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State of California <br />Financial Information System for California (FI$Cal) <br />GOVERNMENT AGENCY TAXPAYER ID FORM <br />2000 Evergreen Street, Suite 215 <br />Sacramento, CA 95815 <br />www.fiscal.ca.gov <br />1-855-347-2250 <br />EXHIBIT 1 <br />F►$Cal <br />Financial information System for California <br />The principal purpose of the information provided is to establish the unique identification of the government entity. <br />Instructions: You may submit one form for the principal government agency and all subsidiaries sharing the same TIN. Subsidiaries with a <br />different TIN must submit a separate form. Fields bordered in red are required. Hover over fields to view help information. Please print the <br />form to sign prior to submittal. You may email the form to: vendors@fiscal,ca.gov, or fax it to (916) 576-5200, or mail it to the address above. <br />Principal JCity of Santa Ana <br />Government <br />Agency Name <br />Remit -To 120 Civic Center Plaza M-25 <br />Address (Street <br />or PO Box) <br />City Isanta Ana State CA Zip Code+4 92701-4076 <br />Government Type: Q City <br />❑ County <br />Special District ❑ Federal <br />❑ Other (Specify) <br />Federal 95-6000785 <br />Employer <br />Identification <br />Number <br />(FEIN) <br />List other subsidiary Departments, Divisions or Units under your principal agency's jurisdiction who share the same <br />FEIN and receives payment from the State of California. <br />Dept/Division/Unit <br />Name Community Development Agency <br />Dept/Division/Unit <br />Name <br />Dept/Division/Unit <br />Name <br />Dept/Division/Unit <br />Name <br />Contact Person <br />Phone number <br />Signature <br />Santa Ana Police Department <br />Public Works Agency <br />Planning Building Agency <br />Terri Eggers <br />714-647-5378 <br />Complete <br />Address 20 Civic Center Plaza, Santa Ana, CA 92701 <br />Complete <br />Address 60 Civic Center Plaza, Santa Ana, CA 92701 <br />Complete <br />Address 20 Civic Center Plaza, Santa Ana, CA 92701 <br />Complete <br />Address F <br />Civic Center Plaza, Santa Ana, CA 92701 <br />Title Homeless Services Manager <br />E-mail address <br />TEggers@santa-ana.org <br />Date <br />55A-7 <br />