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City Manager's Office – WI <br />' City of Santa Ana 20 Civic Center Plaza <br />Donation Request` P.O. Box 1988 <br />Santa Ana, CA 92702 <br />(714) 647.5200 <br />m <br />N <br />IFelipe Guerrero lee: President <br />ddress: <br />204 N. Susan Street <br />city, state, zip: <br />Santa Ana, CA 92703 <br />Phone: <br />(714) 265.2071 <br />Emau: <br />godfnannaol.com ^Fa� <br />x' <br />Name: Santa Anita Neighborhood Association <br />Tax-Exempt Status: Is your organization a non-profit or public tax-exempt organization as galea One: <br />No <br />defined under Sectlon 501(c)(3) of the Internal Revenue Code? ✓ Yes ff <br />If No, you will only qualify for a credit for City-related costs for your request (!.e, permit fees, '"" ` <br />If Yes, <br />staff time, rental rates for facilities or equipment, arc.). Costs for City services vary and if rp O"C77 O <br />approved, credit mayor may not cover full cost of requested City services. (fax ID #: V GJ <br />Fiscal Sponsor: Charitable Ventures of Orange County Inc. <br />9 0 9 <br />;' <br />fff9 <br />(City Services Credit <br />mount Requested: <br />q <br />$ 1 ,66® Date Needod: PUiy Z1 , ZQ17 MayortCouncilmember: Tinajero <br />Direct Payment Amount <br />��--��T���^•��a —� <br />Uii 21 2017 Event Time: <br />$ Event Date: �.,____ F 6:30 <br />Requested: _ <br />,f y p 171 <br />Event Location: <br />Santa Anita park ��II <br />Address, City, State, zip <br />-r <br />Movie night event intended to bring the community together and provide a fun <br />Description of <br />night of entertainment. <br />Event/Purpose: <br />.... <br />� .... �._ __ ..... _.. _cpm.:...._....;:.:;. ^... '.,gym <br />Neighbors come out of their homes and get to know each other better. This event will be our <br />Community Benefit: <br />second annual. Our event last year was very successful and attracted several hundred <br />participants. <br />�414n <eR u` r <br />A{pplicant S19niture f " r"(Y°' ` ' dR it "W✓ y� r , / q fiky.� � ' - <br />ss7` sr a, AR"'Fw A dN 4TOO <br />Y�/at� ✓ I <br />i�"�! <br />,'Wrt`+'�eiJ 7 <br />}n <br />4 t,..wfl .rvfi✓A.,i ;. a i ' ae r= Y f4.st i.�nn(IV`, 4M.Pf* I{wn 'rv'9,�i�r✓rix11`I! <br />® D C - 1 4 MEN= <br />Mail: City Manager's office–M-31 Email: donationrequest@santa-ana.org <br />20 Civic Center Plaza. Fax: (714) 647.6954 <br />P.O. Box 1988 <br />Santa Ana, CA 92102 <br />d <br />Donation f"vequo st g : DR - -- -- <br />�R,eferE.nea ion att re!atedr)PIre - Council Meeting Date:44/04/2417 <br />� <br />. Eligibility Mat ., .; YES / NO Approved Amount. � $1,000 . <br />City Manager Signature;, - - Data <br />2 i-T3 <br />Revised 01/05/20'17 <br />