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Names <br />Address; <br />City of Sonto Ana Community Development Agency — M-25 <br />Downto,wri Even' Sponsorship Request 20 Civic Center Plaza, 61h floor <br />Santa Ana, CA 92701 <br />(714) 647-5479 <br />to <br />City, State, Zip. <br />Phone <br />NN, <br />MEW <br />Name: -- <br />Tax -Exempt Status*, is your organization a nton-profit or public tax-exempt organization as defined <br />under Section 501 (c)(3) of the Internal Revenue Code? <br />Select One: Yes— <'= NpIf yes, Tax ID #; _aQ_OtL5__A _01/__ <br />If no, you will only qualify for a credit for City-reiated costs for your request (i.e, permit fees, skiff time, rental <br />rates for k)aiflties; or equipment, etc.), Costs for City services vary and if approved, credit may or may not cover <br />full cost of requested City sevices, <br />p <br />Direct Payment Amount Requested <br />City Services Credit Arnount Requested <br />Event Name-. <br />I <br />Event Date: Event Time: <br />Event Location:"7k ' a a <br />Description of Event/Purpose; <br />Community Benefit: <br />Applicant Signature13 4� Date: tplo//Z <br />� <br />Return comolet cl form to Victor Negrefe at: viiegreto@sanio-cino.org <br />