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City Manager's Office—M-31 <br />City of Santa Ana 20 Civic Center Plaza <br />Donation Request P.O. Box 1988 <br />Santa Ana, CA 92702 <br />(9) <br />(714) 647.6200 <br />(Address: 200 S. Sycamore Street, Apt. 305 <br />(Clty, State, zip: Santa Ana, CA 92701 Phone: <br />Email: [fjharris49@gmail.com Fax: <br />Name: (Santa Ana Senior Center Advisory Board <br />Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization as Select One: <br />lefined under Section 501(c)(3) of the Internal Revenue Code? <br />will only qualify for a credit for City -related costs for your request (i.e. permit fees, If Yes, <br />rental rates for facilities or equipment, etc.). Costs for City services vary and if <br />credit may or may not cover full cost of requested City services. ax ID #: <br />(714) 975-3968 <br />❑ Yes FZ No <br />City Services Credit <br />Amount Requested: <br />I$ 550 <br />Date Needed: <br />6/15/17 <br />MayorlCouncilmember: <br />Sarmiento <br />Direct Payment Amount <br />$ N/A <br />Event Date: <br />6/15/17 (Event Time: <br />B:O Dam - 10;30am <br />lRequested: <br />Event Location: <br />( Santa Ana Senior Center, 424 W 3rd Street, Santa Ana, CA 92701 <br />Address, City, State, Zip <br />i <br />' On the second Thursday of every month, the Santa Ana Senior Center Advisory Board collaborates to host a rummage <br />Description of <br />'sale to help raise funds to support activitles and various projects at the Santa Ana Senior Center. Specific to this request, <br />Event / Purpose: <br />the Advisory Board will be raising funds for the Birch Park restroom and fence project. Additional fundraising events <br />include the Snack Sale, which will take place on Thursday, June 15, 2017 from 8:00am to 10:30am. <br />This project will help maintain our public facilities, while ensuring a safe, clean <br />Community Benefit: <br />park for the community to enjoy. <br />(Applicant Signature: <br />I FRANCINE HARRIS Date: 16/8/17 <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 />