Resolution Number CRA 05-08-16-01RESOLUTION NO. CRA 05-08-16-01
A RESOLUTION OF THE BOARD OF DIRECTORS OF THE SAN JUAN
CAPISTRANO COMMUNITY REDEVELOPMENT AGENCY ADOPTING
THE DECLARATION OF CONDITIONS, COVENANTS AND
RESTRICTIONS FOR THE LITTLE HOLLYWOOD AFFORDABLE
RENTAL HOUSING LOCATED ON ASSESSOR'S PARCEL NOS. 649-
281-05, 121-142-01, AND 121-142-07 IN THE LOS RIOS DISTRICT AND
DIRECTING THE AGENCY SECRETARY TO PROCESS RECORDING
OF THE DECLARATION OF CONDITIONS, COVENANTS AND
RESTRICTIONS
WHEREAS, the San Juan Capistrano Community Redevelopment Agency
(the "Agency") owns the Little Hollywood affordable rental housing located on
assessor's parcel nos. 649-281-05, 121-142-01, and 121-142-07 in the Los Rios
District; and,
WHEREAS, the Agency rents the housing units to low and very -low
income households; and,
WHEREAS, the Agency desires to adopt income and affordability
covenants on the units for a period of not less than 55 years to fulfill the Agency's
inclusionary housing obligation and to help satisfy the City's Regional Housing Needs
Assessment ("RHNA") requirements.
NOW, THEREFORE, BE IT RESOLVED, that the Board of Directors of
the San Juan Capistrano Community Redevelopment Agency, San Juan Capistrano,
does hereby (1) adopt the Declaration of Conditions, Covenants and Restrictions for the
Little Hollywood affordable rental housing located on Assessor's Parcel Nos. 649-281-
05, 121-142-01, and 121-142-07 in the Los Rios District (Exhibit A); and (2) direct the
Agency secretary to process recording of the Declaration of Conditions, Covenants and
Restrictions.
PASSED,APPROVED,AND
ATTEST:-_:�4 � A 4
MA T R. MONAHAN, SECRETARY
D this 16th day of August 2005.
STATE OF CALIFORNIA )
COUNTY OF ORANGE )ss -
CITY
ss.CITY OF SAN JUAN CAPISTRANO )
I, MARGARET R. MONAHAN, appointed Agency Secretary of the Community
Redevelopment Agency of the City of San Juan Capistrano, do hereby certify that the
foregoing Resolution No. CRA 05-08-16-01 was duly adopted by the Board of
Directors of the Community Redevelopment Agency at a regular meeting thereof, held
the 16th day of August 2005, by the following vote:
AYES: DIRECTORS: Bathgate, Hart, Allevato, Swerdlin, and Chairman
Soto
NOES DIRECTORS: None
ABSENT: DIRECTORS: None
R. MONAHAN, Agency Secretary
RECORDING REQUESTED BY
— AND WHEN RECORDED MAIL TO: )
San Juan Capistrano )
Community Redevelopment Agency )
32400 Paseo Adelanto )
San Juan Capistrano, California 92675 )
Attention: )
EXHIBIT A
This documem is exempt from the
pursuant m Govemment Code See
DECLARATION OF CONDITIONS, COVENANTS
AND RESTRICTIONS
This DECLARATION OF CONDITIONS, COVENANTS AND RESTRICTIONS (the
"Declaration") is hereby made as of August 16, 2005 by the SAN JUAN CAPISTRANO
COMMUNITY REDEVELOPMENT AGENCY, a public body, corporate and politic (the
"Agency"), in its capacity as the owner of the real property located in the City of San Juan
Capistrano, County of Orange, State of California, which is legally described in Exhibit "A" attached
hereto and incorporated herein.
RECITALS
A. The Agency is the owner of fourteen (14) existing units of single family rental
housing (the "Housing Units") located on Assessor's Parcel Nos. 649-281-05, 121-142-01, and 121-
142-07 in the Los Rios District, adjacent to Mission Street and Ramos Street in the City of San Juan
Capistrano (the "Housing Development"). The Housing Development is legally described in the
Legal Description attached hereto as Exhibit "A" and incorporated herein. The Agency may also, at
its discretion, construct or acquire additional Housing Units within the Housing Development and/or
within the Agency's project area boundaries at some time'in the future.
B. By this Declaration, the Agency desires to provide for the long-term restriction of all
of the Housing Units within the Housing Development, as well as any future rental housing units
constructed and/or acquired by the Agency within the Housing Development, to persons of Very
Low Income and Lower Income at an Affordable Rent (as those terms are defined herein).
NOW, THEREFORE, the Agency hereby declares that all of the real property described
above and all improvements thereon shall be subject to the following protective conditions,
covenants, restrictions and equitable servitudes:
1. Income Requirements. Four (4) of the Housing Units within the Housing
Development shall be made available, rented and occupancy -restricted to Lower -Income Households
at an Affordable Rent, and an additional ten (10) of the Housing Units within the Housing
Development shall be made available, rented and occupancy -restricted to Very -Low Income
the effective date of this Declaration, those additional units shall be rented and occupancy -restricted
to Lower -Income Households at an Affordable Rent. The income requirements shall be set in
accordance with Section III (B) of the San Juan Capistrano Community Redevelopment Agency
Little Hollywood Affordable Rental Housing Program Guidelines & Operating Procedures.
Tenant households occupying a Housing Unit prior to the effective date of this Declaration
may be exempt from the above income requirements provided: (1) the household's income does not
exceed eighty percent (8051o) of the Orange County annual median income; and (2) the household is
in compliance with the San Juan Capistrano Community Redevelopment Agency Little Hollywood
Affordable Rental Housing Program Guidelines & Operating Procedures.
For purposes of this Declaration, "Lower -Income Households" shall mean those households
with incomes that do not exceed the maximum lower income limits for Orange County, adjusted for
family size, as established and amended from time to time by the State of California pursuant to
Health and Safety Code Section 50079.5.
For purposes of this Declaration, "Very -Low Income Households" shall mean those
households with incomes that do not exceed the maximum very low income limits for Orange
County, adjusted for family size, as established and amended from time to time by the State of
California pursuant to Health and Safety Code Section 50105.
2. Housing Unit Size. The housing unit size shall be in accordance with Section V of
the San Juan Capistrano Community Redevelopment Agency Little Hollywood Affordable Rental
Housing Program Guidelines & Operating Procedures.
3. Affordable Rent. The affordable rent shall. be in accordance with Section VI of the
San Juan Capistrano Community Redevelopment Agency Little Hollywood Affordable Rental
Housing Program Guidelines & Operating Procedures.
4. Income Certification. The Agency shall annually complete an income certification'
form ("Income Certification'), in the form attached hereto as Exhibit B and incorporated herein, or
such other form as the Agency may determine. In the Income Certification form the Agency shall
certify that all of the tenants of the Housing Units meet the income restrictions of Section 1. The
Agency shall annually obtain an income certification from each tenant of a Housing Unit, in the form
attached hereto as Exhibit C and incorporated herein, or such other form as the Agency may
determine, which shall certify that the income of the tenant is truthfully set forth in the income
certification form. The Agency shall use its best efforts to verify the information set forth in the
tenant's income certification submitted by each tenant of a Housing Unit at the time of submission of
such certification, in one or more of the following methods:
i. obtain two (2) paycheck stubs from the tenant's two (2) most recent pay
periods, if any.
ii, obtain a true copy of an income tax return from the tenant for the most recent
tax year in which a return was filed, if any.
obtain an income verification certification from the employer of the tenant, if
any.
iv. obtain an income verification certification from the Social Security
Administration and/or the California Department of Social Services if the tenant receives assistance
from such agencies, if any.
V. obtain an alternate form of income verification reasonably requested by the
Agency, if none of the above forms of verification is available.
5. Administration of Declaration. The Agency may appoint an administrator as its
agent in the administration of this Declaration (the "Administrator"). If the Agency has not
appointed an Administrator, the tern "Administrator" shall mean the Agency. The Administrator
shall monitor compliance of the Housing Development with the requirements set forth herein on
behalf of the Agency and shall provide the Agency with notice of any circumstances of non-
compliance of which it becomes aware.
6. Duration of Affordability Requirements. The requirements of this Declaration
shall apply to the Housing Development for fifty-five (55) years from the effective date of this
Declaratiori. Except for Housing Units existing as of the effective date of this Declaration, the
affordability requirements for any new units added to the Housing Development shall become
effective from the date of issuance of the Certificate of Occupancy for each such unit.
7. Non -Discrimination Covenants. The Agency covenants by and for itself, its
successors and assigns, and all persons claiming under or through them that there shall be no
discrimination against or segregation of any person or group of persons on account of race, color,
religion, sex, marital status, familial status, disability, national origin, or ancestry in the sale, lease,
sublease, transfer, use, occupancy, tenure, or enjoyment of the Site, nor shall Agency itself or any
person claiming under or through it, establish or permit any such practice or practices of
discrimination or segregation with reference to the selection, location, number, use or occupancy of
tenants, lessees, subtenants, sublessees, or vendees in the Site. The covenants established in this
Section 7 shall, without regard to technical classification and designation, be binding for the benefit
and in favor of the Agency and its successors and assigns, and shall remain in effect in perpetuity.
8. Compliance with Guidelines. The Agency shall operate the Housing Development
and cause the tenants of the Housing Units to comply with the Little Hollywood Affordable Rental
Housing Program Guidelines and Operating Procedures, The Agency may revise and replace the
guidelines from time to time.
9. Binding Effect. This Declaration shall run with the land, and all of the terms,
covenants and conditions of this Declaration shall be binding upon the Agency and the successors
and assigns of the Agency with respect to the ownership of the Housing Development. Whenever the
term "Agency" is used in this Declaration, such term shall include any other successors and assigns
to Agency with respect to the ownership of the Housing Development as herein provided.
10. Third Party Beneficiaries. This Declaration is made and entered into for the sole
protection and benefit of the Agency and its permitted successors and assigns, and no other person or
persons shall have any right of action hereon; provided, however, that the City of San Juan
Capistrano shall be a third party beneficiary of this Declaration with rights of enforcement.
11. Partial Invalidity. If any provision of this Declaration shall be declared invalid,
illegal, or unenforceable, the validity, legality, and enforceability of the remaining provisions hereof
shall not in any way be affected or impaired.
12. Governing Law. This Declaration shall be construed in accordance with and be
governed by the laws of the State of California. Any references herein to particular statutes or
regulations shall be deemed to refer to successor statutes or regulations, or amendments thereto.
IN WITNESS WHEREOF, the Agency has executed this Declaration as of the date and
year set forth above.
SAN JUAN CAPISTRANO COMMUNITY
REDEVELOPMENT AGENCY, a public body,
corporate and politic
Joe Soto, Chairman
ATTEST:
Margaret R. Monahan, Agency Clerk
APPROVED AS TO FORM:
Stradling Yocca Carlson & Rauth
Special Counsel to the Agency
EXHIBIT A
LEGAL DESCRIPTION
That real property located in the State of California, County of Orange, City of San Juan
Capistrano, and described as follows:
PARCEL 1: Lot 2 in Block 2 of the Townsito of. San Juan Capistrano, in
the City of San Juan Capistrano, County of Orange, State of California,
per map recorded in book 3, pages 120 to 125 'inclusive of Miscellaneous
Records of Los Angeles County, California, together with that portion of
Water Street abandoned by Resolution No. 654 of the Board of Supervisors
of 'Orange County, recorded on November 16. 1920, in book 15, page 307 of
Miscellaneous Records of said Orange County.
Excepting therefrom that portion of said land included within the land
described as Parcel L2-108 in the final order of condemnation by Orange
County Flood Control District, a certified copy of which Was ,recorded
April 1, 1963 in book 6490, page 314 of Official Records, which lies
westerly `of a line that begins at a point in the Southerly line of Lot
51 of Tract 103, as shown on a map thereof recorded in book 1,1, pa es 29
to 33 inclusive, of Miscellaneous Maps, records of Orange County, California,,
distant thereon North 84" 08' 31" East 30 feet from the Southwest corner
of said Lot 51, and running thence North 15° 07' 29" West 195.89 feet;
thence North 20° 45' 07" East 88.35 feet to,a�point on the Southerly
line of Water Street, now known as Ramos Street, as shown on the quip of
said Tract No. 103, distant thereon North 79" 54' 31" East 301.02 feet,
from the Westerly tenninus'of said Southerly line.
PARCEL 2:
Lot 3 in Block 1, of the Townsite of San Juan Capistrano, in the City of
San Juan Capistrano, County of Orange, State of California, per map
recorded in book 3, pages 120 to 125 inclusive of Miscellaneous Records
of Los Angeles County, California.
Excepting therefrom that portion of said land included within the land
described as Parcel L2-110 in the final order of condemnation by Orange
County Flood Control District, a certified copy of which was recorded
April 1, 1963 in book 6490, page 314 of Official Records, which lies
Westerly of a line which is parallel and concentric with and Easterly 85
feet from a line that begins at a point on.the centerline of Cal. Obispo
Street as described in the deed to, the County of Orange, recorded December
9. 1943, in book 1224, page.177 of Official Records, in the office of
the County Recorder of said Orange County, distant thereon N. 82" 34'
32" E. 239.22 feet from the intersection of said centerline with the
centerline of Alipaz Street; thence.N. 7" 25' 28" W., 442.52 feet to the
beginning of a tangent curve, concave*We;terly and having a radius'of
1500.00 feet; thence Northerly. 510.00 feet along ,said curve through a
central angle 'of 19" 28' 50"; thence tangent to said curve N. 26° 54'.
Exhibit A-1
oocsoO 7494v1=99.00N
18' W., 1951.84 feet to a point on the North line of Parcel 00' as shown
on the omp of San Juan Capistrano and Vicinity, filed in book 2, pages
31 to 38 inclusive of Record of Surveys in the office of said County
Recortler, distant thereon N. 74. 44' 58' E. 951.57 feet from a capped
iron pipe marked 'J.F.D.' at the Westerly terminus of that certain
course cited as 'S. 73. 59' W., 1076.6' on said map of San Juan Capistrano
and vicinity.
PARCEL 1 Lot 4 in Block 1 of the Townsite of San Juan Capistrano, in
the City of -San Juan Capistrano, County of Orange, State of California,
as shown on a map recorded in Book 3, pages 120 to 123 inclusive of
Miscellaneous Records of Los Angeles County, California, together with
that portion of Water 8 Tract abandoned by Resolution No.. 654 of•the
Board of Supervisors of Orange County, recorded on November 16, 19209 in
book 15, page 307 of Miscellaneous Records of said Orange County. -
Excepting therefrom that .portion of said land. included within the land
described as Parcel L2-109 in the Final Order of Condemnation by Orange
County Flood Conptrol District, a certified copy of which was recorded
April 1, 1963, In book 6490. page 314 of Official Records, which lies
Westerly of a line which is parallel and concentric with and Easterly 85
feet from a line that begins at a point on the centerline of Dei Obispo
Street as described• in the deed to the County of Orange recorded December
9, 1943, in book 1224, page 177 of Official Records, in the office of
the County Recorder of said Orange County, distant thereon N. 82' 34'
32' E., 239.22 feet from the intersection of said centerline with the
centerline of Alipes Street; thence N. 7. 23' 23' W., 422.52 feet to the
beginning of a tangent curve concave Westerly and having a radius of
1500.00 feet; thence Northerly 510.00 feet along said curve through a
central angle of 19. 28' 500; thence tangent to said curve N. 26. 64'
18' W., 1951.84 feet to a point on the North line of Parcel '0' as shown
on the map of San Juan Capistrano and vicinity filed in book 2, pages 31
to 32 inclusive of Record of Surveys in the office of said County Recorderp
distant thereon N. 74' 44' 58' E., 931.57 feet from a capped iron pipe
marked 'J.F.D.' at the Westerly tangious of that certain course sited as
'S. 73. 39' W., 1076.6' on said map of San Juan Capistrano and vicinity.
EXHIBIT A
AP.N. 649-281-04 & 649-281-05
OPER7Y_--
THAT CERTAIN PIECE OF PARCEL OF LAND, BEING.A PORTION OF LOT
2 IN BLOCK 1 OF SAN JUAN C_APISTRANO TOWNSITE, IN THE CITY OF
SAN JUAN CAPISTRANO, COUNTY OF ORANGE, STATE OF CALIFORNIA,
AS RECORDED IN MISCELLANEOUS RECORDS BOOK ;3, PAGE 120,
RECORDS OF LOS ANGELES COUNTY, CALIFORNIA, MORE PARTICULARLY
DESCRIBED AS FOLLOWS:
COMMENCING AT AN IRON PIPE MARKING THE SOUTHEAST CORNER OF
ABOVE MENTIONED LOT 2, 'BLOCK 1, AND RUNNING THENCE NORTH 890
29' WEST 562.70 FEET ALONG THE SOUTH LINE OF ABOVE MENTIONED
LOT 2, BLOCK 1 TO AN IRON PIPE IN SAID SOUTH LINE DISTANT
85.00 FEET FROM THE, SOUTHWEST CORNER OF SAID LOT 2; THENCE
NORTH 190 42' EAST 171.60 FEET TO A POPLAR TREE, THENCE
NORTH 80 22' WEST 171.60 FEET TO A'PIPE; THENCE NORTH 660
10' EAST 49.50 FEET" TO A PIPE; THENCE SOUTH 140 40' EAST
248.35 FEET TO A PIPE AT AN OLD FENCE CORNER; THENCE ALONG
SAID FJWCE NORTH 860 28' EAST 174.81 FEET; THENCE SOUTH 870
41' EAST 173.95 FEET; THENCE SOUTH 90 48" EAST 67.71 FEET;
THENCE ON A LINE PARALLEL TO THE SOUTH LINE OF SAID LOT 2,
SOUTH 890 29' EAST 52.77 FEET TO A POINT IN THE EAST LINE ON
SAID LOT 2; THENCE SOUTH 90 48' EAST 53.46 FEET ALONG SAID
EAST LINE OF LOT 2 TO THE PLACE OF BEGINNING.
EXCEPTING THEREFROM THE FOLLOWING: BEGINNING AT THE
NORTHWESTERLY CORNER OF LOT 5 IN 'BLOCK 1 OF SAN JUAN
CAPISTRANO, AS SHOWN ON A MAP RECORDED IN BOOK 3, PAGE 120,
ET SEQ., OF MISCELLANEOUS RECORDS OF LOS ANGELES COUNTY,
CALIFORNIA, SAID CORNER BEING THE SOUTHEASTERLY CORNER OF
IAT 87 AS SHOWN ON A LICENSES SURVEYORS' MAP FILED IN BOOK
2, PAGE 34, RECORD OF SURVEYS IN THE OFFICE OF THE COUNTY
RECORDER OF ORANGE COUNTY; THENCE NORTH 90 48' WEST 53.46
FEET TO THE SOUTHEASTERLY CORNER OF LOT 88 AS SHOWN ON SAID
RECORDS OF SURVEYS; THENCE NORTH 890 29' WEST ALONG THE
SOUTH LINE OF SAID LOT, 88, 10.16 FEET TO THE TRUE POINT OF
BEGINNING .OF THE LAND HEREIN DESCRIBED; THENCE CONTINUING
NORTH 890 29' WEST ALONG THE SOUTH LINE OF SAID LOT 88 AND
SAID LINE EXTENDED WESTERLY, 60 FEET; THENCE SOUTH 90 48'
EAST 40.66 FEET; THENCE SOUTH 890 29' EAST 60 FEET;CE
NORTH 90 48' WEST 40.66 FEET TO THE TRUE POINT OF BEGINNING.
ALSO EXCEPTING THEREFROM THE FOLLOWING:
THE NORTHERLY 100 FEET OF THAT CERTAIN PARCRLOF LAND
DESCRIBED IN DEED TO FIDEL SEPULVEDA AND L.A. SEPULVEDA, HIS
WIFE; -RECORDED IN BOOK 360, PAGE 173, OF DEEDS, RECORDS OF
ORANGE COUNTY, AND BEING MORE PARTICULARLY DESCRIBED AS
FOLLOWS:
EXHIBIT A
ORDER NO 19706530-08
BEGINNING AT THE MOST NORTHERLY CORNER OF PROPERTY DESCRIBED
IN THE ABOVE MENTIONED DEED AND RUNNING THENCE FROM SAID
POINT OF BEGINNING SOUTH 140 40' EAST ALONG THE EASTERLY
LINE OF SAID PROPERTY,,, 100 FEET, THENCE SOUTH 66' 101 -•WEST
60.89 FEET TO A POINT IN THE WESTERLY LINE- OF SAID PROPERTY;
THENCE NORTH Be 22' WEST 102.43 FEET TO THE NORTHWEST -CORNER
OF SAID PROPERTY; THENCE NORTH 66° '10' EAST 49.50 FEET TO
THE POINT OF BEGINNING.
EXHIBIT A
CERTIFICATION OF TENANT INCOME
The undersigned, being duly authorized to execute this certificate on behalf of the
San Juan Capistrano Community Redevelopment Agency (the "Agency"), hereby represents and
warrants that:
1. The undersigned has read and is thoroughly familiar with the provisions of the
Declaration of Conditions, Covenants and Restrictions (the "Declaration") made by the Agency.
2. As of the date of this certificate, the following number of residential units within the
housing development located on the northeast portion of the Los Rios District, adjacent to Mission
Street and Ramos Street in the City of San Juan Capistrano (the "Housing Development"), (i) are
currently occupied by tenants qualifying as Lower Income Households and Very Low Income
Households, at not greater than the rents as required by the Declaration, or (ii) are currently vacant
and being held available for occupancy by Lower Income Households and Very Low Income
Households, and have been so held continuously since the date vacated:
Lower Income: units.
Very Low Income: _ units.
3. The unit size, the rental amount charged and collected by the Agency, the number of
occupants and the income of the occupants for each Housing Unit on the Housing Development is set
forth below. All of the following Housing Units in the Housing Development are rented at
Affordable Rent:
Unit No. Rent Number of Occupants Income of Occusputs
Dated: By:
Its:
Exhibit B-1
DOCS009774941122299,0000
TENANT'S INCOME CERTIFICATION
Unit No.
The rent and occupancy ofyour housing unit is subject to a Declaration of Conditions, Covenants
and Restrictions made by the San Juan Capistrano Community Redevelopment Agency. The
Declaration limits the rent which may be charged and the income level of tenants of the housing
units within the development. This form is required by the San Juan Capistrano Community
Redevelopment Agency under that Declaration. This form must be completed in your own
handwriting.
I. NAME OF RESIDENTS
Total number of persons in your household:
List the correct legal name of each member of your household (both adults and children):
Name:
Name:
Name:
Name:
Name:
Name:
Name:
Name:
Exhibit C-1
DOCSM977494v 1=99.0000
II. HOUSEHOLD INCOME
List all gross income earned or received by the head of the household (even if temporarily absent)
and all other adults living in your household (use additional form if necessary):
GROSS
INCOME
Household Member.
Household Member
Household Member
Household Member
Wages & Salary
(Before Deductions)
Business &
Professional Income
Interest &
Dividends
Social Security
Annuities
Insurance
,
Retirement Funds &
Pensions
Regular Gifts
Disability Benefits
Death Benefits
Unemployment
Compensation
Severance Pay
Public Assistance
(AFDC, Welfare)
Alimony & Child
Support
Armed Forces Pay &
Allowances
Other (Describe)
TOTALS
Note:. The following items are not considered income: casual or sporadic gifts; amounts specifically for or in
reimbursement of medical expenses; lump sum payments such as inheritances, insurance payments, capital gains
and settlement for personal or, property losses; educational scholarships paid directly to the student or educational
institution; government benefits to a veteran for education; special pay to a serviceman head of family away from
home and under hostile fire; relocation payments under federal, state or local law; foster child care payments; value
of coupon allotments for purpose of food under Food Stamp Act of 1964 which is in excess of amount actually
charged the eligible household; payments received pursuant to participation in the following programs: VISTA,
Service Learning Programs, and Special Volunteer Programs, SCORE, ACE, Retired Senior Volunteer Program,
Foster Grandparent Program, Older American Community Services Program, and National Volunteer Program to
Assist Small Business Experience.
Exhibit C-2
DOCSOC\9774941 l'l4Y99,0000
M. ASSETS
List the current value of all assets of everyone living in the household (Note: Do not report
necessary items such as furniture and automobiles):
ANNUAL INCOME
CALCULATION SHEET
1. Name
Family Member
2. Identification
Asset
Description
Social
Security
No.
Current Cash
Value of
Assets
Actual Income
from Assets
3. Net Cash Value of Assets:
4. Total Actual Income from
5. If line 3 is greater than
Rate) and enter results
ANTICIPATED ANNUAL
INCOME
Assets:
$5,000, multiply
here; otherwise
linaby_
leave blank
3.
(Passbook
4.
5,
Family
Members
Wages/
Salaries
Benefits/
Pensions
Public
Assistance
Other Income
Asset Income
Enter the
greater of
lines 4 or 5
from above
In e.
6. Totals
a.1
b.1
C.1
d.
e.
Enter total of items rom Be
This Is Annual Income
through Be
7.
Exhibit C-3
DOCS00977494 v 122299.0000
This affidavit is made with the knowledge that it will be relied upon by the San Juan Capistrano
Community Redevelopment Agency to determine maximum income for eligibility and (Uwe) warrant
that all information set forth in this document is true, correct and complete and based upon
information (I/we) deem reliable and based upon such investigation as (1/we) deemed necessary.
(I/We) acknowledge that (I/we) have been advised that the making of any misrepresentation or
misstatement in this affidavit will constitute a material breach of (my/our) agreement with the
Agency to rent the unit and will additionally enable the Agency to initiate and pursue all applicable
legal and equitable remedies with respect to the unit and to me/us.
(I/We) do hereby swear under penalty of perjury that the foregoing statements are true and correct.
Date Printed Name:
Date Printed Name:
Attached are true copies of the following:
_ Paycheck stubs from two most
Bank/savings account verification
recent pay periods
_ Employment verification
_ Self-employment verification
_ Income tax return
_ Unemployment verification
_ Social Security verification
_ Welfare verification
_ Alimony/child support verification
_ Disability verification
Exhibit C4
DOCSOCV774941=99.0000
STATE OF CALIFORNIA )
as.
COUNTY OF )
On before me, Notary Public,
(Print Name of Notary Public)
personally appeared
❑ personally known to me
-or-
proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/shchhey executed the same
in his/her/their authorized capecity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signature Of Notary
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form.
e
u
E
CAPACITY CLAIMED BY SIGNER
Individual
Corporate Officer
partner(s) ❑ Limited
❑ General
Attomey-In-Fact
Trustee(s) .
Guardian/Conservator
Other:
Signer is representing:
Name Of Pemon(s) Or Entity(ies)
DOCS00977494v 1\22299.000a
DESCRIPTION OF ATTACHED DOCUMENT
Title Or Type Of Document
Number Of Pages
Date Of Documents
Signers) Other Than Named Above
W
STATE OF CALIFORNIA )
ss.
COUNTY OF )
On before me, , Notary Public,
(Print Name ofNolary Public)
personally appeared
❑ personally known to me
-or-
F1 proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) istare
subscribed to the within instrument and acknowledged to me that he/she/they executed the same
in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signature Of Notary
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form. `
CAPACITY CLAIMED BY SIGNER
❑ Individual
❑ Corporate Officer
❑ parmer(s) ❑ Limited
❑ General
❑
Attomey-In-Fact
❑
Trustee(s)
❑
Guardian/Conservator
❑
Other:
Signer is representing:
Nemo Of Pmon(s) Or Er4ny(les)
DOCS009774941=99.0000
DESCRIPTION OF ATTACHED DOCUMENT
Title Or Type Of Document
Number OfPages
Date Of Documents
Signer(s) Other Than Named Above