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C) City Manager's Office - M -31 <br />City of Santa Ana 20 Civic Center Plaza <br />I. <br />Donation Request P.O. Box 1988 <br />;l�„P Santa Ana, CA 92702 <br />(714) 647.5200 <br />Name: Marta Rodriguez <br />!Address: 1510 North Parton Street <br />__ ------- ----- -- ----- ..... -------- <br />City, state zip, Santa Ana, CA 92707 <br />_,._ ..... <br />- .--- _...__ <br />!Email: manta @saintpeterlutheran.net <br />!Title: <br />Office Administrator <br />Phone. 1714-542-6781 <br />--- _.... _ _ . __..... -.... ......_ - . <br />Fax <br />Name: Willard Neighborhood - account with Charitable Ventures of OC (501 c(3) - CVOC <br />Tax - Exempt Status: Is your organlzatlon prof <br />anon - it or public tax - exempt arganizatlon as ' <br />;defined under Section 501(c)(3) of the Internal Revenue Code? tact One: 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 r <br />approved, credit may or may not cover full cost of requested City services. Tax ID #: IC.VOC-20- 8756660 <br />Amount nested: r <br />!City Services Credit <br />! q $ !Date Needed; j 05/30/2016 (Mayor /COUneilmembar: Rayne <br />Direct Payment Amount - _....._.�, 1 8;00 am - 12.00 pm $1500 Event Date: 06/04/2016 Event rime: <br />,Requested: 1 <br />!Event Location: 11510 North Parton Street, Santa Ana, CA 92706 <br />Address, City, Stale, Zip <br />Description of Event lPurpose: ........ <br />. •" a X.lgp wllXnpirlmenmanlapers In NenelgM II— L.mnnge,rtI.r, r1 In— = w e1m yw.ew-111 w -kI.-e lm <br />o 61 Ma.iMI -1IItl ab .bJ a IIInMo1e6 <br />11 'I1111111114 W11111IIIy,W11W TI. 1mme11119 eoXel111eJ nn <br />aeoW.pmxreek ooMp�Ip„ anlom.aAn al=ere ,rM1 W =m mllgaue no ua.nn.e,lro,grle,Pa.neerseml.xr,We.rM1meIpXmmO .rewMMemO,r,y a 16> nm ,c>.uI1M1anee 1 m nr.wr,gmena,en.qr,ruIrwrcnMn.a. .wkmrmrznrpe .w mup ., aaXularernpnala,,l..lXrFa ee wnlm ,wn r <br />Mey 131111111m YOUy f.ttd lnou,llonopal P,um11m11X a1.5lOX -Pp111 SlloM, Santa Pna, Cp9RRM. <br />'The community benefit is to promote a titter -free neighborhood and community <br />]Community Benefit: <br />!pride. <br />i <br />;Applicant Signature: ;,tin 1.- (f, <br />5/2�),' 1i, <br />Mail: City Manager's Office -M -31 —_ IEmail: donationrequost@santa-ana.org — <br />20 Civic Center Plaza Fax: (714) 647-6954 <br />P.O. Box 1988 <br />i <br />Santa Ana, CA 92702 <br />Revised 11/16/2015 <br />