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City of Santa Ana <br />Donation Request <br />City Manager's Office— M-31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />(714) 647.5200 <br />address: <br />Icily, s— para, zip: Santa Ana, Calif, 92705 Suite 202 Phona: 714-267-7747 i <br />�Emal� I: — nati@ngsenrices.org F—F <br />------------ ---- --- - ------ Fa --- — ---- - —--.� <br />IName: INati's House DBA Neutral Ground <br />Tax -Exempt Status: Is your organization anon -profit or public lax -exempt organization as elect One: <br />defined under Section 50l(c)(3) of the Internal Revenue Code? FZ Yes ❑ No <br />If No, you will only qualify for a credit for City -related costs for your request (i.e. permit fees, <br />staff time, rental rates for facilities or equipment etc.).Costs for City services vary and if If Yes' 45-4041042 <br />approved, credit may or may not cover full cost of requested City services. ax ID 0: <br />City Services Credit <br />mount Requested: <br />Direct Payment Amount <br />Requested: <br />Event Location: <br />Address, City, State. Ztp <br />Description of <br />Event Purpose: <br />Community Benefit: <br />Applicant Signature: <br />Needed: 107-20-2018 <br />1,000 (Event Date: 107 -through -08 (Event Time: <br />7:00pm-10:00prn <br />Nniiz I -Iv :�- Il.ovic4r truc4:�ti.•• n„o� ;,.tu vG�ri�-. s..rv:mr fu 5.....+�, h,..� <br />s/o+�r nrd iar,-i 1. c� i rhe.. d•.-1',�+- f7...+cls F,�,., tri. S�a..S�rsn:� wLL rl. <br />}uVrrda .,�-✓�u,�� ),V /)I-- C -St II S<": LLS E..N�gh ��IK Lal (l �u 4,05,4r 1,s <br />t <br />Mail: City Manager's Office—M-31 <br />i 20 Civic Center Plaza <br />P.O. Box'1988. <br />Santa Ana, CA 92702 <br />i .. <br />ate:. 07-18-2018 . <br />Email: donationrequest@santa-ena.org <br />Fax: (714) 647-6964 <br />r. o r <br />Donation Re4uest #: <br />Rerrre_nne qoi, au relaretl OPVr <br />OR' ' - <br />Council Meeting Date: <br />Eligibility Met: <br />YES / NO <br />Approved Amount: <br />•city Managor,S(gnatlirei - <br />- <br />Date: <br />— ----_i <br />Revised 0110 5/2 01 7 <br />