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0 <br />City of Santa Ana <br />Donation Request <br />City Manager's Office - M-31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />.Santa Ana, CA 92702 <br />(714) 647.8200 <br />e: Patricia Wenskunasisle: Founder CEO�� <br />ass; _J1 301 N Tustin Ave. <br />. �--._ -. - <br />State, zip: Santa Ana, CA 92705 Fhone: (949) 872-7895 <br />, �_m-mow._�-�--- <br />I: pa @ <br />triciacrimesurvivors...:or9_.Fan x: (775) 245-4798 Y` <br />Name: lCrime Survivors <br />Ji - <br />__nom <br />Tax•Ex¢mpt Status:.ls your—organization anon-pro0t or public ta>f exempt organizatlori as <br />ieflned under Section 601(c)(3) of the Internal Revenue Code? 1Select One: Yes ❑ No <br />If NO, you will only quality for a credit for City -related costs for your request (le, permit fees,i <br />staff time, rental rates for facllrtles orqulpment,etc,).Costs /or City services nary and 7f Fl_Y11_ <br />mm��G2.7��� <br />tpproved, credit may or may not cover full cost of requested City services. ax ID #:. y'7 <br />Bo a ca f <br />)ity Service <br />s Crodit t ------ —�---- --�--- <br />4mountRequested: �$ {Date N¢eded; - 201 H IMI ayodCouncilmem6er i �/Iiie9aS <br />Direct Payment Amount---�.---.-.--_ or"Coua._.v__ <br />2equested i I-I@veno Dato. <br />201$ vent Tim¢: t2o1$ <br />....._..._..... t nits. ..,.�.........._ <br />.vent Location: - Crime Survivors Rescurce Center <br />address, City, state, zle 1301 N Tustin Ave. Santa Ana, CA 92705 <br />FC,.... .,....,...—,.,._,:.___..__,.,_,,,._. me Survivors well use these direct fundsrequaeted In partnership to 611Pod and provide aememees, prevention advocacy and healing smomm to all residence In <br />)ascription of the city Osamu Ana Ourprograms have a brand reach Including an ages, genders ethnic backgrounds, range, asweli as direct program supportortarnbeaot <br />vioact cure, Including tandem of ummer and survivors of attempted murder, rape sexual assault domestic violence, child abuse, and elder abuse, Although Come <br />aVent/PUPp088 survivors services are ovailable to ell victims of crime via estimate that 75% of lndWlduals aurum! by Cnma Survivors are low income These victims are often deeply <br />IackIng In Mmomiea following a violent stun& Clime SuMVOrs will continue to provide gabs programa, services and ealnings that ere not covered by the slate. <br />P bl Ny III IM B I6A bd/d a Ivir a'We P.W11 Reumt.bles, "Weh p W etthl gMM Me teAmtObr0P Y h bgl I Javrym, ec QMtb ub adveemrul <br />Icame tesetal fm t I p tl 1vhmpltb O We bbbdea 1.1e.c.dl otee emilbe.G dhe, pobll ry will One b gained thah %b CmMGSUNe ry p F dPmgram antl addlib.nal <br />:ommunity Benefit:IP I SppM,M ll gE l6 adF r,J IIny Events for nlret seMgm Calms aunNonwtliId. . ug Wmmunrylocellon In the C4....... M"'. (her eme votmrcan aceese <br />City Manager's Office- M-31 <br />20 Civic <br />Donation Request #: <br />HPfflYCnG2 on cli Melee s <br />Eligibility Met: —_ <br />City Manager Signature: <br />santa•ana,org <br />Fax: (714) 647-6954 <br />council Meeting Dat¢: <br />YES/ NO YES Approved Amount: <br />Date: <br />FEBRUARY 6, 2018 <br />$500�� _ <br />Revised 01/05/2017 <br />