01 Household Information

Candidate NameJaden Beltran
Address2466 E Tahquitz Canyon Way Apt#124
Palm Springs, 92262
Emailriveraelsie81@gmail.com
Phone(760) 905-8275
Type of Phone NumberCell/Mobile
GenderMale
Parent/Guardian #1 NameElsie Rivera
Address2466 E Tahquitz Canyon Way Apt#124
2466 E Tahquitz Canyon way Apt #124
Palm Springs, 92262
Emailriveraelsie81@gmail.com
Phone(760) 905-8275
Phone Number TypeCell/Mobile
RelationshipMother
Parent/Guardian/Responsible Adult #2 NameJohn Rivera
Same address as above?Same Address as above?
Address2466 E Tahquitz Canyon Way Apt#124
2466 E Tahquitz Canyon way Apt #124
Palm Springs, CA 92262
Emailriveraelsie81@gmail.com
Phone(760) 699-1652
Phone Number TypeCell/Mobile
RelationshipUncle
Emergency Contact NameElsie Rivera
Same address as above?Same Address as above?
Address2466 E Tahquitz Canyon Way Apt#124
2466 E Tahquitz Canyon way Apt #124
Palm Springs, CA 92262
Emailriveraelsie81@gmail.com
Phone(760) 905-8275
Phone Number TypeCell/Mobile
RelationshipMother