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''_` City of Santa Ana City Mat Civc Center Plaza <br />Donation Request P.O. Box 1988 <br />t: --r Santa Ana, CA 92702 <br />- (714) 647-5200 <br />(Name: Il <br />Name: <br />Raul Ramos <br />itis: President <br />Address: <br />120 Civic Center Plaza <br />Ft,, state, zip: <br />Santa Ana, CA 92701 Pbone_ ',1714-651-6176 <br />-- <br />_ <br />staff lime, rental rates for facilites or equipment, etc.).Qosts for City services vary and if <br />Fax:_ <br />Direct Payment Amount <br />(Name: Il <br />Memorial Park Neighborhood Association <br />DR - <br />Tax -Exempt Status: Is your organization a non-profit or public lax -exempt organization as <br />defined under Section 501(cx3) of the Internal Revenue Code? <br />Select One: <br />� <br />❑ Yes No <br />If No, you will only qualify for a credit for City -related costs for your request (i.e. permit fees, <br />If Yes, <br />_ <br />staff lime, rental rates for facilites or equipment, etc.).Qosts for City services vary and if <br />Direct Payment Amount <br />approved, credit may or may not cover Poll cost of requested City services. <br />ax ID #: <br />Requested: <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 92702 <br />t nAlI�GT�Lk�9 ,ms �. <br />Icily Services CreditCJ00 <br />DR - <br />Date Needed: 6/25/2018 <br />Mayor/Councllmember:' <br />Martinei <br />Amount Requested: <br />Approved Amount: <br />—' <br />City Manager Signature: <br />Direct Payment Amount <br />Event Date: 6/30/18 Event Time: <br />$aril-10:30am ! <br />Requested: <br />Event Location:Memorial <br />Park, Eastside NA, Sandpointe NA, & Lacy NA <br />Address, City, State, Zip <br />The City of Santa Ana in collaboration with various neighborhoods to conduct community <br />Description of <br />Event) Purpose: <br />clean-up efforts and beautification activities on June 30, 2018 from 8am-11 <br />Volunteers will be welcomed to assist with the community clean-up. <br />mny will benefit from the event by having clean neighborhoods, beautified parks, and <br />Community, Benefit, <br />FanoppormtuUnityto engagewith others in the community. The event will promote community pride. <br />Applicant Signature: <br />lfe rJZQf1lOJ ;Date: <br />JUneJ, 2018 <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 92702 <br />t nAlI�GT�Lk�9 ,ms �. <br />Donation Request at <br />Reference # on all reletl DPVS <br />DR - <br />Council Meeting Date: <br />June 19r 2019 <br />Eligibility Met: <br />YES I NO YES <br />Approved Amount: <br />@e <br />$500 <br />City Manager Signature: <br />Date: <br />Revised 01/05/2017 <br />