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SUPERIOR COURT OF CALIFORNIA
COUNTY OF SAN FRANCISCO
Document Scanning Lead Sheet
Dec-24-2013 10:57 am
Case Number: CUD-13-644474
Filing Date: Dec-24-2013 10:56
Filed by: WESLEY G. RAMIREZ
Juke Box: 001 Image: 04320505
DECLARATION
NASIR PATEL VS. MARK THOMAS EDWARDS
001004320505
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DECLARATION OF MARK EDWARDS
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CLERK QE THE GOURT
BY: pl phon nun
) Case woe. 6477
) In: Declarant - Mark Edwards
For The City and County of San Francisco. )
In the Superior Court of California,
I, the declarant first duly sworn states as follow:
1. That I am party to the hereof civil dispute as defendant, and residence of the
City and county of San Francisco, California.
2. That the plaintiff herein has submitted an “Ex-parte Motion for Summary
Judgment” Claim against I the defendant on calendar 12/20/13 without
appropriate compliance of 48 hour window of supply defendant with copy.
3. That San Francisco Rules of Court and Rule > andCode§_
of Civil Procedure requires “Ex-parte Motions” that defendant be provide copy
of motion in advance to hearing to raise any intended opposition to claim.
(See Attachment of Notice & Copy provided at hearing on 12/23/13)
4. That defendants was/ and is with limited access to legal material and internet,
concerning the window to a 4 — 5 hour preparation response to plaintiff motion
as being grounds of “irreparable harm.”
5. That plaintiff inappropriate using the Ex- Parte Motion — Process System for
circumventing Summary Judgment is not within standard compliance practice
pursuant Code§ of Civil Procedure in filing and process.6.
10.
That further defendant has supportive sufficient of “withdrawing” his plead
under Code§ 473 (__ ) of Civil Procedure, demonstrating that plaintiff and his
onsite agents (manger/ family member) intention breach the terms of the contract
retaliatory and adversely in pursuant with 1) California Business & Profession
Code§ 17200, 2) Civil Code§ 1709, 3) Code§ 1942.5(a-c) of Civil Procedure and
4) Government Code§12955.8.
That supporting appendix attachment A — E is with substantial legal grounds
presented in paragraph number 6. Above
That prior and during the phase of “negotiable plead” conference April 18 and
21, 2013 and during trial on April 25, 2013 plaintiff and his agent committed
“obstruction of City Administrative Justice” regarding a pending ongoing city
arbitration hearing with San Francisco Stabilization rent broad.
That defendant last month had learn that a required hearing proceeding
schedule by acting Administrative Arbitrator of 3/26/13 proceedings had found
enough merit in declarant/ defendant claims to issue.
That another hearing schedule for April 15, 2013 which plaintiff brother and
onsite manage had knowledge of and concealed such correspondence and slipped
the letter back into defendant mailbox after the fact to “irreparable harm”
committed. (See attachments)11. That both plaintiff, his agents and the Rent Board Staff had prior knowledge of
the hearing and the “irreparable harm” committed and all silently concealed the
damages incurred.
12. That plaintiff on April 25, 2013 was unlawful coerced into an in volunteer plead
in violation of his due process and entitlement of procedure safeguard.
13. That further evidences also reveal on November 6, 2013 an “fake check” was
placed in defendant residential mailbox which open and non-protected under
San Francisco Municipal Code§ (City Residential Mail Code).
14. That according to the content address on the 1-day special deliver envelope that
discover of fictitious name using the address of Welfare Office (Social Service)
dated sent October 25, 2013 with a check concealed in the sum amount of $2,230.
15. That between the alleged time period of 1-day postal delivery service of 10/25/13,
dates stemming October 26 — 31, 2013 no such mail was defendants mailbox, and
again between November 1 — 5, 2013 the alleged 1-day postal service was not
applied.
16. That on November 6, 2013 at appropriately 2:47 pm the envelope was found
sticking out of defendant non-protected mailbox keep in the clerk office, which he
took to UPS made a copy prior to depositing it into his bank account.
17. That on November 10, 2013 the bank notify defendant and gave him a copy that
the check was fake and a list of the “irreparable damages” incurred.18. That thereafter defendant witness multiple times plaintiff's brother/ onsite
manager giving the keys to the clerk’s office to other residential tenants, which
mail was retrieve out of other residence mailbox and brought to him in the
manager office located and connected to his residential unit.
19. This occurred During the ending proportion of November 2013 multiple times.
20. That under the Urhuh Civil Rights- housing law as disable person of color
Civil Code§ 51 — 54 and 42 U.S.C. 1201, 3604, and Title I of the Americans with
Disabilities Acts of 1990 (42. U.S.C. § 12131) that plaintiff has and is imposing
fact to impose undue hardship against a person means adverse and retaliatory.
21. That defendant is not with non-compliance to a contract in regards to the pursuant
of Evidence Code§ 1116. (_ ), 1118 (b) and 1119 (_ ), where the circumstances are
beyond his control and the breach is by plaintiff and his agents.
22. That the defendant is entitled to cross “summary judgment” in view of the multiple
“irreparable injuries” he suffered that was incurred.
Hereafter Declarant Sayeth Not:
UNDER PENALTY OF PERJURY I THE DECLARANT STATES THAT
THE FOLLOWING STATEMENT GIVEN HEREOF IS TRUE AND CORRECT
Date of December 24, 2013
Mark Edwards
DeclaranResidential Rent Stabilization and Arbitration Board
City & County Of San Francisco
Esta notificacion puede afectar a sus derechos como ABER VSCAARRRB SNA
ffopietario o inquilino. Si necesita ayuda para entender este MRICS ES RAR AIBA,
aviso, por favor llame al 415-252-4602. PBB 415-252-4602,
Notice Of Mediation Session
A Tenant Petition has been filed with the San Francisco Residential Rent Stabilization and Arbitration Board involving the
property at the following location:
2048 Polk Street #308
San Francisco, CA 94109
We are pleased to notify you that Petition Number T130154 has been selected for participation in our mediation program.
A MEDIATION SESSION WILL BE HELD ON THIS PETITION ON:
Date of Mediation: 4/15/2013 Location of Office of the Rent Board
Time of Mediation: 9:00 AM- 12:30 PM Mediation Session: 25 Van Ness Ave. #320
(This mediation will start promptly at 9:00 AM.) San Francisco CA 94102
It is critical that you appear at the mediation session. If the tenant does not appear, the petition will be dismissed with
prejudice. If the landlord does not appear, an arbitration hearing will be held that day instead of a mediation
session; a decision will be issued by the Administrative Law Judge based on the testimony and evidence presented by the
tenant at the hearing. If both parties appear, but either one or both do not voluntarily agree to use the mediation process, an
arbitration hearing will be held that day instead of a mediation session. In addition, if no agreement is reached and the
Administrative Law Judge has not met privately with either party, an arbitration hearing might be held that day after the
mediation session. Therefore, you should always be prepared for arbitration even if your case is scheduled for a mediation
session. You should bring all of your documents related to the subject of the petition. You must bring an interpreter, if one is
necessary. You may also bring witnesses, an attorney or other representative. If a representative appears at the mediation
session on your behalf, s/he must bring written authorization to represent you and to settle the case on your behaif.
Be advised that you are not required to participate in a mediation. Any party has the right to elect arbitration.
Mediation offers the parties the opportunity to resolve their differences in a less adversarial setting than an arbitration
hearing. In mediation, the participants reach their own agreement, with the assistance of a neutral, independent Rent Board
mediator. The agreement must be mutually acceptable to both participants, and it is legally binding and enforceable in a
court of law. The differences between mediation and arbitration are more fully described in the enclosed memorandum
entitled “The Rent Board Offers Mediation Services.”
The mediation process will allow each participant to discuss his or her concerns. You should come prepared to make some
brief opening remarks about the subject of this petition. You should also come prepared to negotiate and discuss the
matters set out in the petition. The mediator will conduct the mediation session by meeting jointly with all participants and/or
meeting separately in a private caucus with each participant. After an agreement is reached, the mediator will prepare a
written agreement for the participants to sign and keep. If no agreement is reached, and the Administrative Law Judge has
met privately with either party, the petition will be scheduled for an arbitration hearing within 30-45 days with a different
Administrative Law Judge.
Postponement of your mediation session may be granted by the Rent Board only for good cause and in the interest of
justice. See Rent Board Rules and Regulations Section 11.13. Requests for postponement must be made in writing at the
earliest date possible. If an emergency arises which precludes a written request or if there are other questions, call the
Hearing Coordinator at 252-4629.
The petition and file in this matter may be inspected during normal business hours, 8:00 - 5:00, Monday through Friday.
Copies of the Residential Rent Stabilization and Arbitration Ordinance and the Rules and Regulations are available for
purchase and/or inspection at the Rent Board office and can also be found on our website at sfgov.org/rentboard.
Please advise the Board in writing if the case settles, so that the mediation session can be canceled.
25 Van Ness Avenue #320 24-hour Information Line 416.252.4600 Phone 415.252.4602
San Francisco, CA 94102-6033 Internet: www.sfrb.org Fax 415.252.4699Residential Rent Stabilization and Arbitration Board
City & County Of San Francisco
THE RENT BOARD OFFERS MEDIATION SERVICES
Upon review of the tenant's petition for arbitration, we have determined that this matter is ideally suited to mediation, and
we have selected this case for participation in our mediation program.** Mediation is a new and exciting alternative to the
traditional arbitration process. Through mediation, the participants develop their own agreement, instead of having an
Administrative Law Judge decide the outcome. The mediator assists and guides the participants toward a mutually
acceptable agreement. The Rent Board has successfully mediated more than 80% of the cases participating in our
mediation program.
The mediation process is flexible, to meet the needs of the participants. Each participant will have an opportunity to discuss
their concerns. Then, the participants will discuss possible resolutions together, or in separate meetings with the mediator.
At the conclusion of a successful mediation session, you will have a written agreement signed by all participants and the
mediator.
™Be advised that you are not required to participate in a mediation. All parties have the right to elect arbitration.
AT THE MEDIATION
At the mediation, you should be prepared to discuss the matters in the petition. You should bring any photographs,
documents or other things that you might need to show the mediator and the other participants. You must bring an
interpreter, if one is necessary. You may also bring witnesses, a representative and/or an attorney.
It is critical that you appear at the mediation session. If the tenant does not appear, the petition will be dismissed with
prejudice. If the landlord does not appear, an arbitration hearing will be held that day instead of a mediation session; a
decision will be made by the Administrative Law Judge based on the testimony and evidence presented by the tenant at the
hearing. If all parties appear, but either one or both do not voluntarily agree to use the mediation process, an arbitration
hearing will be held that day instead of a mediation session. Therefore, you should always be prepared for arbitration even
if your case is scheduled for a mediation session. If all parties appear and go through the mediation process but are unable
to reach agreement, an arbitration hearing will be scheduled within 30-45 days with a different Rent Board Administrative
Law Judge.
BENEFITS OF MEDIATION
The use and acceptance of mediation is growing rapidly, partly because of the benefits mediation offers. Mediation allows
participants to make their own decisions, and to influence the outcome of their mediation session. Mediation allows the
participants to create agreements that might not be available in a traditional arbitration hearing. After a successful
mediation, the participants know the outcome that same day. No further Rent Board action is needed after a successful
mediation. If an agreement is reached through mediation, that agreement is legally binding and may be enforced in a court
of law. The tenant would be required to withdraw his/her petition after the parties sign the agreement. Information used in
the mediation process is kept confidential; no tape recording is made of the proceedings. If the parties agree, the mediation
agreement itself may be kept confidential. In such cases, no copy of the agreement will be kept on file with the Rent Board.
COMPARISON OF MEDIATION AND ARBITRATION
Mediation Arbitration
Parties reach a mutually-acceptable The Administrative Law Judge interprets the
solution on their own terms. facts and applies the relevant laws.
Resolution reached at the mediation - Decision issued approximately 8-10 weeks
no further Rent Board action is needed. after the hearing.
No appeal. The agreement is legally Appeal may be filed within 15 days and can
binding on all parties. take months to resolve.
Agreement enforceable in court. Decision enforceable in court.
Hearing not tape recorded. The process Hearing is tape recorded and available at cost.
and agreement may be kept confidential. Tapes and written decision are part of public record.
25 Van Ness Avenue #320 24-hour Information Line 415.252.4600 Phone 415.252.4602
San Francisco, CA 94102-6033 Internet: www. sfrb.org Fax 415.252.4699Residential Rent Stabilization and Arbitration Board
City & County Of San Francisco
- Esta notificacion puede afectar a sus derechos como AAAS RES SCS AR RRB SHEA.
propietario o inquilino. Si necesita ayuda para entender este | #0 PIB BRA RT RAS,
‘aviso, por favor llame al 415-252-4602. RMB 415-252-4602,
Proof of Service Proof of Service page 1
CASE NO. 1130154
| am over the age of 18, not a party to this case, and am employed at 25 Van Ness Avenue #320, San Francisco,
California, 94102. | served a copy of the attached:
Administrative Postponement/Notice of Rescheduled Hearing
regarding the property at 2048 Polk Street #308 by placing a true copy in a sealed envelope with postage prepaid in the
United States mail at San Francisco, California, on the date shown below, and addressed to the parties as shown below.
Name Property Address Mailing Address
Landlord Respondent
Lorrine and Raymond Choy 170 23rd Avenue
San Francisco, CA 94121
Landlord Non-Attorney Rep
Ovays Patel 2048 Polk Street #1
San Francisco, CA 94109
Nasir Patel 2048 Polk Street, Manager's Office
San Francisco, CA 94109
Tenant Petitioner
Sunshine R. Cuthbertson 2048 Polk Street #308 2048 Polk Street #308
San Francisco, CA 94109 San Francisco, CA 94109
Tenant Non-Attorney Rep
Mark Thomas Edward 2048 Polk Street #308 2048 Polk Street #303
San Francisco, CA 94109 San Francisco, CA 94109
| declare under penalty of perjury that the foregoing is true and correct and that this declaration is executed on the date
shown below at San Francisco, California.
Signed: ‘ Dated: 4/5/2013
25 Van Ness Avenue #320 24-hour Information Line 415.252.4600 Phone 415.252.4602
San Francisco, CA 94102-6033 Internet: www. sfrb.org Fax 415.252.4699City and County of San Francisco Residential Rent Stabilization
and Arbitration Board
REQUEST FOR POSTPONEMENT OF HEARING
if you or a representative cannot attend the scheduled hearing due to unforeseen circumstances or pre-
arranged plans which cannot be changed, you may request a postponement.
Requests must be made in writing at the earliest date possible with supporting documentation
attached. If an emergency arises which precludes a written request or if there are other questions, call
the hearing coordinator at 252-4629.
Postponements may be granted by the Administrative Law Judge only for good cause and in the
interest of justice. Mere inconvenience or difficulty in appearing shall not constitute good cause. See
Board Rules and Regulations Section 11.13.
Before the hearing time, you will be notified of the determination on the postponement request either by
telephone call from the Rent Board or by mail.
Name (please print): Administrative Postponement
Property Address: 2048 Polk Street #308
Day and Date of Hearing: Monday, April 15, 2013
Time of Hearing: 9:00 am — 12:30 pm
Case Number(s): 7130154
Reason for Postponement: _The Administrative Law Judge is unavailable on 4/15/13, so the
Mediation has been rescheduled for a later date. See the box below for the new date and time.
Q Supporting documents attached Q Other parties notified of this
Q Other parties agree to this postponement. postponement request.
DETERMINATION ON POSTPONEMENT REQUEST
- ] Not Granted @ Granted
By: S 1 ”) ab Date: April 5, 2013
Sandra Gartzman, Senior Administrative Law Judge
A rescheduled mediation will be held on Monday, April 29, 2013, from 9:00
Comments: a.m. — 12:30 p.m., without further notice. The mediation will start promptly at
9:00 a.m. Postponements may be granted for good cause only and must be
requested in writing. For additional information, call the Hearing Coordinator
at 252-4629.
581 Request for Postponement 11/13/06
25 Van Ness Avenue #320 Phone 415.252.4602
San Francisco, CA 94102-6033 FAX 415.252.4699 :Residential Rent Stabilization and Arbitration Board
City & County Of San Francisco
Esta notificacion puede afectar a sus derechos como AAS TROVE AARRRES NEF
propietario o inquilino. Si necesita ayuda para entender este | M1R/SA ERAT AIBA.
aviso, por favor llame al 415-252-4602. GBR 415-252-4602,
Proof of Service Proof of Service page 1
CASE NO. 7130154
| am over the age of 18, not a party to this case, and am employed at 25 Van Ness Avenue #320, San Francisco,
California, 94102. | served a copy of the attached:
Notice of Mediation Session
regarding the property at 2048 Polk Street #308 by placing a true copy in a sealed envelope with postage prepaid in the
United States mail at San Francisco, California, on the date shown below, and addressed to the parties as shown below.
Name Property Address Mailing Address
Landlord Respondent
Lorrine and Raymond Choy 170 23rd Avenue
San Francisco, CA 94121
Landlord Non-Attorney Rep
Ovays Patel . 2048 Polk Street #1
San Francisco, CA 94109
Nasir Patel 2048 Polk Street, Manager's Office
San Francisco, CA 94109
Tenant Petitioner
Sunshine R. Cuthbertson 2048 Polk Street #308 2048 Polk Street #308
San Francisco, CA 94109 San Francisco, CA 94109
Tenant Non-Attorney Rep
Mark Thomas Edward 2048 Polk Street #308 2048 Polk Street #303
San Francisco, CA 94109 San Francisco, CA 94109
| declare under penalty-of\perj
joing is true and correct and that this declaration is executed on the date
shown below at San et -
ye
¢
Signed: qe Dated: 3/22/2013
25 Van Ness Avenue #320 24-hour Information Line 415.252.4600 Phone 415.252.4602
San Francisco, CA 94102-6033 Internet: www. sfrb.org Fax 415.252.4699Residential Rent Stabilization and Arbitration Board
City & County Of San Francisco
Esta notificacion puede afectar a sus derechos como AROS ROLE CAARRRE SNA
propietario o inquilino. Si necesita ayuda para entender este ROR ES RBI T RAIA,
aviso, por favor llame al 415-252-4602. FRE 415-252-4602,
Proof of Service Proof of Service page 1
CASE NO. 17130154
| am over the age of 18, not a party to this case, and am employed at 25 Van Ness Avenue #320, San Francisco,
California, 94102. | served a copy of the attached:
Dismissal
regarding the property at 2048 Polk Street #308 by placing a true copy in a sealed envelope with postage prepaid in the
United States mail at San Francisco, California, on the date shown below, and addressed to the parties as shown below.
Name Property Address Mailing Address
Landlord Respondent
Lorrine and Raymond Choy 170 23rd Avenue oatot
San Francisco,
Landlord Non-Attorney Rep
Ovays Patel 2048 Polk Street #1
San Francisco, CA 94109
Nasir Patel 2048 Polk Street, Manager's Office
San Francisco, CA 94109
Tenant Petitioner
Sunshine R. Cuthbertson 2048 Polk Street #308 2048 Polk Street #308
San Francisco, CA 94109 San Francisco, CA 94109
Tenant Non-Attorney Rep
Mark Thomas Edward 2048 Polk Street #308 2048 Polk Street #303
San Francisco, CA 94109 San Francisco, CA 94109
| declare under penalty of perjury that thé foregoing is true and correct and that this declaration is executed on the date
shown below at San Francis¢6 , Californja-
Signed: xy WA cL Dated: 5/7/2013
25 Van Ness Avenue #320 24-hour Information Line 415.252.4600 Phone 415.252.4602
San Francisco, CA 94102-6033 Internet: www.sfrb.org Fax 415.252.4699Law Construed:
Ordinance Section: 37.8(f)
Rules and Regulations Sections: 11.14(a)&(b)
Index Code: M1
RESIDENTIAL RENT STABILIZATION AND ARBITRATION BOARD
CITY AND COUNTY OF SAN FRANCISCO
IN RE: 2048 POLK STREET (#308) CASE NO. 7130154
SUNSHINE CUTHBERTSON, HEARING: APRIL 29, 2013
TENANT PETITIONER,
DISMISSAL
and
LORRAINE and RAYMOND CHOY,
LANDLORD RESPONDENTS.
INTRODUCTION
On February 4, 2013, the tenant filed a petition with the Rent Board alleging a
substantial decrease in housing services without a corresponding reduction in rent, that the
landlords failed to perform requested repair and maintenance that is required by law, and that
the landlords violated the federal Fair Housing Act.
On March 22, 2013, the tenant and her non-attorney representative were sent notice
at their respective addresses identified on the petition of a mediation session scheduled on the
petition for April 15, 2013 at 9:00 a.m. The notices were not returned to the Rent Board by the
post office. On April 5, 2013, the tenant and her representative were sent notices at the same
addresses that the April 15 hearing date was postponed due to the unavailability of the
Administrative Law Judge, and that a rescheduled mediation session on the petition was set for
April 29, 2013 at 9:00 a.m. These notices were not returned to the Rent Board by the post
office. The tenant petitioner and her representative failed either to appear for the mediation
session scheduled for April 29, 2013 at 9:00 a.m. or to file a written excuse for non-appearance.Rent Board staff left voice mail messages for the tenant petitioner and her representative at the
_ telephone numbers listed on the petition on the day of the hearing. The property manager
appeared at the scheduled mediation session.
ORDER
1. In accordance with Rules and Regulations Section 11.14(a), Petition 7130154
is dismissed with prejudice for the tenant's failure to appear.
2. This Dismissal is final unless the Rent Board vacates the Dismissal following
appeal to the Board. The parties must file appeals no later than fifteen calendar days from the
date of the mailing of this Dismissal, on an appeal form available from the Rent Board.
[Ordinance Section 37.8(f)(1)] If the fifteenth day falls on a weekend or legal holiday, then the
parties may file their appeals on the next business day.
3. If the tenant bases an appeal substantially on the fact that notice of hearing
was not received, the tenant must attach declarations under penalty of perjury on a form
provided by the Rent Board. The declaration must include facts to support the contention that
the notice was not received. [Rules and Regulations Section 11,14(b)]
‘
co ey
Dated: May 7, 2013
Adena S. Gilbert
Administrative Law Judge.
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October 25 2013 a
MAIL Mate fon 20 91045 5
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Commercial Ps Price 971800759150
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|
“REQUIRED KEN WALTER Ship Date: 1025/13,
SQUIRED ! Pe eeoAShny CA S1945 (267) cons
| WAIVER OF SIGNATURE
|
MARK EWDARDS
ere: | MARK EWDARDS
| 2048 POLK ST #303
| SAN FRANCISCO CA 94109-2520
|
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PART OF THE SANTANDER GROUP OFFICIAL CHECK
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See RRRARK RAE EH EERE? 250.00
10/28/2013
Branch: 0569
PAY TO THE
ORDER OF *e* Mark Ewdards *«**
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Drawer: Sovereign Bank, N.A.
AUTHORIZED SIGNATURECHASE
syea/ia 2098 Re oumhene CHASE G CHASE ©
ATM CA8927
10/32/13 03:12 PM CARD s28— 31/23/13 10:34 a CARDK 4918
Sequence# 1410 100 Hat ‘*, an Francisco CA 1500 Polk St, San Francisco CA 7
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it chSSI, or Supplemental Security Income, is a
tederal program that provides monthly cash
payments to people in nced. SST is for people
who are 65 or older, as well as for blind or
disabled people of any age, inchiding children.
To quality you also must have little or no
income and few resources. This means that the
value of the things you own must be less than
$2,000 if you are single or less than $3,000 if
you are married. The value of your home does
not count if you live in it. Usually, the value
of your car does not count. And the value of
certain other resources, such as a burial plot,
may not count either.
To receive SSI, you also must apply for any
other cash benefits you may be able to get.
You must live in the United States or the
Northern Mariana Islands to receive SSI. If
you are not a U.S. citizen, but you are lawfully
residing in the United States, you still may be
able to receive SSI. For more information, ask
for Supplemental Security Income (SSI) For
Noncitizens (Publication No. 05-11051).
The state of California adds money to the
federal payment. The single payment you get
in the beginning of each month includes both
the federal SSI payment and your supplement
from California.
If you receive SSI, you usually can get
medical assistance (Medi-Cal] automatically. A
separate Medi-Cal application is not necessary.
If you have questions about Medi-Cal, contact
your local county welfare office
People who receive SSI in California cannot
get Supplemental Nutrition Assistance Program
(SNAP), formerly known as food stamps
because the state adds moncy to the federal SSI
payment instead.
However, you may be able to get SNAP:
* While you are waiting for a decision on your
SSI application;
* If your application for SSI is denied; or
* If you move to another state.
For more information, contact your local
county welfare office.
Other services you may be able to get through
your local county welfare office include:
* A special allowance for assistance dogs for
people who are blind or have a disability,
* Certain domestic and personal care services
are provided to eligible aged, blind, and
disabled persons who cannot perform the
services themselves and who cannot safely
remain in their own homes unless such
services are provided; and
* Protective services.
For more information, contact your local
county welfare office.
(over)
Supplemental Security Income (SSI} In CaliforniaSingle people : : : ‘Aged Disabled
Independent living status "$866.40 "$866.40
Non-medical out-ofhome care _ : $1,122.00 ~~: $1,122.00
Independent living status, no cooking facilities $950.40 395040 “$710.00, |
Living in the houschold of someone else $633.17 : + $633.17 8688.17
$773.40
40.17
Disabled minor child
"Disabled minor child in the household of another
Aged or disabled couples
t living status
Independe
Non-medical out-of-home care
Independent living status, no cooking facili
Li
$1,630.20
$1,112.00
ving in the household of sor
Independent living status eee $1,609.20
Living in the household of someone else bate: |
or disabled spouse
ses s eB
For more information and to find copies of our publications, visit our website at
www-socialsecurity.gov or call toll-free, 1-800-772-1213 (for the deaf or hard of hearing, call
our TTY number, 1-800-325-0778). We treat all calls confidentially. We can answer specific
questions fromi 7 a.m. to 7 p.m., Monday through Friday. Generally, you'll have a shorter wait
time if you call during the week after Tuesday. We can provide information by automated phone
service 24 hours a day.
We also want to make sure you receive accurate and courteous service. That is why we have a
second Social] Security representative monitor some telephone calls.
see, Social Security Administration
g 7X SSA Publication No. 05-11125
Z iif \ January 2013 (Recycle prior editions}
Passer
Printed on recycled paperSAN FRANCISCO HOUSING AUTHORITY
2013 PURGE COVER LETTER
Any individual with a disability or other medical need who needs accommodation with respect to this correspondence should inform the agency.
IMPORTANT & URGENT
October 26, 2013
Client #74311
se seeeeeeee4 AUTO**SCH S-DIGIT 94109
eee LT ead ieee |
MARK EDWARDS
2084 POLK ST # 303
SAN FRANCISCO CA 94109-2520
Re: 2010 Public Housing/ 2001 Housing Choice Voucher (Section 8) Program Waiting List Purge
Dear Applicant:
The San Francisco Housing Authority is in the process of purging the 2010 Public Housing/ 2001 Housing
Choice Voucher (Section 8) Program Waiting List. You must respond to remain on the Waiting List.
In order to remain on the Waiting List, you must update your waitlist status by:
1) Completing and mailing or delivering the attached form titled “San Francisco Housing Authority
2013 Purge Form” within fifteen (15) working days.from the date of this letter to:
San Francisco Housing Authority
ATTENTION: 2013 Waitlist Purge
1815 Egbert Avenue
San Francisco, CA 94124 OR
2) Completing the form online at www. SFHA.org by completing the “Check Wait List Module”
within fifteen (15) working days from the date of this letter.
If the SFHA does not receive your response by FRIDAY, NOVEMBER 29, 2013, THE
SFHA WILL WITHDRAW YOUR APPLICATION FROM THE WAITING LIST.
If you request a reasonable accommodation for any special needs, including the need to receive
alternate forms of communication, please advise us of such needs.
Thank you,
San Francisco Housing Authority
Waitlist Purge Project
1815 EGBERT AVENUE, SAN FRANCISCO, CALIFORNIA 94124.
TELEPHONE: (415) 715-3280
TTY: 415.467.6754
WWW.SFHA.ORGSAN FRANCISCO HOUSING AUTHORITY
2013 PURGE FORM
Any individual with a disability or other medical need who needs accommodation with respect to this correspondence should inform the agency.
The English Version of this letter MUST be completed and signed. The translated versions are for reference purposes ONLY.
1AM INTERESTED
DATE iN ONE \pec \ 2. S\ g Hev fr -
CLIENT # WMN2M , PUBLIC HOUSING
NAME MARC EDWARDS foes Los Pole Svea st3z
CNno
San Franciscs, &
ay (oF
TELEPHONE NUMBER (
EMAIL ADDRESS. @
EMPLOYED Cl yYes (no CI Full-Time [_] Part-Time
ANNUAL INCOME $ OTANF OWAGES OGA OSS SSI GUNEMPLOYMENT
HOUSEHOLD MEMBERS | 901 002 003 004 005 006 007 008 009 010
RACE Datrican American [] American Indian and Alaska Native [J Asian C)Native Hawaiian and Pacific islander] White
ETHNICITY 0 Hispanic or Latino O Non-Hispanic or Latino
LOCAL PREFERENCES
1 Veteran/Surviving Spouse of Veteran (assoure) | L] Veteran/Surviving Spouse of Veteran (Absolute)
HCV PUBLIC HOUSING
Please mark one box only. Please mark one box only.
C1 san Francisco District Attorney Referral (Absolute)
C1 Public Housing Resident Approved for Emergency Transfer (absoiste) | C1 involuntarily Displacement in San Francisco (points)
1 involuntarily Displacement in San Francisco ‘spoinsy | C1 Hometess Family in San Francisco (S points)
Cl Hometéss Family in San Francisco (S points) oe Senior or Person With Disability in San Francisco (5 points}
Bonen Senior or Person With Disability in San Francisco Seon) Resident in San Francisco Paying More than 70% of household income in
Rent i
(Homeless Adult in San Francisco tains) | Pre (pein)
No Preference
C1 substandard Non-Homeless in San Francisco (2 points} rere
Ci Resident in San Francisco Paying More than 70% of household income in Rent (2,oins)
Li No Preference
NAME SSN DOB M/F
1) LAE be EMI AR LIL S62 - FF —V/ LQLer7hsass NM
2)
3)
4)
5)
(Please continue on the other side if additional space is needed)
APPLICANT SIGNATURE Zee Sve nck Date - L
AVAILBLE ONLINE AT WWW.SFHA.ORG “CHECK WAITLIST MODULE”. IF THE SFHA DOES NOT RECEIVE YOUR RESPONSE BY FRIDAY, NOVEMBER 29, 2013, THE SFHA
WILL WITHDRAW YOUR APPLICATION FROM THE WAITING LIST.
1815 EGBERT AVENUE, SAN FRANCISCO, CALIFORNIA 94124
TELEPHONE: (415) 715-3280
TTY: 415.467.6754
WWW.SFHA.ORGMISSION CAMPUS ESL Placement
NON-CRE LA: TE
DIT CLASS SCHEDULE by: OVW A)
Approved
1125 Valencia Street, San Francisco, CA 94110 (415) 920 - 6067
Semester/Year
Student ID # 7} toe
LEP) v9 a Pri ‘)/), 45 AUPLEASE CARRY A COPY OF YOUR CLASS SCHEDULE AT ALL TIMES.
Last Name First Name Middle Name
i al 1
é ere eh Je toge €
Date of Birth: Month / Day / Year Years of Education Country of Origin
Address : City /Zip Code Telephone #
eg a | i
Have you taken classeg at City College of San Emergency Contact: Name & Phone #
Yes / No OOS bow
~ a |! Processed by: f SEADETL Code:
Days: T “Time T Room # ] . Course / CRN # T Instructor
1 J Th | i | |
Administrative Support for the Construction Office
DAYS HOURS RM# COURSE/CRN# INSTRUCTOR
mw |08/17/11 |12/19/11 |01:00 p.m. {3:30 471 [Intro to MS Office {81133 Beavers
tr 8/18/11 [10/18/11 }01:00 p.m. [3:30 471 |MS Excel | 80774 Maeitre
mw |@8/17/11 {12/19/11 }03:30 p.m. |6:00 471 |Word Process. 81105 [Beavers
-b————|tr 18/18/11 {10/18/11 |03:30 p.m. 16:00 471 |Keyboarding 81510 |Conrad
Ltr {10/20/11 {12/20/11 |03:30 p.m. |6:00 471 [Office Proc. 81643 |Conrad
f 08/19/11 [12/16/11 }09:00 a.m. {2:00 p.m.| 470 |Computer Lab 81655 |Middleton12 Thursday, Dec. 7, 2006 Daily News ++
BY MARY ANN BUGGS
Happy Thursday to you and here's to a
great day in the crisp December air for ull
our friendly readers, Join us as we meet
two brand new Town Talkers, Wolf and
Kaan and we dare you to not race over and
be one of the first to welcome them to the
East Bay!
CORRECT # FOR COOL BREEZE -
We 1an the wrong phone number yesterday
to reach Mark Edwards of Cool Breeze ,
Home
Inspection,
Reach him
at (510)
645-9368.
Just to
refresh your
memory,
Mark is the
inspection
pro who
knows that buying a home is one of the most
important investments you'll ever make.
Because your home is also where your life
unfolds and lifelong memories are made,
you need to protect that investment with a
Cool Breeze Home Inspection. Mark will
work with you every step of the way to
provide the highest quality customer service.
Cool Breeze has been around since 2003,
but is backed by many more years of
experience in the construction industry.
THE
WOLF LOEWINSOHN-MINOR
invites you to the newly opened California’
Cutlery at 1233 Solano Avenue in Albany.
Wolf tells tis he started collecting and
studying martial arts when he was five.
California Cutlery offers professional
knife sharpening that's important to
prolonging the.life of your fine knives. ©
California Cutlery is.a division of Sword
Soul, a retailer of art, fine cutlery, culifiaty
equipment and swords, sheaths and
accessories. Wolf even stocks martial arts
equipment and antique swords. You know ~
you're dealing with the higest of quality wh
Boker, Kershaw, Cold Steel, Messermeister
CUTTING EDGE
ell you'te choosing. amotig brands like
; and Martini. Coming Soon; Wolf wilt
have photos, and information about knife and sword care;-an online catalog, and
more! Also, in. the near future, Wolf and wife Tanya expect to welcome a brand new
bouncihg baby into their midst: Best Wishes! (510) 525-6700 :
‘Mark says he wants to help revitalize area
neighborhoods to promote widespread
change for the betterment of ALL of our
communities. Cool Breeze is located in
Oakland, but serves the entire Bay Area.
Please call now for a fair and honest
consultation. You can also get Mark on his
cell phone at (510) 395-7656
IT TAKES A VILLAGE - MEET ED
and Sarah Seban owners of Village Grounds,
*1797-A Shattuck Avenue in Berkeley, two in
a family of passionate people committed to
providing a unique and enriching coffee
experience. Sarah has opened coffee houses
for other companies, but wanted to share her
passion for superior coffee and espresso on a
‘more personal level. When she's not pulling
shots of espresso you can find her behind
the counter either knitting or spending
countless hours playing Sudoku. Ed spent
several years in the financial industry before
Tee.
Give them a call if you'd like their great
coffee at your next meeting. Village
Grounds is open Monday thru Friday trom
Jam to 10pm and Saturday and Sunday from
8am to 7pm (510) 486-2877
SPICES - PICTURED HERE ARE
Sybil Buckler, mother (and setious fan of
the Marmaduke cartoon strip), Zimad,
adopted grandson of Sharyl and, Sharyt
Sowole, the owner of Sowole’s African