EXHIBIT G
CITY OF SAN BERNARDINO
COUNTY OF SAN BERNARDINO, STATE OF CALIFORNIA
COMMUNITY FACILITIES DISTRICT NO. 2019-1 (MAINTENANCE SERVICES) ANNEXATION NO. 55
(December 2, 2026)
This ballot is for the use of the authorized representative of the following owner of land within Community Facilities District No. 2019-1 (Maintenance Services) (“CFD No. 2019-1”) of the City of San Bernardino:
Name of Landowner Number of Acres Owned Total Votes
Alex Chernobelsky .51 1
According to the provisions of the Mello-Roos Community Facilities Act of 1982, and resolutions of the City Council (the “Council”) of the City of San Bernardino (the “City”), the above-named landowner is entitled to cast the number of votes shown above under the heading “Total Votes,” representing the total votes for the property owned by said landowner. The City has sent the enclosed ballot to you so that you may vote on whether or not to approve the special tax.
This special tax ballot is for the use of the property owner of the parcels identified below, which parcels are located within the territory proposed to form the CFD No. 2019-1, City of San Bernardino, County of San Bernardino, State of California. Please advise the City Clerk, at (909) 998-2680 if the name set forth below is incorrect or if you are no longer one of the owners of these parcels. This special tax ballot may be used to express either support for or opposition to the proposed special tax. To be counted, this special tax ballot must be signed below by the owner or, if the owner is not an individual, by an authorized representative of the owner. The ballot must then be delivered to the City Clerk, either by mail or in person, as follows:
Mail
Delivery: If by mail, place ballot in the return envelope provided, and mail no later than November 18, 2026, two calendar weeks prior to the date set for the election.
Mailing later than this deadline creates the risk that the special tax ballot may not be received in time to be counted.
Personal
Delivery: If in person, deliver to the City Clerk at any time up to 5:00 p.m. on December 2, 2026, at the Clerk’s office at 201 N. “E” Street, Bldg 201 A, City of San Bernardino, CA 92401.
However delivered, this ballot must be received by the Clerk prior to the close of the public meeting on December 2, 2026.
Very truly yours,
Telicia Lopez, CMC, City Clerk
TO CAST THIS BALLOT, PLEASE RETURN THIS ENTIRE PAGE.
OFFICIAL SPECIAL TAX BALLOT
Name & Address of Property Owner: Assessor’s Parcel Number(s):
Alex Chernobelsky
4316 Saltillo St.
Woodland Hills, CA 91364
0144-113-32, 0144-113-33
CITY OF SAN BERNARDINO
COUNTY OF SAN BERNARDINO, STATE OF CALIFORNIA
COMMUNITY FACILITIES DISTRICT NO. 2019-1 (MAINTENANCE SERVICES) AN “X” OR OTHER MARK WILL CAST ALL VOTES ASSIGNED TO THIS BALLOT SPECIAL TAX BALLOT MEASURE MARK “YES” OR
“NO” WITH AN “X”:
Shall the City Council of the City of San Bernardino be authorized to levy a special tax on an annual basis at the rate set forth in the following table:
Land Use
Category
Taxable
Unit
Maximum
Special Tax A
Non-Residential NR $4,847
plus an annual increase on each July 1, commencing on July 1, 2027 the Maximum Special Tax shall increase by i) the percentage increase in the Consumer Price Index (All Items) for Riverside - San Bernardino - Ontario (December 2017 = 100) since the beginning of the preceding Fiscal Year, or ii) by two percent (2.0%), whichever is greater, to finance certain services within the territory identified on the map entitled “Annexation Map No. 55 of Community Facilities District No. 2019-1 (Maintenance Services) City of San Bernardino” including landscaping and streets as provided in the Rate and Method of Apportionment (including incidental expenses) which is attached as Exhibit C to Resolution No. 2026-__ adopted by the City Council of the City of San Bernardino on October 21, 2026, and shall an appropriation limit be established for the Community Facilities District No. 2019-1 (Maintenance Services) in the amount of special taxes collected? YES _________
NO _________
Certification for Special Election Ballot
The undersigned is an authorized representative of the above-named landowner and is the person legally authorized and entitled to cast this ballot on behalf of the above-named landowner.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on ____________, 20__.
Alex Chernobelsky
Owner
Signature
Print Name
Title