and other countries.Finally, t will help to ensure that regulations are dear and effective, for instance by speeding up the processes for publishing permitted rent increases and interest payable on security deposits. -^^^ ^-^l^
CALIFORNIA FORM7QO
FAIR POUTICAfc PRACTICES COMMISSION
Date Initial Filing Received
fifing OKcial Use Onfy
P/ease type or print in ink.

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE

A PUBLIC DOCUMENT
^FFRPL -MO

RECEIVED
.m.

NAME OF FILER (tAST)
Gibbons
(FIRST)
Simon
(MIDDLE)
Michael — CiTY CL^K
1, Office, Agency, or Court '^ ^ i • Li,- -AoAUcMA'
Agsncy Name (Do not uss acronyms)
City of Pasadena
Division, Board, Departmsnt, District, If applicable
Pasadena Rental Housing Board
Your Position
AMarge member
>- (f filing for fnultiple positions, llsl below or on an attachment. fOo no( use acmnyins)Agency:,——.. — . Position;

2. Jurisdiction of Office (Check at least one box)
' State
! Multi-County
11 City of Pasadena
I Judge (Supreme, AppedaSs, Superior Court), Rstlred Judge, Pro Tern Judge, or Court CammissEoner (Statewide Jun'sdiction] !K County of ^5' A^^^
I" Other

3. Type of Statement (Check at feast one box)
I Annual; The period covered Is January 1,2025, through Docembor 31, 2025.
or.

The period covered is „,„.„„„„„/„,„.„.„„ „ L
December 31, 2025,
Leaving Office: Date Left J. J_
through
j ! Assuming Office: Date assumed - i
[•; Candidate; Date of Election AW^
(Cheek one cirofe below.)
r The period covered is January 1, 2025, through the date of leaving office.
•or.

The period covered is / / _, through
he date of leaving office.
and office sought, if different than Part 1;.

4. Schedule Summary (required)
Schedules attached
> Total number of pages including thfs cover page: "^?
j ] Scheduls A-1 - Investments - schedute attachedIBJ Schedule A-2 • Investments - schedule attachedjlj Schedule B - Real Property " schedule atlached || Schedule C " Sncome, Loans, S, Business Positions - schedule attachedI Schedule D • Income - Site ~ schedule attachedI Schedule E • Income - Gifts - Travel Payments - schsdute attached I Attachment 700-P - Prospective Employment (87200 Filers Ontyj - schedule attached •or-1 ! None- No reportabte interests on any schedule

5. Verification
MUH6 ADDRESS STREET
fBusiness Of Agency Attdvss Racominendeil - PuNfe OoeunttftO CITY
Pasadena
STATE
CA
BPCCBE
91107

DAYTIME TELEPHONE NUMBER
( )

EMAILAOORESS
I have used al! reasonable diligence in preparing Ms statement. I have reviewed this statement and to the best of my knowledge the infonnatiQn coniained herein and in any attached schedules is tnje and complete. I acknowledge this is a public document. 1 certify under penalty of perjury under the laws of the State of Caflfornla that the foregQjqg is^true aryi corrBct.

Date Signed _f^'S_^ , 2-®2/^ Signature '^(^ 1 /^>
(iBonld, My, ff3f IFieV»aiynal!rsyiW!l paper slstemeiilwShyssif Sing atSsA! PC Form 700 .CowrPaee (2;02S/2026)
*dvleei®tppc.c*,gov • 866.275.3772 • wwwjppe.ca.gisv
Page-(
SCHEDULE A-2
Investments, Income, and Assets
of Business EntitiesfTrusts
(Ownership Interest is 10% or Greater)
CALIFORNIA FORM 700

FAIR POLITICAL PRACTICES COMMISSION
NameSimon Gibbons
». 1. BUSINESS ENTITYOR TRUST
BT Shepherd LLC
» 1. BUSINESS ENTITY OR TRUB7
Name
CA 91107
Address (Business Mdrvss Aceeptable}
Chaalt one
I Trusi, go to S |Ki euslness Enlfly, wmplsh fhe liox, thea go to 2

GENERAL DESCRIPTION OF THIS BUSINESS
Rental Property Management
FAIR MARKET VALUEI I £0-S 1,939
I $2,000 - $10,000|$10.D01 .$100,000I $1QO,Q01 -$1,000,000 Ill Over S 1,000,000
IF APPLICABLE. LIST DATE:
/ 725

ACQUIRED
^_J25-.

DISPOSED
NATURE OF INVESTMENT^•1 Partiership | I Sola PropriBtmshtp OlhBF YOUR BUSINESS POSITION Managing Partner
Name
Address (Biislness Adcfrass Acc^plabls)CKecK orte
f" Trust, go to 2 I..]' Business Entity, eomp/ete the Isw, than go to 2

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
! $0 - $1,999
$2.000 - $10,000
; ! $10,001 .S100.00Q! | $100.001 -$(,000,QOO
I Over $1,000,000
IF APPLICABLE. LIST DATE:

ACQUIRED DISPOSED

NATURE OF INVESTMENT
Partnership ] I Sole Propfiatorshlp j Olhar

YOUR BUSINESS POSITION
••^.IDENTIFY THE 6ROSS INCOIVIE RECEIVED (INC1.UDEYOUR PRO RATAB>- 2, IDENTIFY TNE CROSS INCOME RECEIVED (INCLUDE YOUR PRO RAT^ •SHARE OP THE GROSS INCOME Ifi THE JENTITWTRUST) ';• iSHAREOF THE GROSS INCOME IQTHE ENTITWRUST) I !$0.$49S
. $SOQ - $1,000
<
[•I 510.001 -$100.000
I ] OVER $100,000
$1,001 .$10,000
1» 3. UST THE NAME OFtEACHREPORTABLE SINGLE SOURCE OF
INCOME OF,SIB|COO .OR MORE (Altacha«wtni(»»n»8(irrf«w»«Brii,] j None or II, Namas listed balow
Separate sheet attached
»A INVESTMENTS AND INTERESTS IN REAiS. PROPERTY HELD OR

LEASED MTHE BUSINESS ENTITY OR TRUST
GhecK we DM:

I I INVESTMENT |BI REAL PROPERTY
Name of Business EnUty, if Investfflen!, fie Asseswf's PwwS Number or Street Address of Rsal Property Residsntial Rental Property
Peswipiion Of Buslnoas Aclwityja:City er Othsr Precise LcKaiiian of Real Property ! SO - S499
[1 $500. $1,000
$1,001 . $10.000
I $10,001 - $100,000I OVER (100.000
> 3. LIST THE NAME OF EACH REPORTOBIE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE lAuacK • >«»wiii»h«ai ifmetBiaiyi None or Names listed below
»• 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR

LEASED BX THE BUSINESS ENTITY OR TRUST

FAIR MARKET VALUE
I j $2.000 - $10,000I ; $10,001. sroo.oooI ] $100,001 - $1,000,000 It; Over $1,000,000

NATURE OF INTEREST
I; Property OwnorshIpA3ee<l of Truat
IF APPUGABLE. LIST DATE:
_J_J25-

ACQUIRED
Stock
-L-J21.DISPOSEDI Partnorship
Leasahold
Yra. ramaNng
Other
j Cfteck box If acfdltional schedulBs reporBng jnvastmente Qr real property are attached
Check one box:

INVESTMENT I REAL PROPERTY
Name of Business Entity, If Investmenl, sf.Assesiior'5 Parcel Number or Sine! Address of Real Property Description of Business Acfivlly CECity or 0 ar Precise LOGation of Rest Proparty FAIR MARKET VAi.UEj S2.000 - $10,000
S-10,001 - $100,000
I $100,001 -ti.ooo.QOoj Ovsr $1,000,000NATURE OF INTEREST Property Ownership/Daad of Trust
IFAPPUCA8LE, LIST DATE:

J25-

ACQUIRED
|~ Stock
J—J2&-

DISPOSED
[ Partnership
Laasahold
Yni. rem^tnlng
; OUier
Check box if additional tchBdutes mporting Inveslments or feat propartyara aftaehed Comments: FFPC form 700 -SchBdufeM (282S/ZOZ6)
»<tK(ce@(ppl.<».(OU • BS6-WS'i77i * www.fpjic.ta.ggv
Pags-M
California Form 700 Schedule A-2 and Schedule
Name: Simon Gibbons
Attachment for Reportable Single Source of Income over $10,000 during 2025 ^ -<'.,:*'<?»'•'*"" ";w

1. 2.3,

4.s.6.7.

8.9. 10.11.

12. ".yf'.f^ ?w l:r^ei^iiii^i
700

SCHEDULE B
Interests in Real Property
(Including Rental Income)

CALIFORNIA FORM
FAIR POLITICA1. PtiACTICESCOMMISSION
NameSimon Gibbons
^ ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS
CITY
Pasadena CA 91107

FAIR MARKET VALUE
j [ $2,000 - $10,000
j I $10,001 - $100,000
I j $100,001 - si,ooo,ooa
fj Ovor $1.000,000

NATURE OF INTEREST
|B] Ownershl^Oesd of Trust
Leasahold
IF APPLICABLE, LIST DATE:

J2&.

ACQUIRED
J—J2SDISPOSED
I Easamant
~^fSr r'ematrilftg
I I.

Olho?

IF RENTAL PROPERTY, GROSS INCOME RECEIVED
1 I $0-$499 I $500-(1^100 j I $1,001 .$10,000
; I $10,001 - StOQ.OOO IN: OVER $100,000
SOURCeS OF RENTAL INCOME: If you own a 10% or greaterInterest, list the name of each tenant that is a single soures of income of $10,000 or more.

I None
Separate sheet attached
»> ASSESSOR'S PARCH. NUMBER OR STREET ADDRESS

CITYFAIR MARKET VALUE
f $2.000 . $10,000
j $10,001 • $100,000I (100,001 . $1,000,000
j Qvor $1,000,000

NATURE OF INTEREST
f OwnafshJp/Daad of Trwt
IF APPLICABLE, LIST DATE:
/ 129 I /25

ACQUIRED DISPOSED
Ea»ement
Leasehold
Yfi. remnnlng Other
IF RENTAL PROPERrC, GROSS (NCOME RECEIVED
I (0-$499 i j $500-$1,000 f~ $1,001 - $10,000I (10,001 - $100.000 i OVER $100.000 SOURCES OF RENTAL INCOME: If you Own a 10% Of greaterinterest, list the name of each tenant that is a single Bource ofIncome of $10,000 or fflors. r I None
You are not required to report loans from a commercial lending institution made in the tender'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 ActdMss Aeeeptabls)
BUSINESS ACTIVITY. IF ANY, OF LENDER

INTEREST RATE
-%
TERM (Months/Years)
None
HIGHEST BALANCE DURIN6 REPORTING PERIOD
j I $500 . $1,000 I I $1,001 - S1Q.OOOI 1 S10.001 -SlQO.COO I 1 OVER SIOO.OOO I I Guarantor, If applicable
NAME OF LENDER'ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IFANY.OF LENDER
(NTEREST RATE
-%
TERM (Months/Yaars)
None
HISHEST BALANCE DURING RfiPQRTtNlS PERIOD
S ~| (soo • $1.000 f . $1,001 - tio.ooo
j S $10,801 - $100,000 J OVERSIOO.OOO
i Ouarantar. if applicable
Comments;
FPPCform 700 -SshedulaB (2B315/202?)
»d^e«@(ppc.l;».gov«86M7S-i??,i • wvtwi.ffpc.ca.sm
Page-U
Caiifornia Form 700 Schedule A-2 and Schedule B
Name: Simon Gibbons
Attachment for Reportable Single Source of Income over $10,000 during 2025

1. 2.3

4. 5.

6. 7.

8. 9.

10.11. 12.

SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
CALIFORNIA FORM 700
FAIR POUTtCAfc PRACTICES COMMISSION
NameSimon Gibbons
>• 1. INCOME RECEIVED

NAME OF SOURCE OF INCOME
See attachment for 4 paid positions
AOORESS iBuslness AMry$s Acwplablaf

BUSINESS ACTIVITY, IF ANY, OF SOURCE

YOUR BUSINESS POSITION
6ROSSINCOME RECEIVED | | No Income . Businew Posiiion Only I |tSOO.Sl,000 | j $1,001 - $1Q,000
I I $10,001-$100.000 | | OVER STOO.OOO
CONSiOERATlON FOR WHICH INCOME WAS ReCEIVED|Bli Salary j Spouse's or registered domestic partner'i Inccims (For aelf-smployed use Schedule A-2.)
I j Partnership (Less than 10% ownerehlp, For 10% or gwalar use Schedule A-2.)
Sato of
I Loan repayment
Commlgsion or
^eaf propsrty, ear, t/asf. etc.}
Rental Income, list Mdi seiiiivv ot Sie,<W or laan
fOaaaibaj
Olhar,
iOescritial
»• 2. LOANS RECEIVED OROUTSTANDING DURING THE REPORTING PERIOD >• 1. INCOME RECEIVED
NAME OF SOURCE OF INCOMEADDRESS (Bwinsss Addmss AswptsWe) BUSINESS ACTIVITY. (F ANY, OF SOURCE

YOUR BUSINESS POSITION
GROSS INCOME RECEIVED | | No IncotWe ' Buainess Paslilon Only I I $500-$1,000 !~"| $1,001 • $10.000
I I $10,001 - $100,000 !' '] OVER $100,000
CONSIOERATION FOR WHICH INCOME WAS RECElVEO
I' J Sslary [ j SpOuss's or registered domestic partner's Ineoing {FW $alf-emptoygd use Schedule A-2.)I j Partnenhip (Less tlian 10% ownership. For 10% or greatar use Schedule A-2,)
') Sale of
] I Loan rapayniGntI I Commission or !
{l!es! pmpfKy, car, fioat, ate.;
Rental Ineome. teradi swns v! S1S.<mor mwe
fOswrlbvj
OUief
(OGScfibst)
You are not required to report loans from a commercial lending institution, or any indebtedness created as part of s 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 (Momhsft-BBre)
ADDRESS fSMlnass Addfess Aweptabto}
-% I (Nona
BUSINESS ACTIVITV. IF ANY, OF LENDER

SECURITV FOR LOAN
None i I pBraonal rssldBnca
HIGHEST 8ALANGE DURINS REPORTING PERIOD
1 |$500..$1,QM) [ti.ooi -$10,000I 1110,001 .KIOO.OOOI I OVER $100,000 Real Proparty Simai address
GW
Guarantor
J" Other,
(DasQibe)
Comments:

FPPC Form 700 •SclteduliiC (20W2026)
[email protected] • SW-xn-SJn • www.lppc.ai.tsr
Page-M
Addendum to California FPPC Form 700 Schedule C
Name: Simon Gibbons
During 2025, my spouse and I provided paid management services to the following companies in Los Angeles County:

Company Company Address Business Activity Business
Position
Gross Incomereceived in 2025as Salary
Rose Berlin LLC
, Los Angeles,
CA 90029
Rental Property Property
Manager
$10,000 -$100,000
Rose Cairo LLC
Los Angeles,
CA 90029
Rose London
LIC
Rental Property Property
Manager
, Los Angeles,
CA 90029
Rental Property Property
Manager
$10,000 -$100,000$10,000 -
$100,000
Rose Rio LLC
Los Angeles,
CA 90029
Rental Property Property
Manager
$10,000 -$100,000
0^ PAS
<<. ^> ^ ^?7 ?s 0
^ ^
(D z
co 0 <& 0
^
%
^
0 ^
^ ^4TEP s

RECEIVED
2C?&^PR22 AH IQ= 3 7
l^'l:.TY C...ERK
CiTY OF PASADENA
Pasadena Rental Housing Board
'^•''
. i t--
:,-.
^
of ^
tv 0
i
s; <u ^ s? •^EO J

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 the CityCouncil in its evaluation of your application. Applications certified by the City Clerk as eligible for appointment shall remain valid for use towards future vacancies for a period of up to one year fromcertification. In the event of a vacancy, if the applicant has not been appointed to the Rental HousingBoard and still desires to be considered for appointment, they may submit an updated application, ormay advise the City Clerk's Office in writing that the information contained on the original application is still current. For example, if an application is certified on February 21, 2025 as eligible, saidapplication will continue to be qualified subject to written confirmation by the applicant to the City Clerk's Office through February 21, 2026.

Applicant Name: 1PO<><51 L-eiV^
Home Address:

Mailing Address:

Email Address:Business Phone:

Home Phone:
r' .- ^^flckw a\ qiio'7
C3aw\t o^^ G^^€
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):
^
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, resen/ed for tenants)
V/Alternate At-large Member (1 seat, open to any Pasadena resident without respect to tenancy or Council District)
Community Service - List boards, commissions, committees, and organizations on which youare currently serving or have served, offices held and in what city. ^a ^c-V^ w n4-
Employment - Title and duties, current and past (acceptable to attach resume as an alternative). ^« a.{ Education - Include professional or vocational licenses or certificates, , ftSrsj (ft^6oc~^-^ o^F ^6-i^Q^ LV^ i\ \)06^<)vi^[ nu/sc)

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 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
YESD
NONO
D
Ef

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 have a Material Interest in 4 or more units of Rental YES Property within the City of Pasadena? (If yes, please read the "Note" on the Supplement to Statement of Economic Interest Form (Form RHB-002) regarding property owners with interest in 4 or more rental units, attached to this application) D NONO
Extended Family: any spouse, whether by marriage or not, domesUc partner, parent, child, sibling, grandparent, aunt or uncle, niece or nephew, grandchild, or cousin (Charter Section 1803(g)).

7. Do you reside at a property owned or managed by a member of YES j | 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?

8. 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 HousingBoard? CD
NO Q
NO Q

9. Are you aware of the time commitment necessary to fulfill the YES obligations of the Pasadena Rental Housing Board?

10. Are you aware that you may serve no more than eight YES consecutive years as a member of the Pasadena Rental
Housing Board?
11 .Can you, upon appointment, provide proof of identity and proof YES | \/| NO | | of eligibility to work in the United States?

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

SC<' C(4fciC^i^/i+

13. How would you add value to the Pasadena Rental Housing Board? ^7—a wi^n+

14.What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
Sc-r a^(}/\W,v\¥

15. How would you help to achieve these objectives and goals? r^S?£ ~(A^LC^I wierv
i, RCS^ Ui\/q (printed name), declare under penalty of perjury under the law o the State of California that the information reported in this Form RHB-001 is true, accurate, and complete.

Signed this <j^^~~ day ^f
Signed: 4^{^Tt
ft^r- \ , 20?~t/.

Printed Name: ^.^ \<'\^1^
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CITY OF PASADENA
Residency Verification - MANDATORY RECEIVED
?02SAPK22jmn^o 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. Proof of residency may to'e established by either of the following: .. CI'i^Y Of-iA3.',DE:MA \ :

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.

I reside at
^
of the City of Pasadena
CA ^ HOI (zip code).

Signed:
(street), Pasadena,
^^-]
Printed Name: RO<><?I L-^'\/(;l

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

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

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 Ser/ice (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 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 andinclude 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, 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 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 AssessorCourt 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 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 tracingdocument due to a name change (for example, marriage, divorce, or courtorder), name change documentation is required. b?
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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 (City 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. When completing Form 700 to report such interests and dealings in rental property, please note that City Charter 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.

City Charter Article XVIII 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)). Please acknowledge you have read the following:

Note: While the City Charter is permissive in allowing At-large members to own rental property, California's Conflict of Interest regulations for public officials contain separate standards. As a result, Board members who are property owners with interest in 4 or more rental units in the City of Pasadena might not be able to freely participate in all matters that come before the Pasadena Rental Housing Board. Interested applicants in such a position should consult with legal counsel prior to submitting an application. ftL, / acknowledge I have read the foregoing Note V^—(initials) 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)). prQci ci\f'FO '.' :..
••'1;';' : , ^ ^ ^ 3? CITY OF PASADENA Economic Interests Affidavit - MANDATORY I, M<c>^'-rvl^ ^(^.'',0£^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. nl
Signed this
Signed:
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Printed Name: ^6, ^}\ja
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
1, ^)€?<^ \^\\IC{ _(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 ^ 1(0'^ (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 f^W ^ ' _, 20^
Signed:

Printed Name: ^0-5^ \^\\J^i
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Rosa Leiva, Nurse Auditor
Pasadena, CA' Licensed Vocational Nurse (LVN)
Profile
Experienced Nurse Auditor with a proven track record of delivering high-quality healthcare services.

Experience
Clinical Nurse Auditor) Blue Shield of California | January 2016- present Carried out audits of medical records to assess clinical documentation for the Initial Health Assessment Program and Comprehensive Perinatal Services Program. Maintained adherence to government regulations for medical records review and compliance.

Managed the monitoring and tracking of audit results, ensuring effective oversight of Corrective Action Plans (CAPs). Additionally, delivered education to the IPA/ FQHC regarding identified deficiencies.

Took part in practice audits for L.A Care Health Plan and Department of Health Care Seivices (DHCS). In practice audits, we examine medical records, annotate observations, and compile any necessary additional data.Collaborate across departments to address disability-related processes, procedures, protocols, and policies. Work closely with disability consultants to integrate an emergency preparedness plan for individuals witli disabilities. Coordinate the annual AmericanDisability Act training.

Oversee and manage the implementation of the Chronic Care Improvement Program (CCIP), State Performance Improvement Plans (PIP), and Plan Do Study Act [PDSA] regulatory submissions for HEDIS measures.Contribute to the yearly analysis and preparation of die 2017 Geographic-Access report Assisted in the write-up process for the NCQAcertification.

Quality Improvement and Compliance Nurse] Pacific Clinics | January 2006 - December 2015
Performed internal audits wifliin the Department of Mental Health (DMH) guidelines to ensure clinical documentation standards. Formulated intervention plans and training materials for individual sites to achieve a passing score. • Engaged In simulated audits for the Department of Mental Health. As part of the simulated audit process, we assess medical records, note key findings, and collect omitted information.

Created a training manual for nurses and conducted training sessions for newly hired physicians and nurses on documentationstandards. * Administered medications as prescribed by Psychiatrist and documented findings. Assisted with refilling medication orders and assessing patients. Monitor the inventory and distribuHon of medications and design forms to track daily room and refrigerator temperature.

Brighton Convalescent Center) Charge Nurse | November 2006- May 2007 Coordinated care of assigned residents, including the assessment of the resident's needs and development of a preplan. Analyzed and interpreted information from staff and documents and reported to charge RN or MD.

Utilized nursing process to assess, plan and evaluate patient care and oversaw unit staff to ensure delivery of timely and quality care.

Administer physician-prescribed medication and assessed patient's vital signs and dressed open wounds and assessed the healing process.Keep patient comfortable through palliative care. Assess signs and symptoms indicating changes in patient's condition.

Education
ASSOCIATE IN SCIENCE- VOCATIONAL NURSING | JUNE | PASADENA CITV COLLEGE, PASADENA CA Professional Summary
High-performing Nurse Auditor with many years of clinical experience. My skills include a good understanding of medical necessities, problem resolution and self-direction. I have a strong clinical judgement with high analytical skills. I have developed a deep understanding of patient care in the managed healthcare industry. My expertise in these areas has enabled me to provide valuable insights and recommendations to healthcare professionals, resulting in improved patient outcomes and increased efficiency.

Community Services: A lifelong Pasadena resident, I have committed over 30 years to local community service. Community service has been a cornerstone of my life since my time in JROTC back in 1994.

From cleaning our local parks to assisting at the Rose Bowl, I learned early on the importance of showing up for Pasadena. Over the years, that passion has evolved from a rewarding two-year volunteer term at Huntington Hospital to supporting my three children's schools, where I have been recognized year-round for my involvement.

I believe in leading through action, especially during times of crisis. During the Eaton fires, my husband and I worked to house and feed families who had lost everything. Today, I am honored to continue thatlegacy of service as the PTA President at Don Benito Elementary, working to strengthen the bond between our schools and our community.12. lama current tenant in Pasadena and have been consistently following the Rental Housing Department's work. I've attended several seminars to better understand local housing regulations and am now interested in exploring opportunities to serve or participate further.

13.1 add value by acting as a bridge between the city's housing department and the rental community. Asa resident who is actively engaged in community, I understand the common challenges tenants face and the regulatory framework intended to solve them. I am prepared to use my knowledge to help the Board implement policies that are clear, accessible, and effective for alt Pasadena residents.

14. In my view, the Board's most important goal is to serve as an objective governing body that upholds the City Charter. This involves not only regulating rent increases but also providing essential education to the public. Success for the Board looks like a community where both tenants and landlords have access to clear information, disputes are handled through proper due process, and housing remains accessiblefor our local workforce.

15.1 believe the Board's goals are best met when the community is well informed. I would help achieve these objectives by acting as a bridge for communication. Drawing on my experience leading large community organizations, I can help translate complex housing policies into clear, accessible information for residents. My goal would be to ensure that every tenant and landlord knows their rights and responsibilities, which reduces conflict and promotes stability.

CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES CON1MISSION

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE

A PUBLIC DOCUMENT RECEIVED
Date Initial Filing Received
Filing Officsal Uss Only
Please type or print in ink.

NAME OF FILER (LAST) Lc'i^« (FIRST)^Sc\ •^•^ J^P&LE)^ ^ iU: j r r^—:! '•" (•—(-/•

1. Office, Agency, or Court CITY OF PASADENA
Agency Name fDo no? use acivnyms) C\\-\\ o-F P^sa^ci^^ ^ ^Division, Boart-d, Department, District, if applicable Your Position P^ciem Q£V}\^\ ti-^i^ ^rj _AT)?I!^M+ > If filing for multiple positions, list below or on an attachment, f0o not use acronyms) Agency: _ Position:

2. Jurisdiction of Office (check at least one box)
' State
Q Multi-County
@^Cityof Vfl^ckl^^
j Judge (Supreme, Appellate, Superior Court), Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction) ^County of U)^ At^^-e-ICS j Other

3. Type of Statement fc/iec/c a( /eas( one box)
Q Annual: The period covered is January 1, 2025, through December 31, 2025.
•orThe period covered is / / _, through
December 31, 2025.
_ Leaving Office: Date Left _/_ _/_
fC/iec/f one circle below.)
D The period covered is January 1, 2025, through the date of leaving office.

U Assuming Office: Date assumed /_
•Fyi Candidate: Date of I
J-
•orC] 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: \
|_] Schedule A-1 • Investments - schedule attached
i i Schedule A-2 • Investments - schedule attachedF] Schedule B - Real Property - schedule attached Q Attachment 700-P • Prospective Employment (87200 Filers Only) - schedule attached "or- 3[ None - No reportable interests on any schedule
Q Schedule C • Income, Loans, & Business Positions - schedule attached Schedule D - Income - GiUs - schedule attached
D Schedule E • /ncome - GiUs - Travel Payments - schedule attached

5. Verification

MAILING ADDRESS STREET
(Business w t"~ — • '-'-'ress Recommp'"<ar' - °"'•'" "——-" CIFI' STATE ZIP CODE ?<isa^oi CA ^iio^-
D(\YTIME^ELEPHONE I^UMBER . . _ EVAIL ADDRESS (; '.' . • I ^ I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best ofjny knowledge the iMormation contained herein and in any attached schedules is true and complete. I acknowledge this is a public document.

I certify under penalty of perjury uqder the laws of the State of California that the foregoing^ ^rue and ({ptrect. Date Signed ^f^^[^ Signature -WL^JY (FSetlk originally s^nedft ler statement with your Sliny olScial.) FPPC Form 700 -Cover Page (2025/2026)
[email protected] • 866-275-3772 • www.fppc.ca.gov
Page-6
Types of Statements
Assuming Office Statement:If you are a newly appointed official or are newly employed in a position designated, or that will be designated, in a state or local agency's conflict of interest code, your assuming officedate is the date you were sworn in or otherwise authorized toserve in the position. If you are a newly elected official, your assuming office date is the date you were sworn in.

Report: Investments, interests in real property, and
business positions held on the date you assumed theoffice or position must be reported. In addition, income(including loans, gifts, and travel payments) received during the 12 months prior to the date you assumed the
office or position.

For positions subject to confirmation by the State Senate orthe Commission on Judicial Appointments, your assumingoffice date is the date you were appointed or nominated to the position.

Example: Maria Lopez was nominated by the Governor
to serve on a state agency board that is subject to stateSenate confirmation. The assuming office date is thedate Maria's nomination is submitted to the Senate.Maria must report investments, interests in real property, and business positions Maria holds on that date, and
income (including loans, gifts, and travel payments)
received during the 12 months prior to that date.

If your office or position has been added to a newly adopted or newly amended conflict of interest code, use the effectivedate of the code or amendment, whichever is applicable.

Report: Investments, interests in real property, and
business positions held on the effective date of the code or amendment must be reported. In addition, income(including loans, gifts, and travel payments) receivedduring the 12 months prior to the effective date of thecode or amendment.

Annual Statement:

Generally, the period covered is January 1, 2025, throughDecember 31, 2025. If the period covered by the statementis different than January 1, 2025, through December 31, 2025, (for example, you assumed office between October
1, 2024, and December 31, 2024 or you are combining
statements), you must specify the period covered.

Investments, interests in real property, businesspositions held, and income (including loans, gifts, and travel payments) received during the period covered
by the statement must be reported. Do not change thepreprinted dates on Schedules A-1, A-2, and B unless you are required to report the acquisition or disposition ofan interest that did not occur in 2025.If your disclosure category changes during a reportingperiod, disclose under the old category until the effective date of the conflict of interest code amendment anddisclose under the new disclosure category through theend of the reporting period.

Leaving Office Statement:Generally, the period covered is January 1,2025, through the date you stopped performing the duties ofyour position. If the period covered differs from January 1, 2025, through the date you stopped performing the
duties of your position (for example, you assumed officebetween October 1, 2024, and December 31,2024,oryou are combining statements), the period covered must be specified. The reporting period can cover parts of two calendar years.
• Report: Investments, interests in real property, business positions held, and income (including loans, gifts, and travel payments) received during the period covered by
the statement. Do not change the preprinted dates on
Schedules A-1, A-2, and B unless you are required toreport the acquisition or disposition of an interest thatdid not occur in 2025.

Candidate Statement:

If you are filing a statement in connection with your
candidacy for state or local office, investments, interestsin real property, and business positions held on the dateof filing your declaration of candidacy must be reported.In addition, income (including loans, gifts, and travelpayments) received during the 12 months prior to the date of filing your declaration of candidacy is reportable. Do not change the preprinted dates on Schedules A-1, A-2, and B.Candidates running for local elective ofltces (e.g., county sheriffs, city clerks, school board trustees, or waterdistrict board members) must file candidate statements,as required by the conflict of interest code for the electedposition. The code may be obtained from the agency of the elected position.Amendments:

If you discover errors or omissions on any statement, filean amendment as soon as possible. You are only requiredto amend the schedule that needs to be revised; it is notnecessary to refile the entire form. Obtain amendment schedules from the FPPC website at ivww.fppc.ca.gov.

Note: Once you file your statement, you may not withdraw it. All changes must be noted on amendment schedules.Expanded Statement:If you hold multiple positions subject to reportingrequirements, you may be able to file an expandedstatement for each position, rather than a separateand distinct statement for each position. The expandedstatement must cover all reportable interests for all jurisdictions and list all positions on the Form 700 or on an attachment for which it is filed. The rules and processesgoverning the filing of an expanded statement are set forthin Regulation 18723.1.

FPPC Form 700 (2025/2026)
[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 Coundl 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 certified by the City Clerk as eligible for appointment shall remain valid for use towards future vacancies for a period of up to one year from certification. In the event of a vacancy, if the applicant has not been appointed to the Rental Housing Board and still desires to be considered for appointment, they may submit an updated application, or may advise the City Clerk's Office in writing that the information contained on the original application is still current. For example, if an application is certified on February 21, 2025 as eligible, said application will continue to be qualified subject to written confirmation by the applicant to the City Clerk's Office through February 21. 2026.

Applicant Name: 'B^l'lrf-^- L^.,
Home Address: flija^^c CAMailing Address;
Email Address:

Business Phone:

Home Phone:
tv /-
Date Available to Start; ^ ^ ^f
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
Af-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 r'espect to tenancy or Council District)
Communitv Sen/ice - List boards, commissions, committees, and organizations on which youare currently sen/ing or have served, offices held and in what city. ^g 11 Q^\}^^,^ C^utvU-L Toc&£. A/^s ^(5ij<.?tx^-^^
EmDlovment- Title and dtutfes, current and past (acceptable to attach resume as an alternative). ^t/u^^x
pducation_- Includte professional or vocational licenses or certificates. &-S. 4-^<-i^ - -dUno-isJ^b [/U'dv^^t^^

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

2. Are you related to any employee, appointed or elected official of the City of Pasadena? ('/f yes, please indicate name and refationship) YES a NO

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

4. Rules of law and ethics prohibit members fronn 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 confiicts) YESYES
D
NONO
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 have a Material Interest in 4 or more units of Rental Property within the City of Pasadena? (If yes, please read the "Note" on the Supplement to Statement of Economic Interest Form (Form RHB-002) regarding property owners with interest in 4 or more rental units, attached to this application) YES
YES
D NO
DNO
@

7. 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?

8. 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?

9. Are you aware of the time commitment necessary to fulfill the obligations of the Pasadena Rental Housing Board?

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

11. Can you, upon appointment, provide proof of identity and proof ^ES of eligibility to work in the United States?
a NO
YES |y,j NO
T

YES NO Q
NO
D

12. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landtord Tenant Relationships/Real Estate: Sr ^CU-^L^.^ .^i ^-^^'I-^LL^ ff^p.^^-! h^^.n/usyU^ (l^-rv^pi^U.'f __ JA-; ^^^r^-P^- ti^^^ [-1.^^^ rt ^^^tS^^Y^^'c-'r^^^ • ^ 13 How would you add value to the Pasadena Rental Housing Board? ^ ^--.A t &.. ("t'b+Ac/<'u--(

14.What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
-^ ^LJU £€t^^/l"VA^--

15. How would you help to achieve these objectives and goals? 4- ^.U/, a-h{€fl-€^^£A

1. BA^/t^J>(- l-^-'^-^ (printed name), declare under penalty of perjury under the law c thiState of Californi^hat the information reported in this Form RHB-001 is true, accurate, and complete.

Signed this _lL__ day of -f^/bujSigned: Q^nA^^S4-oZ^Wl^^- , 20°L€?.

Printed Name: 1^/?^nAa^^yoVl
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CITY OF PASADENA
Residency Verification - IVIANDATORY
ftjf applicants must provide proof of residency in a City Council cfistncf under section 18'f1(b) of The Pasadena Fair and Equitable Housing Charter Amendment. Proof of resicfency 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 verity your gignature on file with the Los Angeles County Registrar of Voters.

I am a resident of District No.

I reside at
s of the City of Pasadena
CAq?^^ (zip code).

Signed:
(street), Pasadena,
Printed Name: B^/^^- L^on
-i-7-

2.If you a re not a registered voter, please provide clear, readable copies of 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, municipatity, district, agency, department, or any other political subdivision of a country or state Mortgage bill Employment documents
Tax return (either Internal Revenue Semce (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 Sen/ice Property tax bill or statement Letter attesting that the applicant resides in Pasadena from a homeless shelter, shelter for abused women, non-profit entity, falth-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' Propert:/ 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)
M 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 (City Charter Article XVIll) 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. Alt 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. When completing Form 700 to report such interests and dealings in rental property, please note that City Charter 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.

City Charter Article XVIII DefinJtions:

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 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)). Please acknowledge you have read the following:

Note: Whife the City ChartQr is permissive in allowing At-large members to own rental property, Californfa's Conflict of Interest regulations for public officials contain separate standards. As a result, Board membQrs who are property owners with interest in 4 or more rentsl units in the City of Pasadena might not be Qbleto freely participate in all matters that come before the Pasadena Rental Housing Board. Interested applicants in such a position should consult with legal counse! prior to submitting an application. / acknowledge I have read the foregoing Notefii^ (initials} 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^\^A L^l7n _ (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 theattached Form 700 is true, accurate, and complete.

I
Signed this I / day of _1 Signed this (7 day of J^lpr^Signed:.

Printed Name: f^r^ht/t U|^"^
_,20^_.
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CITY OF PASADENA
Affidavit of Tenancy - IVIANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
I. foa^^^
State of Caiifomia that^the Jprinted name), declare under penalty of perjury under the law of the foregoing is true and correct:

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

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

3. I reside at the following address: Pasadena, California ^jloM (zip code) (street). i
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 ^£ IX^L^ ^ . 2o2^
SigneA.O'Z^'vU-^lf ^V
BfLenA^Jr-t^fl_
Signec
Printed Name:

Hello,
Thank you so much for taking the time to read this, My name js BrendaLyon. and I'm very inspired to run for the At Large seat on the Rental Housing Board.Pasadena has been on my heart since I was a little girl, as I grew up inChicago, and my mother adored the Rose Parade. Every New Year's Day we would tune in from afar, and now I get to experience the joy of an entireweek of events right in my own neighborhood. This year was especiallywonderful to me, as my Mom flew in to visit and we sat at the end of the parade in the rain with my 2 year old, new cherished joy. The stories, the artistry, the community, what a treat!
Before the recent Eaton Fires, I was a Sr. Manager of the original core staff of a raptdty growing online property management company that handled fullservice listings, showings, property management, repairs, turnovers, relisting, and lease renewals of rental units. Each city boasted their own ever changing ordinances that we had to keep up to date on. It was a daily balance to be the peacemaker and liaison between owners and tenants.

There were many heated arguments, phone calls and emails on a daily basis that we had to deescalate. I truly understand the challenges on a large and small scale that landlords face when dealing with trying to increase rents to match the costs they face on a local and federal level for taxes, fees, utilities and upkeep. I also watch the widespread rent increases of the last decade that have doubled and tripled all across the United States that not many tenants can afford.

This past year, I became an advocate for tenant rights in Altadena and Pasadena as a plaintiff in a lawsuit against LA County and Pasadena. Myrental unit was covered in soot and had smoke damage and I was faced with a landlord who refused to file a homeowners claim. I spent months reaching out to city offices and public offices, only to be told that my issue was a civil matter. I hope to be a voice of reason for common sense laws to keep renters safe, as more than half of the city of Pasadena are renters.

It is my hope that Pasadena, and the state of California, can dh/e deeper into hygienists, inspections, habitability laws, and public health guideltnes.

It's rmportant that everyone can enjoy the right to a habitable premise. https://Jaist.com/news/housing-homelessness/los-ange(es-county-pasaden a-renteMenant-landlQrd-lawsuit-smoke-damage-ash-fire.

I would add value to the Pasadena Rental Housjng Board, as a woman,mother, and a community member who cares for my neighbors, both landlords and tenants. I am passionate about a diverse, multigenerationalcity that advocates for its most vulnerable. I promise to keep a fair and open mind in regards to all the voices that want to be heard, to make lawsthat work for everyone. I have worked in acxiounting, law firms, theatres, churches, and restaurants. My office management skills have made me a superb leader in research, time management, and managing money. I amvery well rounded in understanding each cornerstone and root of what it takes to keep a balanced city of diverse culture.

I see the primary objectives of the Pasadena Rental Housing Board as tomake sure that an annual rent stabilization increase is maintained to protect renters from too great an increase, to make sure Just CauseEvictions are followed property, that the Fair and Equitable Housing Charter is enforced and maintaining a balance of education and support tolandlords and tenants alike.

My family was supported so very well by the Rent Stabjlization Department last year, when we realized that our rent increase was done improperly.

Our rep Ktana was so organized and kind!
I would make sure to be passionate about community outreach so that tenants and landlords knew the proper Increases that were allowed. I would hope to mirror the patience, clear communication, and mediatjon that Kiana did effortlessly.

I am happy to answer any questions you have and look forward to hearing from you.
3j^/ /5

BRENDA LYNN LYON

EMPLOYMENT
Sr. Manager

7.iprcnt Property Management
Feb 2022 " Feb 2025
Los Angeles, CA
•
•
First point of contact for ati potential clients, covering all seivices and closing agreements.

Managing all paid lead accounts on multiple platforms.Streamlining communication between all departments, highly tech based system.

Training new learn members.Fielding and prioritising emails, phone calls at-id text communicatio.ns between owners and tenants.

Maintaining positive retationships with clients in escalated circumstances.

OfFicc Manager/Personal Assistant
Internatioiwl Trauma Institute/Gina Ross
March 2013-August 2021Los Angeles, CA
Assistant to Presidenfc/Founder for persona! and intemationaj business.

Accounting, Quickbooks, bank reconciliations, client billing, tiling, insurance claitns, Accounts receivable/payable, maintaining contracts, tax preparation.

House management, IT liaisoii, travel booking, ftlming of content.

Special EventsGeffen Playhouse
March2013-Marcli2020
Los Angeles. CA
On site assistant for donors, VfPs, and celebrity performers.Set up/break down of events, food/bevcrage manager, coiiciergc for all services.Honored to have been taisted witlt taking care of our most esteemed guests, and many of them spoke tomy bosses about my excellent care, Accouiiting/StageMaRager/Producer
Rogue Machine Theatre
April 2011-2016
Los Angeles, CA
Core member/staff for the #1 Tlieatre In LA. Ovation, LAWeekIy, Variety, Backstage.com, LATimes,Critics dioice- award winning shows, • Stage Manager, Prodticer, Assistant Director in shows year roi.md.

Box office, tJckethig, bookkeeping, all around support to the Artistic Director and Board of Directors.

Office Manager
Petrol A dvertissng
November 2008. April 201 IBwbank, CA
•
Accounling/HRA^ice President Assistant.

Front desk Reception, mail, FedEx, messengers, lobby guests.

Accouiits receivable/payable, filing, billing, errands, ordering suppliesEvent plannjng for the office, maintaiiiing at! vendors (plumbers/livac/pest control).

R.ecoDciUng Amex bill for all managers, Brand development, faxing, maintaining ofoffiee database.

Nanny/Personal Assistant
Shocket Family
June 2005 - November 2008
Los Atiigcles, CA
Tlic caring for twins (bay and girl).

Trasnport for appointments, sclzool pick-up, cookiiig^ aidiiig with homework.Traveling with family on bHsincss trip/vacations.Running errands for family, organizing schedules, and cleaning up after children.

AccouuitantQwnii Emmanuet Urqudrt, Oliver and Hedge.s.PC March - May 2005
Los Angeles. CA
Opening of now cilent files for entire firm (six offices total). • Mauitaining hours/time for hundreds of partners, law clerks, associates and paralegals.

Assisting CFO aiid Contfollcr with Accounting procedures 'far billing.

Filing, phone/email coiTespond&nce, aiding legal secretaries on all levels.

EDUCATION
B.S. in Theater/Acting August 1 999 - May 2003
lUfnofs State UniversUy Nonnal, IL
Presldsnt ofllliaois State University Theatre Assuciadon Foiir-Year Tuition Waiver for Education
• College of Fine Arts HQnc»rs in Acting

SKILLS AND RELEVANT ASSETS
Exceptional people skills, excellent under pressure, superb managef, deqily creative, problem solver, organizer, peacekeepei'. Joyful, kind, smart, fun!Word, Excel, very Internet savvy, impeccable researehef, strong SQcial media knowtedge. ;FAIRPOtlTICAt.I»RACTICESCOMNIISSION'< ^s^ig^tl:^si%&^;:i^'®iii Dste initisi Filing Received
Fv,ny iWcit! Vse O-iy
P/ease type or print in ink.

SWTEMENT OF ECONOMIC INTERESTS

COVER PAGE
A PUBLIC DOCUMENT P?^C £? VE H
I— t.'
/l.'n- rNAME OF FILER (LAST)
L (FIRST) ^v/^nJEx D^<co?7 PM^: ^(-n^ rr''^%

1. Office, agency, or Court - ClH r^ -•^•.;~j'i?l
Agency Name (Do not use acronyms} 'rup^^A ^ c^r -N&X^^UUSL Division, Board,''Departmenf, District, if applicable Your Position ^<^JM^^t2^^ lix^^^&^'ri -^pM
> If filing for multiple positions, list below or on an attachment, po)^( use se/Dnyms) Agency; Position:

2. Jurisdiction of Office (Check at least one box)
Stats
MuJti-County
^^^_^s^im^
Judge (Supreme, Appellate, Superior Court). Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Junsdiction) ^County of
Other
&^-

3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2025, through
December 31, 2025.
-orThe period covered is _._„,„„„„/„- / _, through
December 31, 2025,
Leaving Office; Date Left J. _/_
•or-
(Check one circle below.)
The period covered is January 1, 2025, through the date ofleaving office, Assuming Office: Date assumed _/_ J- The period covered is J- J_ ., through /Candidate: Date of Eleciion
the date of leaving office.
and office sought, if different than Part 1:
4, Schedule Summary (required) ^ Total number of pages including this cover page:

Schedules attached
Schedule C - Incoine. Loans, & Business Positions - schedule attachedSchedule D • Income - Gifts ~ schedule attached Schedule A-1 • liwestments - schedulo aStachedSchedule A.2 • Investments - schedule aStached Schedule B • Rest Property - schedule attached Schedule E . Income - Gifts - Travel Payments - schedule attached Attachment 700-P • Prospective Employment (87200 Filers Only} - schedule attached •or- None • No reportable interests on any schedule

5. Verification

MAILING ADDRESS STREET
(Susineas oi-Aciency AMmss Rewrtimencled • Putlic DocunienB CITl'
DAYTIME TELEPHONE NUM3ER
STOT6
e^-
EMAil. AOORESS

ZIP COOE
c?//61/
t- I have used all reasonable diligence in preparing this slafement. I have ravlawed this statement wia (o the be^bf my knowledge Iho infdrmafiQn contajncd 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 fos Date Signed 1 | j lj JoIU^ Signature
(Fie the aiginaffy sifntS^pet stal^mfsnl with fWt ditig tffia'al.) jmisith, iSaf. fss/'l , and correc, ing is
•^
FPPC Foriri 700 - Cover PaBe (202S/Z026)
adyiffiiriDfi'iftc.iffai.frftu * RftK-JJ^tff) » **A*<t..< ^nn^ <*« »»*,* Types of Statements
Assuming Office Statement:

If you are a newly appointed official or are newly employed in a position designated, or that will be designated, in a state or local agency's conflict of interest code, your assuming office date is the date you were sworn in or otherwise authorized toserve in the position. If you are a newiy elected official, yourassuming office date is the date you were sworn in.

Report; Investments, interests in real property, andbusiness positions held on the date you assumed the office or position must be reported. In addition, income(including loans, gifts, and travel payments) receivedduring the 12 months prior to the date you assumed theoffice or position.

For positions subject to confirmation by the State Senate or the Commission on Jludicia! Appointments, your assumfngoffice date is the date you were appointed or nominated tothe position,* Example: Maria Lopez was nominated by the Governor to serve on a state agency board that is subject to stateSenate confirmation. The assuming office date is thedate Maria's nomination is submitted to the Senate,Maria must report investments, interests jn real property,and business positions Maria holds on that date, andincome (inciuding loans, gifts, and travel payments)received during the 12 months prior to that date.

If yourofRce or position has been added to a newly adopted or newly amended conflict of Interest code, use the effective date of the code or amendment, whichever is applicable, • Report; Investments, interests in real property, and
business positions held on the effective date of the code or amendment must be reported- In addition, income
(inclucfing loans, gifts, and travel payments) receivedduring the 12 months prior to the effective date of thecode or amendment.

Annual Statement:Generally, the period covered is January 1, 2025, through December 31, 2025, If the period covered by the statement is different than January 1 , 2025, through December 31 ,2025, (for example, you assumed office between October 1, 2024, and December 31, 2024 or you are combining
statements), you must specify the period covered,
Investments, interests in real property, business
positions held, and income (includirig loans, gifts, andtravel payments) received during the period coveredby the statement must be reported. Do not change thepreprinted dates on Schedules A-1, A-.2, and B unlessyou are required to report the acquisition or disposition ofan interest that did not occur in 2025.If your disclosure category changes during a reportingperiod, disclose under the old category until the effective date of the conflict of interest code amendment anddisdose under the new ciisdosyre category through theend of the reporting period.

Leaving Office Statement:

Generally, the period covered is January 1,2025,through the date you stopped performing the duties Ofyour position, If the period covered differs from January 1, 2025, through the date you stopped performing the
cfuties of your position (for example, you assumed officebetween October 1, 2024, and December 31, 2024, or you are combining statements), the period covered must
be specified. The reporting period can cover parts of two calendar years.

Report: Investments, interests in real property, business positions held, and income (including loans, gifts, and travel payments) received during the period covered bythe statement. Do not change the preprinted dates on SchedulesA'1, A-2, and B unless you are required toreport the acquisition or disposition of an interest that did not occur in 2025.

Candidate Statement:If you are filing a statement in connection with your candidiacy for state or local office, investments, interests in real property, and business positions held on the date of filing your declaration of candidacy must be reported.

In addition, income (including loans, gifts, and travelpayments) received during the 12 months prior IQ the date of filing your declaration of candidacy is reportable. Do not change the preprinted dates on Schedules A-1, A-2, and B, Candidates running for local elective offices (e.g., county sheriffs, city clerks, school board trustees, or waterdistrict board members) must file candidate statements, as required by the conflict of interest code for the electedposition. The code may be obtained from the agency of the elected position,Amendments:If you discover errors or omissions on any statement, filean amendment as soon as possibte. You are only requiredto amend the schedule that needs to be revised; it is notnecessary to refile the entire form. Obtain amendment schedules from the FPPC website at www.fppc.c3.gov.

Note: Once you file your statement, you may not withdrawit. Al! changes must be noted on amendment schedules.

Expanded Statement:

If you hold multiple positions subjeet to reportingrequirements, you may be able to file an expanded statement for each position, rather than a separateand distinct statement for each position. The expanded statement must cover all reportable interests for all
jurisdictions and list alt positions on the Form 700 or on an attachment for which it is filed, The rules and processesgoverning the filing of an expanded statement are set forth in Regutation 18723.1.

FPPC Fopm 700 (Z02S/2028)
^bk
SCHEDULE A-1
Investments
Stocks, Bonds, and Other Interests
(Ownership Interest Is Less Than 10%)
Investments must be itemized.

Do not attach brokerage or nnawiaf statements.
wfsyy:-s'^'f-;""»-s ;{ liiiliilj^ooij yAIRPQ|:mCA,^BRACTIC]ESCC(MW(SS)bN; Name
^ fA
>- NAME OF BUSINESS ENTITY
jT<5h ^ -H^hCOC/^

GENERAL DESCRIPTION OF THIS BUSINESS
T: DS<^ f ^nrA fSc'ti ^ M.&n^-

FAIR MARKET VALUE
SZ.OOO » 510,000
sinn nni ..';; 1,000,000
^si o.001 -sioo.ooa
Over 51,000,000
w /( NATURE OF INVCSTMCNT Stock Y" Other
(DeKnbej
Partnership Income Received of So - SOS
Income Received of SSOO or More (Rapon on Sclwduio C)
tF APPLICABLE, LIST DATE;
J- J25.

ACQUIRED
J. J25-

DISPOSED
>. NAME OF BUSINESS ENTITY
GEN^AU DESCRIPTION OF THIS SUSlNES GEN^AU DESCRIPTION OF THIS BUSINESS ^ i^V[ ^^^V ^^

FAIR MARKET VALUE
S2,OQO-S10,000sioo.001 -si.ooo,ooa

NATURE OF INVESTMENT
Stock
^<S10,001 -S100.000
Over S1.000,000
INVESTMENT !l^r ^^^f^-
Partnership Income Received of SO - S48S
Income Received of SSOO or More iRspori on SchiK/ula C) IF APPLICABLE, LIST DATE:

J- J25- J_ J25_

ACQUIRED DISPOSED
^ NAME OF BUSINESS ENTITY

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
52,000 - S10,000
S100.001 . £1,000.000

NATURE OF INVESTMENT
Stock Other
sio,aoi. siQo.ooo
Over S1.000,000
(DesenDei
Partnership ~ Income Recewed ol SO - 5499
Income Received of SSOa or More fRsoort on Schetfute c;

IF APPLICABLE, LIST DATE'
J- J25-

ACQUIRED
J- J25.

DISPOSED
>- NAME OF BUSINESS ENTfTY
GENERAL DESCRIPTIOhf OF THIS BUSINESS'

FAIR MARKET VALUE
S2.000 . Sia.OOQS100.001 -51,000,000

NATURE OF INVESTMENT
Stock Other
510,001 . 5100,000Over $1,000,000
(OBtCnfas)
Partnership . Income Received of SO - S49S
Income Received of S5DO or More I'ftBport on ScAeffuto C; IF APPLICABLE. LIST DATE:

J_ J25_ J_ jm.

ACQUIRED DISPOSED
^ NAME OF BUSINESS ENTITY

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
SZ.OOO - SIO.OOOsioa.ooi -si,ooo,ooo
NATURE OF (NVES^ENT
Stock Other
sio,ooi - siQo.oaoOver 51,000,000
(Ocseoba)
Partnership Income Received of SO • S499
Income Received of S500 or More (Ruport on Schadula Cl
IF APPLICABLE, LIST DATE;
J. J25-

ACQUIRED
J-. J2&.

DISPOSED
>• NAME OF BUSINESS ENTtrr

GENERAL DESCRIPTION OF THIS BUSINESS

FAIR MARKET VALUE
S2.000 . S10,000$100,001 -51,000,000

NATURE OF INVESTMENT
Stock Other
S10.001 -S100,000
Over £1,000,000
lUBscnoei
Partnership Income Received of SO • S439
Income Receivad of SSOO or More iRepo/i on SeAarfufe C) !F APPLtCABLE, LIST DATEJ- j2£-

ACQUIRED
J_ J2S.

DISPOSED
Comments:

FPPC Form 700 - Schedule A"l (20Z5/Z02G)
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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 bustness/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 pubtic agency name rather than their private firm's name. (Examples: State Assembly; Board of Supervisors; Office of the IVIayor; 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: DJrectar; Chief Counsel; City Council IVtember; Staff Sen/ices Analyst).
• If you hold multiple positions (i.e., a city council 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 you may instead complete a single expanded statement and file «t with each agency.

The rules and processes governing the ffling of anexpanded statement are set forth in Regulation 18723.1.

To file an expancted 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 anadditional sheet if necessary. Complete one statement disclosing ati reportable interests for all jurisdictions.Then file the expanded statement with each agency asdirected by Regulation 18723.1(c).

If you assume or leave a position after a fifing deadline, youmust complete a separate statement. For example, a city council member who assumes a position with a county special district after theApnf annual filing deadline must file a separateassuming office statement. In subsequent years, the city council member may expand tdelr 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 may eemplete one expanded statement to disclose all reportable interests for both officss and list both positions on the Cover Page, Brian will file the expanded statement with each theCity and 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, identity the jurisdiction. Judges, judicial candidates, and court eommissioners have statewide
jurisdiction, All other filers should review the Reference Pamphlet, page 14, to determine their jurisdiction.
• If your agency is a myftj-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, specialdistricts 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 jurisciiction in portions ofYuba and Sutter Counties.
|1. OfHco. Agcne^ cr Gttyrt
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Part 3. Type of StatementCheck at least one box. The period covered by a statementis determined by the type of statement you are filing. If you are completing a 2025 annual statement, do not change the pre-printed dates to reflect 2026, Your annual statement is used for reporting the previous year's economic Interests, Economic interests for your annual filing covering January 1, 2026, through December 31 > 2026, will be discjosed on your statement filed in 2027. See Reference Pamphlet, page 4.

Combining Statements: Certain types of statements for the same position may be combined. For example, if you (eaveoffice 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 reportableInterests.

Enter the total number of completed pages induding the
cover page and either check the box for each schedule youuse 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. VenficatiOflComplete the verification by signing the statement andentering the date signed. Each statement must have an original "wet" signature unless filed with a secure eleGtFoniGBignatuFe, (See page 4 above.) All statements must be signedunder penalty of perjury and be verified by the filer pursuant toGovernment Code Section 81004. See Regulation 18723.1(c)for filing instruetions 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 aythority to sign the statement. An unsigned statement is not considered filed and you may be subject to late filingpenalties.

FPPCFom70C (203iS/20Z6)

SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
^i^g?g?sK^;"y'ft ft( teALI^ORNI^QRM;
iSAIRPOl.tTICAl.'RRACTICES COMMISSIONName
%. b\{o^
^^.ilNCOME:RECEIVEDi^3^®ffS^BS^e®l@»(SgS««|^Kae ^C;tW^^

NAME OF SOURCE OF INCOME
T^,^dL^^i^ XT of Pc^^^^
ADDRESS (ausiness Adlt}sss Aaieptablg) ISusiness Ad^ss Accgptablg)

GUSINCSS ACTIVITY, IF ANY, OF SOURCC
Jr. -Suh U_ffl^Q£ggf/n_
)UR BUSINESS
d2L
ilTION 0
-£a]S3cA^m-%^^

GROSS INCOME RECEIVED
S500 -S1.0QO'sio.ooi - sioa,ooo
No Income - Business P^s/ion Only
51,001 - S10,000OVER S100.000

CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Salary -^ Spouse's OF feglstered domesfie partner's income /^^Far seir.emptoyed use Schedule A-Z.)Partnership (Less than 10% ownership. For 10'A or greater use Schedule A-2.) Sale of
Loan repayment
Commission or
jRvsl prvpaitf. car. liaat, elc.)
Rental Income, tist fiach source of Sl0,000 tif ffiort? (Dssvtbe)
Other
fOffSiC^be)

NAME OF SOURCE OF INCOME
ADDRESS (Business AMresa Acceptabtej

BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITIONGROSS INCOME RECEIVED No Income - BuSinsss Position Only SSOO - S1,000 S1,001 < S1Q.OOO$10,001 - S100,000 OVER 5100,000

CONSIDERATION FOR WHICH MCOME WAS RECEIVED
Salary Spouse's or registered domestic partner's Income (For sstf-employed use Schedule A-2.)
Partnership (Leas than 10% ownership. For 10% or greater use Schedule A-2.)
Sala of
Loan repaymentCommission or
(Raal property, car. boat etc.)
Rental Income, lisi each sowca illSlO.OOO ormora
(Dffaeriboj
Other
lOoscntiai
^•52^0ANK(UECEtyEDf»I^UTOTANI»jNe;CURWSiH&ftH'ORTING>BERi^ 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 availableto 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- INTEREST RATE TERM (MonthsA'ears)
ADDRESS (Biisiness Address Aeoeptable)
-% None
BUSINESS ACTIVITY. IF ANY, OF LENDER
SECURirr FOR LOAN
None Personal residence

HIGHEST BALANCE OURINS REPORTING PERIOD
ssoo. si,ooo
S1,001 -S10,000
510,001 . S100,OODOVER sioo.ooa
Real Property
Slnif( addrsss
Ci<y
Guaranlor
Other
tDesetitiel
Comments:

FPPC Form 700 . Schedule C (202SAOZ6|
Instructions - Schedule B
Interests in Real Property
Report interests in real property located in your agency's jurisdiction in which you, your spouse or registered domestic partner, or your dependent children had a direct, indirect, or beneficial interest totaling S2,000 or more any time during the reporting period. Real property is also considered to be "within the jurisdiction" of a local government agency if the property or any part of it is located within two miles outside the boundaries of the jurlsdictfon or within two miles of any land owned or used by the local government agency. (See Reference Pamphlet, page 14.)Interests in real property include:
' An ownership interest (including a bensflclal ownership interest)
• A deed of trust, easement, or option to acquire property• A leasehold interest (See Reference Pamphtet, page 15.) • A mining lea$e* An interest in real property held in a retirement account (See Reference Pamphlet, page 16.)
* An interest in real property held by a business entity or trust In which you, your spouse or registered domesticpartner, and your dependent children together had a 10% or greater ownership interest (Report on Schedule A-2,) • Your spouse's or registered domestic partner's interests in real property that are legally held separately by him or her You are not required {o report;
A residence, such as a home or vacation cabin, used
exclusively as a personal residence (However, a residencein which you rent out a room or for which you claim a business deduction may be reportable, If reportable,report the fair market value of the portion claimed as a tax deduction.)
Some interests in real property held through a blind trust (See Reference Pamphlet, page 17.)
Please note: A non-reportable property can stillbe grounds for a conflict of interest and may bedisqualifying.

To Complete Schedule B:
• Report the precise location (e.g., an assessor's parcel number or address) of the real property,
• Check the 6ox indicating the fair market value of your interest in the property (regardless of what you owe on the property).
• Enter the date .aGquiFed or disposed only if you initiafly acquired or entirely disposed of your interest in the
prQperty during the reporting period,
Identify the nature of your interest. If it is s leasehold,disclose the number of years remaining on the lease.

FReminders
• Income and loans already reported on Schedule B are
not also required to be reported on Schedute C.
• Real property already repQrted on Schedule A-2, Part 4 is not also required to be reported on Schedule B.
• Code filers - do your disclosure categories require
diselosure of real property?
If you received rental income, check the box indicating the gross amount you received.If you had a 1 0% or greater interest in real property and received rental income, list the name of the source(s) Ifyour pro rata share of the gross income from any single tenant was $10,000 or more during the reportJng periQd.If you received a total of $10,000 or more from two or more tenants acting in concert (in most cases, this will apply to married couples), disclose the first and last name of eachtenant, OtheFwise, mark "None."Loans from a private tender that total $500 or more and are secured by real property may be reportable. Loans
from commercial lending institutions made in the
lender's regular course of business on terms availableto members of the public without regard to your officialstatus are not reportable.

When reporting a loan:

Provide the name and address of the lender.Describe the lender's business activity,Disclose the interest rate and term of the loan. For variable interest rate loans, disclose the conditionsof the loan (e.g., Prime + 2) or the average interest rate paid during the reporting period. The term ofa loan is the total number of months or years givenfor repayment of the loan at the time the loan was estabtished.

Check the box indjcaUng the highest balance of the
loan during the reporting period.Identify a guarantor, ifappticable.

If you have more than one
reportable loan on a singlepiece of real property, reportthe additional loan(s) onSchedule C.

Example:

AIIIson Gsnde is a cityplanning commissioner,During the reporting period, Allison received rental incomei
ofS12,000, from a single
tenant who rented property
owned In the city's jurisdiction.!
KAItison received S5,000each from N/o tenants, thetenants' names would not berequired because no singte tenant paid her $10,000 or
more. A married Gouple is
considered a single tenant.
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f 1 :..l»nC! >
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M-,
SS2-£S15.
"W^fV |.M< 1)'
%&plt;a PfitrcKitoi'til'i't'A** •^tk.!'JK*;iJ«*.,'l .t-iyftfilfe'i'ii 2121 6'yy 5f<Y Parkway, Sscrartwnto
^•Jlil^V^'^^ ^ A^^ ^
Roslaurani Qwtief
irKff.i;- >t^T -i-w;(t:«->**»iflku<.^
Ctur W years
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^ lt~» M./< ^ fAif .»'!;ti?'iX' iit^^»! .w^f^ii ~'^,^^' t^f-v Cemmemt^
FPPC rorm 700 (Z025/2026|
»ilvli;e®)fppe.ca.(s" • 866-175-3772 « wwiw.fppc.eii.gov ^

RECETVED
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CITY CLERK

CITY OF PASADENA
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CITY OF PASADENA

APPLICATION FOR APPOINTIVIENT 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 certified by the City Clerk as eligible for appointment shall remain valid for use towards future vacancies for a period of up to one year from certification. In the event of a vacancy, if the applicant has not been appointed to the Rental Housing Board and still desires to be considered for appointment, they may submit an updated application, or may advise the City Clerk's Office in writing that the information contained on the original application is still current. For example, if an application is certified on February 21, 2025 as eligible, said application will continue to be qualified subject to written confirmation by the applicant to the City Clerk's Office through February 21, 2026.

Applicant Name:

Home Address:

Mailing Address:

Email Address:

Business Phone:

Home Phone:
£cl£^_JULU^rlDate Available to Start:

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 IVIember (1 seat, open to any Pasadena resident without respect to tenancy or Council District)
Community Service - List boards, commissions, committees, and organizQtlons on which youare currently serving or have served, offices held and in what city. jfzj'.-^ ^^ah^of r'€£5(yi'H^
Employment-. Title and duttes, current and past (acceptable to attach resume as an Qltemative). <£?•&. ^i^c>h^JI f<&^ym<eEducation - Include professional or vocational ficenses or certificates. 4^-c Q.Mue.k^ y^-^v^c^

1. Have you ever worked for the City of Pasadena? f/fyes, ptease list dates/department) YESDNO

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

3. Are you aware that financial disclosure is required annually? {e.g., sources of income, loans and gifts, {nvQStments, 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)

YESYESD
NO
NO
D
E]

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 have a IVlaterial Interest in 4 or more units of Rental Property within the City of Pasadena? (If yes, please read the "Note" on the Supplement to Statement of Economic Interest Form (Form RHB-002) regarding property owners with interest in 4 or more rental units, attached to this application) YES
YES
D Noa NO

7. 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 extendedfamily, or in which any member of the City Council, or memberof the City Council's extended family, has any ownership stake in said property?

8. 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?

9. Are you aware of the time commitment necessary to fulfill the YES obligations of the Pasadena Rental Housing Board?
10,Are you aware that you may serve no more than eight YES consecutive years as a member of the Pasadena Rental
Housing Board?

11. Can you, upon appointment, provide proof of identity and proof YES of eligibility to work in the United States?
DNO
NO Q
NO QNO

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

T. ~T 1,-^W^ ki^ff^ iAJiftrkcr^f ^^ CL /y^l.'S/'-l'-'} /l.'rt^i^/-^&^ ^^ ^^i^^' h^mciy-^t, <?<>ynA^^ '^^ift^S .^ J:Tli/^ brf.<syt/i j» r-c^i'c-^ 4wr ^^_70^

13. How would you add value to the Pasadena Rental Housing Board? ^ ^C-^^Q^ 4 s^,A ^^ >/^^ •^ <P ^v^ {^A ^ ^. u^ 1 -I-JA. / ^ "J-i'n^ u M &.f h"l-n^S<//hs" ji2A.ot d Jl^-c:^^.t-lr orf'/<->^^/-.-^^c^ ••(-0 h^^'S^X.ci .'

14. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
'T f? (' •^-i n/-c; m e44 /'?. v^J en-a^i-e. 4'^'- F^^GL^ •<' '^.i ^-^ r ^\. n <^ 'K,<^><4abt^ •(-^^••r\^ ^h£t.y-ie^ Ah^^^men"/- ^t4/lti^S^<'e t

15. How would you help to achieve these objectives and goals? iy pr^^^n-^ -S^ir^ -(r^^p/%^rt^ ^>/<Ll<:/^ a^i^ ^n£, rn^ s^pe'rt €:n<--£^ ^^^l- ^l-< 4-0 V\^o .^^^,>r^ ^ PA^J£?<^S, r^SiJ-^Ate, 12',-: c.^. j^j. yn.^'-z-. (printed name), declare under penalty of perjury under the law o the State of California that the information reported in this Form RHB-001 is true, accurate, andcomplete.Signed thisSigned:
y day of __M4r^hz. 1:

Printed Name: efr"» e^\ /^v^yi^
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CITY OF PASADENA
Residency Verification - MANDATORY
All applicants must provtcfe proof of residency in a City Council district undQr section 1811(b) of The Pasadena Fair and Equitable Housing Charier Amendment Proof of residency may be Qstabfished by either of the folfowsng:

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.
reside at
-b of the City of Pasadena
CA_BJM1_ (zip code). (street), Pasadena,
Signed: /—
^
Printed Name: €-v"»c<^ ^tv^vOX2, If you are not a registered voter, please provide clear, readable copies of two forms of proof of residency acceptable to the Department of Motor Vehicles (DMV) for a REAL, ID, listed below (Cal. Code Regs. fit. 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 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 card Insurance documents, Including medical, dental, vision, life, home, rental or vehicleMedical 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 Califomja 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 aae the reGord was issued. •
•
*
Ill
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, employeror government agency within the United States Deed or title to residential real property
Voter registration confirmation tetter or postcard issued by the CaliforniaSecretary of State or the Los Angeles County Registrar of Voters Proof of payment of resident tuition at a public institution of higher education in CalifornEa
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, 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 tracing document due to a name change (for example, marriage, divorce, or courtorder), name change documentation is required. j
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CITY OF PASADENA
Supplement to Statement of Economic
Interest (FPPC Form 700)
(Form RHB-002)
Ml applicants must complete a Statement of Economic Interest (FPPC Form 700) and "Economic Interests Affidavit" attesting to the information reported in appficant's Form 700.

Inistructions: The Pasadena Fair and Equitable Housing Charter Amendment (City 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. Aft 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. When completing Form 700 to report such Interests and dealings in rental property, please note that City Charter 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.

City Charter Article XVIII Definittons:

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)).

IVlaterial 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)). Please acknowledge you have read the following:

Note: While the City Charter is permissive in allowing At-large members to own rental property, California's Conflic! of Interest regulations forpubf!c officials contain separate standards. As s result. Board members who are property owners with interest in 4 or more rental units in the City of Pasadena might not be able to freely participate in all matters that come before the Pasadena Rental Housing Board. Interestecf applicants In such a position should consult with legal counsel pnor to submitting an application. / acknowledge I have read the foregoing Note^M(injtiaM
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 Affjdavit - MANDATORY
I, E^tc-<^. )^v/io'2- (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:

Printed Name:
^__ day of \n^^V\ 20-U^.
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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 (ease (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
y^. This form Is not applicable to my application as I am not seeking a Tenant Board or Tenant Alternate Seat, Signed this
Signed:
^ day of rN^^^h
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Printed Name: '^rf-\ C.-C^
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Erica Munoz
Pasadena, CA

EDUCATION
University of California - Irvine, Irvine, CA
Master's Program, Criminology, Law & Society (incomplete)August 2008-January 2010 University of California - Irvine, Irvine, CAB.S. Major: Criminology, Law & Society August 2005 -June 2008
Minor: Chicano/Latino StudiesPasadena City College, Pasadena CA A.A. Major: Administration of JusticeAugust 2002 -June 2005EMPLOYMENT HISTORY February 2026 - Present Housing Navigator, Union Station Housing Services, Pasadena, CA Conduct comprehensive intake assessments to determine client eligibility for housing programsand supportive services.

Develop individualized housing stabilization plan focused on rapid rehousing and long-term stability.Assist clients in securing permanent housing through landlord engagement, rental applications, and housing search support.
• Coordinate with property managers and landlords to negotiate lease agreements and advocate for clients.Provide case management services including budgeting assistance, employment referrals, and connection to mental health and substance use services.

Ensure compliance with HUD, CES, and local housing authority requirements and documentation standards.Enter and maintain accurate client data in HMIS and other case management systems.

Facilitated crisis resolution related to eviction prevention, landlord disputes; and housingretention barriers.

Collaborate with multidEsdplinarY teams, sodal workers, and community partners to ensure holistic client support.

Conduct fottow-ups and home visits to monitor housing stability and prevent returns tohomelessness.

March 2024 - Present CristS Interventionist, Right Direction Crisis Intervention, Global * On-Catl basfs
Respond to crisis calls involving individuals experiencing mental health emergencies, trauma, oracute distress.

Conduct oh-site risk assessments to evaluate danger to self or others and determine appropriate interventions.Utilize de-escalation techniques to stabilize Jndividuais in high-stress situations.

Collaborate with law enforcement, hospitals, and social service agencies to coordinate emergency response and safe placements.
•
•
Develop safety plans and provide short-term stabilization counseling.

Connect individuals and families to commurtity-based mental health resources, shelters, andtreatment programs.

Maintain detailed and confidential documentation in aGcordance with HIPPA and agency protocols.

Provide culturally responsive, trauma-informed care to diverse populations.ParttCfpate in case reviews and team briefings to improve crisis responseoutcomes.

Support Follow-up services to reduce repeat crisis incidents and promote iQng-term recovery. •
•
March 2014 - Present Legal Document Preparation Services, Erica's_Legeil Service, Los Angeles Area Prepare legal documents, court filing, process service for attorneys and individual clients, specializing in Famiiy Law
Perform court filings, bfffmg and scheduling functions, legal research, document management and other clerical and administrative work for attorneys on an as needed basis Prepare and file Ceitifomia State and Federal Income Tax returns Corporation and Non Profit Set Up
September 2024 " April 2025 Court Services Representative, ACE Attorney Services, Los Angeles, CA Create work orders for law firms, e-filings and e-recording documents Prepare documents for e-filing and e-recording in timely mannerFollow up on status offilings/recordings and mandatory deadlines • Facilitate services of process and ensure compliance with court procedures Collaborate with team to ensure smooth workflow and provide support as neededAssist with general administrative tasks 2007 - 2010 Mental Health Counselor, South Coast Children's Sqciety, Santa Ana, California Provide crisis intervention services within a group home setting to at risk juveniles who have been removed from parent's custody by court order and have been diagnosed with mild to severe mental retardation along with moQ<d disorders. First Aid and GPR GertJfied. ProAGt certified
• Assist in therapeutic interventions and collaborate with client's assigned therapist Participate and facliltate life skills groups for clients ages 18-24 diagnosed with mood diserdersand residing in transitional housingParticipate In treatment team meetings with resident's therapists 2006 - 2010 Program Assistant, Orange GQwt-v Bar FowciatiQn^ Santa Ana, Galtfornia Conducted family intakes; assessed for drug and alcohol use for diverston program and otherfamtly/indEvtdual needs; Conducted individual intakes; assessed for risk factors for HIV prevention Program; Co-Fadlitated Psycho-educationat groups for at-risk Latinas and delinquency program
Recruited participants for at risk Latina youth program • Administered Baselines and Post Test for program evaluation Assisted in pianning of speakers and events for program cumculum and created program news letters
Answered multiple line phone system
Ordered & paid for office supplies
Provided data entry of all clients serviced within all departments •••

VOLUNTEER
January 2024- Present Administrative Executive Director, Brown & Biack Foundafton, Pasadena, CA Completing form 1023 for non-profit tax exempt statys.Assisted in development of proposed budget.

Assisting in writing proposals for funding and program adoption.

Attended weekly meetings to ensure the process of obtaining nonprofit status is runningeffeetiveiy.Assisting in development of programs to serve violence impacted youth, parolees, and families in need.

CERTIFICATES & SKILLS
Mental Health First Aicf Certificate, National Council on Mental Health 2012 Frgfessiona! Community Intervention Training Cert., Maximum Force Enterprises 2011Personal Defense Certificate. Maximum Force Enterprises 2011Conflict Resolution Certificate. Western Justice Foundation 2011 Advance tutoring Certificate. Pasadena City College 2004 Bilingual: Fluent Spanish-reading, writing, speaking; Microsoft Office: word, publisher, power point References
Yvette McDowell
Retired City Prosecutor
City Of Pasadena
Masood R. Khan, Esq.

Attorney at Law
Khan Law Group
Dr. Alfssa Winkler
Special Education SpecialistWashoe School District
II^TORNlATpRM'^OOI
?FA(R.P01.lTiCAl.'PRACTICES COMMISSIONliNffl'l^
Please typs or print in inh,

STATEMENT OF ECONOMIC INTERESTS

COVER PAGE
A PUBLIC DOCUMENT RECEIVF.H
Date InKiat Filing Received
fi'.up Waft vss os-iy

NAME OF FILER (LAST)
I^A^^o-T- (FIRST) .£^-LC^_ CT-»y?k

1. Office, Agency, or Court ,.^nyCLER^
Agency Name fOo nof use acronyms) ^ CITY OF fy^OEN/T
C'r^H ^ P<^^^n^\
Division, Board, O&partment, District, If applicable
Pc^^Aen^ Ps^^W H
^ If filing for multiple positions, list below or on an attachment. (% f»o( use acrofsyms) ihment. (Di Agency: —,-. Position:

Your PositiQn
EQCH^ A^p^^^A*

2. Jurisdiction of Office (Check at feast one box)
State
.,. Mutti-County
Kcityof Pa^&^s^^
Judge (Supreme, Appellate, Superior Court), Retired Judge,Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction) <Countyof L<>s;? ^^^A.^S
Other

3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2025, through
December 31. 2025.
•OfThe period covered is , /..,„.„, / ,.„„.,„.„„, through December 31, 2025.

Leaving Office: Date Left J- J.
•or-
(Check one circle below.)
The period covered is January 1, 2025, through the date of leaving office.

Assuming Office: Date assumed _/_ J. The period covered is _/_ J. ^Candidate: Date of Election t^Of^ff
the date of leaving office.
and office sought, if differert than Part 1;,
-, through

4. Schedule Summary (required)
Schedules attached
»• Total number of pages including Ws eoverpage:

Schedule A.1 • InvestmeRts - schedule attached
Schedule A-2 • Imestments - schedule attachedSchedule B • Real Property - schedule attached Attachment 7ttO-P - Pmspectlve Empfoyment (87200 Bens Only) - schedule attached "or- K None • No reportable interests on any schedule
Schedule C • Income, Loans. & Business Positions - schedule attached Schedule D • /ncome - GiHs - schedule sltachedSchedule E • tocome - Gifts - Trav^ Pgymente - schedule attached

5. Verification l^S^4^n?v. CA ct>^(

MAILING ADDRESS STREET
{Suainsss w AgsncyWrsss Rewmmstttlett • Publk Oow/fiffit) cm ~SWE ZIP CODE
DWTIME TQ.EPHQHE NUMBER EMAIL ADDRESS
I have used all reasonable diligence In preparing this stalement. I havs reviswsd thiB st3tafnent and to the best ot my howledgo the infomat'ion conlaincdl herein and in any attached sohsdules is true and complste. I acknowledge this is a publfc docurnent.

I certify under penalty of petj^y under the laws of the State of Catffomta that the {oregoing is true and correct Date Signed ^1$ I 2^/ Signature_^- jmonffi'day.yaafl (File Ihewislnaly tgflerf papef ttateiiiwS vitli ydwKg ifsist.) Types of Statements
Assuming Office Statement:If you are a newly appointed official or are newly employed in a position designated, or that will be designated, in a state or local agency's conflict of interest code, your assuming office date is the date you were sworn in or otherwise authorized toserve in the position. If you are a newly elected official, your assuming office date is the date you were sworn in.• Report: Investments, interests in real property, and business positions held on the date you assumed theoffice or position must be reported. In addition, income(including loans, gifts, and travel payments) receivedduring the 12 months prior to the date you assumed the office or position.

For positions subject to confirmation by the State Senate orthe Commission on Judicial Appointments, yourassumingoffice date is the date you were appointed or nominated to the position,
Example; Maria Lopezwas nominated by the Governor
to serve on a state agency board that is subject to state Senate confirmation, The assuming office date is thedate Maria's nomination is submitted to the Senate.

IVtaria must report investments, interests in real property, and business positions Maria holds on that date, andincome (including loans, gifts, and travel payments)received during the 12 months prior to that date, If your office or position has been added to a newly adoptedor newly amended conflict of interest code, use the effective date of the code or amendment, whichever is applicable.

Report: Investments, interests in real property, and
business positions held on the effective date of the codeor amendment must be reported. In addition, income(including foans, gifts, and travel payments) received during the 12 months prior to the effective date of the code or amendment,
Annual Statement:Generally, the period covered is January 1, 2025, throughDecember 31, 2025. If the period covered by the statementis different than January 1, 2025, through December 31, 2025, (for example, you assumed office between October1, 2024, and December 31, 2024 or you are combining statements), you must specify the period covered.
investments, interests in real property, business
positions held, and income (including loans, gifts, and travel payments) received during the period coveredby the statement must be reported. Do not change thepreprinted dates on Schedules A-1 , A-2, and B unless you are required to report the acquisition or disposition ofan interest that did not occur in 2025.

Ifyaur disclosure category changes during a reporting
period, disclose under the old category until the effective date of the conflict of interest code amendment anddisclose under the new disclosure category through theend of the reporting period.

Leaving Office Statement:

Generally, the period covered is January 1,2025,through the date you stopped performing the duties of your position. If the period covered differs from January1, 2025. through the date you stopped performing the duties of your position (for example, you assumed officebetween October 1. 2024, and December 31, 2024, oryou are combining statements), the period covered mustbe specified. The reporting period can cover parts of twocalendar years.

Report: Investments, interests in reaf property, business positions held, and income (including loans, gifts, and travel payments) received during the period covered bythe statement. Do not change the preprinted dates onSchedules A-1.A-2, and B uniess you are required toreport the acquisition or disposition of an interest that did not occur in 2025.

Candidate Statement:If you are filing a statement in connection with yourcandidacy for state or local office, investments, interestsin real property, and business posrtions held on the date of filing your declaration of candidacy must be reported.

In addition, income (including loans, gifts, and travel payments) received during the 12 months pjigr to the date of filing your declaration of candidacy is reportabte. Do notchange the preprinted dates on Schedules A-1, A-2, and B.

Candidates running for local elective offices (e.g., county sheriffs, city clerks, school board trustees, or waterdistrict board members) must file candldatestatements,as required by the conflict of Interest code for the electedposition. The code may be obtained from the agency of the elected position.

Amendments:

If you discover errors or omissions on any statement, file an amendment as soon as possible. You are only requiredto amend the schedule that needs to be revised; it is notnecessary to refile the entire form. Obtain amendment schedufes from the FPPC website at www.fppc.ca.gov.

A/ote: Once you file your statement, you may not withdraw it. Al! changes must be noted on amendment schedules.

Expanded Statement:

If you hold multiple positions subject to reportingrequirements, you may be able to file an expandedstatement for each position, rather than a separate and distinct statement for each position. The expandedstatement must cover all reportable inferests for ati jurisdictions and list all positions on the Form 700 or on an attachment for which it is filed. The rules and processesgoverning the filing of an expanded statement are set forth in Regufation 18723.1.
^

RECEIVED
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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 fi!l 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 certified by the City Clerk as eligible for appointment shall remain valid for use towards future vacancies for a period of up to one year from certjftcation. In the event of a vacancy, if the applicant has not been appointed to the Rental Housing Board and still desires to bo considered for appointment, they may submit an updated application, or may advise the City Clerk's Office in writing that the information contained on the original apptication js still current. For example, if an application is certified on February 21, 2025 as eligible, said application will continue to be qualified subject to written confirmation by the applicant to the City Clerk's Office through February 21 ,2026.

Applicant Name: J^icU^^l UJfiC^^lA ^th^I^^tL
Home Address:

Mailing Address: ^c^^G
Email Address:

Business Phone:
+
Home Phone:

Date Available to Start: V</ Z3^
Celt Phone:

BoardSeat 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 (ft
At-large IVIember (4 seats, open to any Pasadena resident without respect to tenancy or Council District)
AltQrnate Tenant Member (1 seat, reserved for tenants)
A/temafeAt-large Member (1 seat, open to any Pasadena resident without respect to tenancy or Council District)
Community Service ~ List boards, commissfons, committees, and organizations on which you are currently serving or have served. offices held and in what city. Pr^^A^t, E^A^i <$^4 ^ Q^s^l'Q / ^ft $ca< A^W-./C Coiu^v^l( ]^^7!^/ rG^^ttiv^ ^ J^lW. / ^5e. Z^L^ ^lA-^ ^4?e V &^ 4.ffV^^^^^ ga^a< ^K)^^^^- ^((M^UA©tA^, C^f" t
Employment - Title and duties, current and past (acceptable to attach resume as an alternative). ^UA ^€ ^ C^ c^ gr @^^ T^-'k'^^c/ {o^AWe^-fcy^ ^1 'Src^ /^^ a^t^G^\ Education - Include professional or wcational licenses or certificates. G'l^ewo^ Arf^/^^HFi &Ikr^- &//p^ ^A ^^ 4/^ ^ ^c-<y<— •f)^M^u^^f "^i.^i^')^ ?r(?A€?/^/ ^^W^k. luCncaf fin^^i. "tJ^

1. Have you ever worked for the City of Pasadena? (If yes, ptease YES ["~] NO list dates/dQpartment)

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

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
YESD
NO
NO
D
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5. Do you or your extended family1 miembers, have a material interest In rental property in the County of Los Angeles within the last three years?

6. Do you have a Material Interest in 4 or more units of Rental Property within the City of Pasadena? (If yes, please read the "Note" on the Supplement to Statement of Economic Interest Form (Form RHB-002) regarding property owners with Interest in 4 or more rental units, attached to this application) YES D NO g]
YES [3 NO ^
Exfr^ftdftri l?l(tm!t\;'flAV •ttrtati'^tA 4Mh»thCTrh'kfm»rrtftirt»^Utn^l' rtnrnA<ltI^ *<»»*n»^ ih-iirt*»> ofa.Si.i *A.lt-.- „«-,.—*,«.»—»* —^.*.^.i.^.^-.. .^»..^~ —.-..—•

7. 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 stakein said property?

8. 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?

9. Are you aware of the time commitment necessary to fulfill the obligations of the Pasadena Rental Housing Board?

10. Are you aware that you may serve no more than eight consecutive years as a member of the Pasadena Rental
Housing Board?
11, Can you, upon appointment, provide proof of identity and proof of eligibility to work in the United States?

YES Q NO
YES
DNO
p
YES
YES
YES

NO QNO QNO
D

12. Describe your relevant life experience, professional training, and/or education in the following areas: Housing/Housing Justice/Landlord Tenant ReIationships/R&al Estate:
-j'lAffV^:^'^^/ ^^^^U^i^V'^'i^ f^i^i ^'$A^<^J^^^ '3-^ \y»'^±^- .^MMlf_^ ^.L^^f/^l 7$^Uu^ ^ ^fMJ ^ ^ij^_kx- /i^f ^^^'s

13. How would you add value to the Pasadena Rental Housing Board? ^4—tfy^^- /v< ^^-^^le^-!^i^ ^M^f /)^A-^ ^ &^^. _^y^^. ^ ^d^l^^MitlU^ ^i^_^y,^c' tUf// ^±^ :;$_^CJzu-r__^ "h^ A^XI,.^ 'hd-.t ^>M— ^la.^^ ^Kft/ l-(ev^ M^t ^-•'^ /t.

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14. What do you view are the primary objectives and goals of the Pasadena Rental Housing Board?
_^_/)^vu^i c^\^^ ^ fs> ^^o^ iv/l^&.^ b a ^/At, I //^^j ^ ^ CM^; wr

15. How would you help to achieve these objectives and goals? ^ ^6^ ^^ •l^t^^^ ^^/^r a^ ls^^^— 1, /^ ij^if S^"^^^'^ (printed name), declare under penalty of perjury under the law o the State of California that the information reported in this Form RHB-001 is true, accurate, and complete.

Signed this
Signed;
Printed Name:
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CITY OF PASADENA
Residency Verification - MANDATORY
M applicants must provide proof of residency in a City Council district under section 16l1(b) of The Pasadena Fair and Equitable Housing Charter Amendment. Proof of residency may be established by either of the followt'ng:

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. Iff of the City of Pasadena I reside at .

CA QiioS (zip code). (street), Pasadena,
Signed: ^> {.. <^C^i^~^-
Printed Name: ^/cUt^ ^ ~5i(Wr^tp^ —

2. If you are not a regfstered voteri please provide clear, readable copies of two. forms of proof of residency acceptable to the Department of Motor Vehicles (DMV) for a REAL ID, Hsted 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 Qpplication:

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, municipafity, 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/resldent Schoo! 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 aae the record was issued. 1 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 CaliforniaAn original copy of an approved Claim for Homeowners" Property TaxExemption (BOE-266) form filed with the Los Angeles County AssessorCourt 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 ceriLificate, 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. *u
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CITY OF PASADENA
Supplement to Statement of Economic
Interest (FPPC Form 700) (Form RHB-002)
All applicants must compfetQ a Statement of Economio Interest (FPPC Form 700) and ''Economic Interests Affidavit" attesting to the information reported in appficant's Form 700.

Instructions: The Pasadena Fair and Equitable Housing Charter Amendment (City 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 inthe three (3) years before submitting an application. The City is adopting the Fair Political Practices Commission's Form 700 for this purpose. When completing Form 700 to report such interests and dealings in rental property, please note that City Charter 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.

City Charter Article XVIII 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(9)).

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 ownerehip 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)). Please acknowledge you have read the following:

Note: White the City Charter is permissivQ in af lowing At-large members to own rental property, California's Conflict of Interest regulations for public officials contain separate standards. As a result, Board members who are property owners with interest in 4 or more rental units in the City of Pasadena might not be able to freely participate in ail matters that come before the Pasadena Rental Housing Board. Interested applicants in such a position should consult with legal counsel prior to submitting an application, / acknowledge I have read the foregoing Note 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 (SectioFi 1803(aa)).

CITY OF PASADENA
Economic Interests Affidavit - MANDATORY
I, _ ^ef'w-^ <-/J ->^^"^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 theattached Form 700 is true, accurate, and complete.

Signed thisSigned:
/ sr ^ day of __d-as^^f^—' 20^
Printed Name: R^cU^J! ^ ^i-ffyrc^^
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CITY OF PASADENA
Affidavit of Tenancy - MANDATORY for Tenant Board
and Tenant Alternate Seats
(Form RHB-003)
1, ^€lu^-^ U^ *7^-(£/r?-'^'?/f 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. Catifomia - 9/^?<1zip 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 ^tA^f~^ ^- , 20^2^.

Signed: .^Printed Name: ^^u^c/ ^t^^<^^^~
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Richard W. Stan-att
Pasadena, California 91105
Work Experience Commercial Brokers International Broker Associate.

Responsible for securing listing agreements for the sale and leasmg ofmulti-famlly, mdustrial, o-ffice, and retail properties. Aiulysis of current market conditions and valuations of acquisitions anddispositions for clients MacVaugh & Co. Associate. Responsible for securing listingagreements for the sale and leasmg of multi-faniily, industrial, office, and retail properties. Analysis of current ma±et conditionsand valuations of acquisitions and dispositions for clients.

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

Doerken Real Estate Services, Project Manager. Responsible forbusiness development, underwriting loans and joint venture projects, loan administration, customer service and support, investment reports for a $20 Million Mezzanine Loan portfolio.

Colliers-SeeIey, Vice President. Responsible for securing listing agreements for the sale ofm.ulti-famlly, industrial, office, and retail properties. Analysis of current market conditions and valuations of acquisitions 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 offeringmenioranda for the sale of office, industrial, retail, and multi" family assets. Most significant were Town Center Business Park, a450,000square feet mixed use industdal 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 Assooia.te, Responsible for the marketing and sale of multi-family and retail assets 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, commercial, 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 McKeima College, Claremont, California. International Relations Major
King's College, Taunton, Somerset, England. Passed two "A" level exams on year abroad exchange.

Phillips Academy, Andover, Massachusetts.

Military
Affiliations
1st Lieutenant, United States Marine Corps. Comniunications Officer. Stationed in Okinawa, Japan and Pan-is Island, South Carolina.

Citrus Insurance Trust, Chairman. 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, Claremont McKenna College, Board of Governors. The Rose Institute produces publicly useful information through its faculty directed undergraduate research teams. Tlie Board of Governors sets policy and directs the faculty and staff.

Rotary Club of Ontario, CA. Presidei^t 1994-95
Gage Canal Company, Riverside, CA. Director. The Gage Canal Company is an over 100-year-old irrigation delivery system inRiverside, CA servicing the citrus industry.

San Antonio Conim unity Hospital Foundation, Upland, CA Director The Board of Directors of the Foundation is responsible forsetting policy concerning investment, flmd raising, staffing, and support for the San Antonio Community Hospital.

CAQFORNIA FORM700

FAIR POLITICAL PRACTICES COMMISSION
PlQase type or print In Ink.

SWTEIV1ENT OF ECONOMIC INTERESTS

COVER RAGE
^ PUBLIC DOCUMENT R £ C cDate Initial Fiiing Receivetf Rliny OSd9l Usa On;y CIVED ^W^!^ NAME OF FILER (LAST) (FIRST) ^Ck^/ ^/5^y^. k)}^eyn3:f0 1. Office, Agency, or Court Agenq» Name (Oo not iis^amnyms) -:OT^S^ ^)^ r^- %6^Aa^- Division, ^oard, Departmenti District, tf applicable
V^5^c(jeMt i^UA^ ^
Your Posiiiort
&^^
>- If filing fer muttipte positions, li$t below or on an altachment, fDo fiat usa acronyms) Agency: „„-.,„„„„„„...,„-:: „ ,„„- .. ..„: , - - —.„„ .- _ .„ Position:
^c^r

2. Jurisdiction of Office (Check at hast one tsw)
GState
DMuffi.County.
^ Gi^ 6f P^^r^ C^UM
Q Judge (Supreme, Appeflats, Superior Court), Refred Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction) i-county of 4^^ /4-xfZ/^ C Other ^

3. Type of Statement (ChecK at least one box}
Q Annual: The period covered Is January 1,2025, through December 31, 2025, •orThe perfocf covered is. „„ - IDerember31, 2025,
[j leaving Office; Date Left,
x J_
J_ through
Q Assumtng Office: Date assumed J. J_
(Check one eifcle below.)
a The period covered is January 1,202S, through the date of leaving office.

J,„ , through
•or.

Q The period covered is JUie date of leaving office. §A Candictate: Date of Eteetton /^V^S-^ and ofRce sought, if ctiflsrent than Part 1;.

4. Schedule Summary (required)
SchedulQs attached > Total mmbw of pages includ'ing thfs cover page: ^ •orQ Schedule A-1 • ImestmenSs - schedule attached Q Schedule A«Z • Investments - schedule attached [_] Schedule B * Real PropQrty ~ schedule attached f] Attachment 700-P • Pmspectlve Employfnent (872QO Fifers Only) -schedule attachsd .[3 None • Ho reportable fnterests on any schedule i^Schedute C • Income, Loans, & Business Positions - scheduie attached Q Schedule D • Inwme ~ Gffts - schedule attached [j Schedute E • Incwne - Gifts ~ Travel Paymants ~ schedute attested

5. Verification

MAILING ADDRESS STREET
jBusimss w AasHCY Asldreas fiaeonimnmW * Pu6ffe Ooetfflwny circ SWE ZIP CODE DWIME TELEPHONE NUMBER c./^ f//^r~ EMAIL ORESS
I have used all fsasonabie diligence in preparing this stateftient. I have reviewed ttiis statement and to (he best of m/knioiriedge the Informatton contained herein and in any attached schedujss is true snd Gomplete. I acltnowledge this is a public dcmmsnt. I certify under penalty of perjury under the laws of the State of CaNfornla that the foregtt^fl Is true an^correct. Date Signed f/^/'ZQ'i-^ fnwflift, day ynafl Signature AU ^€^^^ (F<& the aiiynafy siyedpaiiw slatment i»ff> yBWftg offFcOt} fPPC farm f 09 •• Cover Page (ZBIS/ 6) •dvlceafooe.ea.tov • liM-VTi-STii • >r.»i»«~~- — —- Types of Statements
Assuming Office Statement:

If you are a newly appointed official or are newly employed in a position designated, or that will be designated, in a state or local agency's conflict of interest code, your assuming office date is the date you were sworn in or otherwise authorized to serve in the position. If you are a newly elected official, your assuming office date is the date you were sworn in.

Report: Investments, interests in real property, and business positions held on the date you assumed the office or position must be reported. In addition, income (including loans, gifts, and travel payments) received during the 12 months prior to the date you assumed the office or position,
For positions subject to confirmation by the State Senate or the Commission on Judicial Appointments, your assuming office date is the date you were appointed or nominated to the position,
• Example: Maria Lopez was nominated by the Governor to serve on a state agency board that is subject to state Senate confirmation. The assuming office date is the date Maria's nomination is submitted to th© Senate.

Maria must report investments, interests in rea! property, and business positions Maria holds on that date, and income (including loans, gifts, and travel payments) received during the 12 months prior to that date.

If your office or position has been added to a newly adopted or newly amended conflict of interest code, use the effective date of the code or amendment, whichever is appficable.

Report: Investments, interests in real property, and business positions held on the effective date of the code or amendment must be reported. In additioni income (including loans, gifts, and travel payments) received during the 12 months prior to the effective date of the code or amendment.

Annual Statement:

Generally, the period covered is January 1, 2025, through December 31, 2025. If the period covered by the statement is different than January 1, 2025, through December 31, 2025, (for example, you assumed office between October 1, 2024. and December 31, 2024 or you are combining statements), you must specify the period covered, • Investments, interests in real property, business positions held, and income (including loans, gifts, and travel payments) received during the period covered by the statement must be reported. Do not change the preprinted dates on Schedules A~1 , A-2, and B unless you are required to report the acquisition or disposition of an interest that did not occur in 2025. • If your disclosure category changes during a reporting period, disclose under the old category until the effective date of the conflict of interest codg amendment and disclose under the new disclosure category through the end of the reporting period.

Leaving Office Statement: Generally, the period covered is Januafy 1, 2025, through the date you stoppeci performing the duties of your position. If the period covered differs from January 1, 2025, through the date you stopped performing the duties of your position (for example, you assumed office between October 1, 2024, and December 31, 2024, or you are combining statements), the period covered must be specified. The reporting period can cover parts of two calendar years. • Report; investments, interests in real property, business positions held, and income (including loans, gifts, and travel payments) received during the period covered by the statement. Do not change the preprinted dates on Schedules A-1, A-2, and B unless you are required to report the acquisition or disposition of an interest that did not occur in 2025.

Candidate Statement:

If you are filing a statement in connection with your candidacy for state or local office, investments, interests in real property, and business positions held on the date of filing your declaration of candidacy must be reported. In addition, income (including loans, gifts, and travel payments) received during the 12 months prior to the date of filing your declaration of candidacy is reportable. Do not change the preprinted dates on Schedules A-1, A-2, and B.

Candidates running for local elective offices (e.g., county sheriffs, city clerks, school board trustees, or water district board members) must file candidate statements, as required by the conflict of interest code for the elected position. The code may be obtained from the agency of the elected position.

Amendments:

If you discover errors or omissions on any statement, file an amendment as soon as possibfe. You are only required to amend the schedule that needs to be revised; it is not necessary to refile the entire form. Obtain amendment schedules from the FPPC website at www.fppc.ca.gov, Note: Once you file your statement, you may not withdraw it. All changes must be noted on amendment schedules.

Expanded Statement: Ifyou hold multiple positions subject to reporting requirements, you may be able to file an expanded statement for each position, rather than a separate and distinct statement for each position. The expanded statement must cover all reportable interests for all jurisdictions and list alt positions on the Form 700 or on an attachment for which it is filed. The rules and processes governing the filing of an expanded statement are set forth in Reguiation 18723J.

FPPC Form TOO (ZOiS/iOZSj
* -. »iSfi.'»Tc^aty'y^ * wu/wlnBc.e^.eov

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

FAIR POUTICALPRACTICES COMMISSION
Name
ff^~^*-y^t"
>• 1, INCOME RECEIVED

NWIE OF SOURCE OF INCOME
^IfwMs.O^^ €a^( P^r^r ADDRESS (Buslfisss Adcfrass Aeoaptalile} BUSINESS ACTIVITY. IF ANY, OF SOURCE

YOUR BUSINESS POSITION'
t-^c^^^ CQajc^-
GROSS INCOME RECEIVED [_j No Income * Business Position Only Q $500 - $1.000 ® ft ,001 - 510,000 Q $10,001. $ioo,oao 'F] OVER (IBO.OOO

CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Q Salary ["] Spoustft or malstend domestic partner^ Inaime (For seEf-emptoyecf use Scheciule A-Z.) Q Partnership (Less than 10% owneraihtp. For 10% orfitBateruse Schedule A-2.) D Sale o(
(Real ffttipyly, car, ftdaf, •te^ Q Loan repayment
Q Co"1"1'83'0" w [i Rental Income, tisfwcA wuw o/tfO.OOO orinow (Ofssaiibaj
D Qthw,
{Desffttw)
^ 1. INCOME RECEIVED

NAME OF SOURCE OF INCOME
ADDRESS (Btiaingss Address Acwptable}
BUSINESS ACTIVITY, IF ANY. OF SOURCE

YOUR BUSINESS POSITIQN
GRIOSS INCOME RECEIVED H No Income . Business Position Only Q $500 . $1,000 [^{$1.001 .$10,000 Q $10,001 . $100,000 [j OVER 1100,000 CONSIOfiRATION FOR WHICH INCOME WAS RECEIVED
Q Salaiy [j Spousa't or resistBred domestic partner's income (For aelf-employed use Schedule A-2.) D Partierahlp (Less than 10% ownership. For 10% cr greater use Sdiedule A-2.) uSals of
(Real pinpaity, ear, tost .)
1) Loan repayment
Commissioner II Rental Income, (fstaach*oun:» of swooo or mow iOssenW)
uOther
(Dswritx)^ »• 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 tTansacUon, made in the tender'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* INTEREST RATE TERM (Montts/Years)
ADDRESS (BtisinBss Address AwepSatile) JK Q None
BUSINESS AGTIVITf, IF ANY, OF LENDER
SECURiTf FOR LOAN
Q None [j Personal restdence
HIQHgST BALANCE DURING REPORTINS PERIOD
Q $500 - S 1,000Q $1,001. $10,000
Q $10,001 .$100.000
Q OVER $100.000
["} Real Property
Strsaf »<KlteM
CHy
f_| Quanintor
DQlher
(Oaswiljal
Comments:

FPPC Form 700 .ScheduteC (2025/20%)
Instructions ~ Schedule B
Interests in Real Property
Report interests in real property located in your agency's jurisdiction in which you. your spouse or registered domestic partner, or your dependent children had a direct, indirect, or beneficial Interest totaling $2,000 or more any time during the reporting period. Real property is also considered to be "within the jurisdiction" of a local government agsncy if the property or any part of it is located within two miles outside the boundaries of the jurisdiction or within two miles of any land owned or used by the local government agency, (See Reference Pamphlet, page 14.) Interests in real property include: * An ownership interest (including a beneficial ownership interest)
• A deed of trust, easement, or option to acquire property • A leasehold interest (See Reference Pamphlet, page 15.) A mining lease
• An interest in real property held in a retirement account (See Reference Pamphlet, page 16.)• An interest in real property held by a business entity or trust in which you, your spouse or registered domestic partner, and your dependent children together had a 10% or greater ownership interest (Report on Schedule A-2.) • Your spouse's or registered domestic partner's interests in real property that are legally held separately by him or her You are flat required to report: A residence, such as a home or vacation cabin, used exclusively as a personal residence (However, a residence in which you rent out a room or for which you claim a business deduction may be reportable. If reportable, report the fair market value of the portion claimed as a tax deduction.)
' Some interests in real property held through a blind trust (See Reference Pamphlet, page 17.) Please note: A non-.reportable property can still be grounds for a confiicf of interest and may be dtsqualifying,
To Complete Schedule B:
• Report the precise location (e.g., an assessor's parcel number or address) of the real property. • Check the box indicating the fair market value of your interest in the property (regardless of what you owe on the property),
• Enter the date acquired or disposed only if you fnitiady acquired or entirely disposed of your interest in the property during the reporting period. • tdenttfy the nature of your interest. If it is a leasehold, disclose the number of years remaining on the lease.

Reminders
• Income and loans already reported on Scheeiule B are not also required to be repsrted on Schedule C. • Real property alreadyreported on Schedule A-2, Part 4 is not also requireci to be reported on Schedule B. • Code filers "do your disclosure categories require disclosure of real property? If you received rental income, check the box indicating the gross amount you received.

If you had a 10% or greater interest in real property and received rental income, list the name of the souree(s) if your pro rata share of the gross income from any single tenantwas $10,000 or more during the reporting period. If you received a total of $10,000 or more from two or more tenants acting in concert (in most cases, this will apply to married couples), disciose the first and last name of each tenant. Otherwise, mark "None."
Loans from a private lender that total $500 or more and are secured by real property may be reportable. Loans from commercial lending institutions made in the lender's regular course of business on ternns available to members of the public without regard to your official status are not reportable.

When reporting a loan:

Provide the name and address of the lender.

Describe the lender's business activity.

Disclose the interest rate and 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 reporting period. The term of a loan is the total number of months or years given for repayment of ths loan at the time the loan was established.

Check the box indicating the highest balance of the
loan during the reporting period.

Identify a guarantor, if applicable.

If you have more than one
reponabte loan on a single
piece of real property, report
the additional loan(s) on
Schedule C.

Example:

Allison Gande is a city
planning commissioner.

During the reporting period,
Allison received rental income
of $12,000, from a single
tenant who rented property
owned in the city's jurisdiction. IfAllison received $6,000 each from two tenants, the
tenants' names would not be
required because no single tenant paid her $10,000 or
more. A married couple is
considered a single tenant,
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