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City Manager's office — M-31 <br />City of Santa Ana 20 Civic Conter F/aza <br />Donation Request a.o: BOX 1988 <br />Santa Ana, CAA 92702 <br />a (714) 647-5200 <br />Name: <br />(Felipe Guerrero <br />IAddr�— es,: —�1204 <br />N. Susan Street <br />ly,-state, zip: <br />Santa Ana, CA 92703 <br />Small: <br />igodfnano@aol.com <br />Yttle: lPresident <br />;Phone: 1(714) 265-2071 <br />Far, <br />Name: (Santa Anita Neighborhood Association <br />Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as ❑ <br />� <br />defined under Section 501(c)(3) of the Internal Revenue Code? Is elect Ono: ✓ Yes No <br />If No, you will only qualify for a credit for City -related costs for your request (I. s. permit fees,`--�'``--"`-"""�"` <br />;Staff time, rental rates for facilities or equipment, etc.). Costs for City services vary and if Yes, in0-875666 <br />(approved, credit may or may not cover full cost of requested City services. �lfax ID #: (�� <br />ty Services Credit ie IDato Needed: 'June 23, 2017 'Mayor/Councilmember: Solorio <br />nount Requested; ' <br />rectPaymentAmount j�-.,.i i -��0 pm <br />quested: $ m Event Date: June 23, 2017 Event Time: <br />,ent LocatIom Santa Anita Park <br />dress, city, Slate, Zip <br />Movie night event intended to bring the community together and provide a fun <br />recriptionnt <br />of in` night of entertainment, <br />rant I Purpose: i <br />come out of their homes and get to know each other better. This event will be our <br />immunity Benefit: <br />IsNecighbors <br />ond annual. Our event last year was very successful and attracted several hundred <br />partiicipants. <br />Mail: City Manager's Office --M-31 <br />20 Civic Center Plaza <br />P.C. Box 1980 <br />Santa Ana, CA 92702 <br />Email: donationrequest@santa-ana.org <br />Fax: (714) 647.6954 ` <br />Revised 01(0512017 <br />