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(Name: <br />Address: <br />(City, State Zip: '.... <br />Email: <br />City of Santa Ana Donation Request # r <br />Reference this # on all ll related DPVs <br />Donation Request <br />-- <br />!Tax- Exempt Status: Is your organizationanon -prof[ or public tax - exempt organization as defined under Section 501(c)(3) of the Internal Revenue <br />!Code? Select One: Yes No <br />If No, you will only qualify fora credit for City- related costs for your request. i.e. permit fees, staff time, rental rates for facilities or equipment. <br />If Yes, _.... <br />Requested: <br />Description of <br />Event/Purpose: <br />i <br />(Location: <br />i <br />!Event Date: Time: <br />iDate Donation Needed: <br />Community Benefit <br />pplicant <br />ignature Date', <br />Council Meeting Date: <br />ity Manager Signature: <br />EXHIBIT 3 <br />Not Approved <br />