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City of Santa Ana <br />Donation Request <br />Gonzalez <br />Address: 11650 E. 4th St., Suite 101 <br />city, state, zip; iSanta Ana, CA 92701 _._.......,_„»_._ Phone: LL - <br />�Emalt iggonzalez@casadelafamilia.org IFax: <br />04171111=111W <br />net status: Is your organization a non-profit or public tax-exampt organization as <br />der Section 501(c)(3) of the Internal Revenue Code? <br />will only qualify for a credit for City relatod costs for your request (i.e. pomtft fees, <br />rental rates for facilities or equipment, ete.).Costs for City services vary and if <br />credit may or may not cover full cost of requested City services. <br />pity Services Credit <br />Amount Requested: <br />Direct Payment Amount <br />Requested: <br />iDate Needed: :7/24/17 <br />i <br />500.00 Event Date 7/28/17 <br />City Manager's Office — M -3f <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />(714) 847-5200 <br />& Development <br />430-3751 <br />select One; ' F Yes F No <br />�If Yes, 3_070478 <br />flax ID #: <br />ayor/Councilmember: <br />,went Time: <br />Location: ;Sowers Museum: 2002 N. Main St., Santa Ana, CA 92706 <br />1, cliy. Slate, TIP <br />Solodo <br />7:00pm <br />On Friday, July 28, 2017, CDLF will hold a benefit event at the Bowers Museum <br />rte lin association with the John F. Kennedy Library Foundation. <br />�Proce <br />{Cmnmumty Benefit:,Victim <br />'Applicant Signature: <br />Mail: City Manager's Office—M.71 <br />20 Civic Center Plaza <br />P.O. Box 1968 <br />Santa Ana, CA 92702 <br />Js to CDLF will help us continue to provide mental health services to <br />of psychological trauma. <br />Date "7/ ' <br />Email; donationmquest@santa-ana,org <br />Fax; (714) 6476954 <br />Dontt'kinn ftequcst fk. . n3a . <br />tr .,,;_,r_.f.: GnUnrR Mmzttlr+g tr2Ee: <br />= EHg1b3tik,y Met: YES i No ,bpProved ,dRwUg1V _ <br />Revised 01/05/2017 <br />29A-9 <br />