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DocuSign Envelope ID: DB13B736-8FBD-4F2C-Al23-96CC38440A03 <br />. ,� City of Santa Aria <br />City Manager's Office— M•31 <br />20 Civic Center Plaza <br />- '. Donation RRequestP.O. <br />Box 1988 <br />Santa Ana, CA 92702 <br />',:_ <br />(714) 847.5200 <br />Kum (alternate contact Victor Payan) �Itia: [Director of Finance <br />1000 N. Alameda Street, Suite 240 <br />_., _...._.-_.__ _._,.__,._� .., _ ..� .. m. -, ..._...,_w____ _ . -_, ._.._._ _.. ._,_.._ <br />.Ity, State, zip: Las Angeles, CA 90012 `Proone: 213-346-3200 <br />!IT• . . <br />_.. _.,w ..,. <br />Name: �Community..Partners for MASA (fiscal sponsor for Film Festival) <br />Tax -Exempt Status: Is your organization a non-profit or public tax-exempt organization ss elect One: <br />refined under Section 501(c)(3) of the Internal Revenue Code? mm ® Yes EJNo <br />If No, you will only qualify for a credit for Ctty-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 <br />approved, credit may or may not cover full cost of requested City services. <br />City Services Credit <br />e <br />Datate Needed:d: <br />11/15117 <br />Amount Requested:— <br />Direct Payment Ameunt <br />5OO <br />Event Date: <br />10/6-10/15/17 <br />R <br />Location: <br />o, City, State, Zip <br />Yes, <br />rx ID #: <br />Martinez <br />11:45am-1 ppm <br />2017 Film Fiesta locations in Santa Ana include: OC Musicians' Association, <br />Heritage Museum_ Santa Ana College. Main Place Mall and Mexican Consu', <br />ption or The Film Fiesta will showcase Santa Ana to the region and to SA residents via <br />Purpose: events throughout the city, and offer free and low-cost screenings to the Santa <br />Ana rrnmmnnifit indurlinn CA raeiripnta ¢fiiriante taachara militarvfuafaranc <br />mnity Benefit: The Film Fiesta will provide $5 admission and free events for the Santa Ana <br />community, including award-winning films and artists such as SNL head writer <br />:ant Signature:. �rp,�,l,1,tr Date: 11/1/2017 <br />Mali: City Manager's Office—M-31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br />Donation Request #: OR- <br />PIMTYr+ncn tP¢v olP rcf+tRrtd DF v-, <br />Eligibility Met: I YES f NO YES <br />City Manager Signaturw <br />Email: donationmquest@santa-ana.org <br />Fax: (714) 647-6954 <br />council Meeting Date: <br />Approved Amount: <br />Date: <br />12/19/17 <br />$500 <br />Revised 01/05/2017 <br />