Agenda packet — Solana Beach City Council, June 4, 2025 (part 2 of 3)

5. Grant funds must be used for services or materials directly associated with the proposed activity.

Please describe how grant funds will be used:

Grant Funds will be used to continue the 7th year of the 8 month Psychosocial Educational Support group for Immigrant mothers, led by a licensed Bilingual LMFT. The costs include educational supplies and materials. This year we have added new support services and mental health programs including swimming, zumba, art and relaxation techniques. We have also begun the process of developing computer skills to further educational opportunities. Disconnect Collective will also help

6. Anticipated Program Objectives or Accomplishments:

We anticipate having 30-50 immigrant Mothers graduate from our group again. They have reported many benefits to the program. Our most recent program that we rolled out was an 8-week swim class. We successfully partnered with the boys and girls club to teach 20 mothers and 4 fathers to swim. We would like to continue to connect these families with City resources and help them offset the costs of these programs. We will continue to provide mental and educational support and education for local immigrant families. This year we will continue add more recreational activities a

7. Program Dates/Location:

The Platicas de Mejorar class is held every Wednesday from 7-9 pm. Additionally have included weekend events such as swim, ocean learning, hiking and running groups.

8. Estimated number of Solana Beach residents to be served by proposed program:
125-
175

9. How will the organization acknowledge the City's financial contribution to the community/ beneficiaries of the proposed activity?
The City of Solana Beach logo will be proudly added to our promotional materials and to our scholarship applications. We are happy to proudly credit the city for it's generous contribution.

10. Will there be any matching funds or other grants that would be applied to this program or service? If awarded this grant, will that enable other funding sources? This cycle our foundation and some private donors have provided some extra funds to help some children with recreational activities and students attending higher education.

Page I 2

11. Will volunteers be used for the proposed program or service and, if so, will they reduce expenses? Currently most of our programs are volunteer run. We have some teens that have been paid to lead tutoring and other events. All funds received from the city or fundraising will go to families and the costs associated with running the programs or community building events.

12. If the proposed program or service is only awarded partial funding, will it still move forward? Will the program/service be scaled back and/or is there a threshold at which it will not move forward? Our program will continue to move fotward as planned. We will continue to provide mental Health Support services to the community regardless of how we much get funded.

Acknowledgment of Responsibility:

Authorized Signature assumes all responsibility for developing and implementing proposed activities or events in this application, including public acknowledgment of the City's financial contribution. Authorized signature will comply with all accounting and budget procedures outlined by the City. Authorized signature and accompanying group will hold harmless the City of Solana Beach from all losses, claims, accidents, and problems associated, directly or indirectly with the development and implementation of proposed activities or events.
5/25/25
Authorized Signature of Organization Date

ALL INFORMATION REQUESTED ON THIS APPLICATION MUST BE COMPLETED AS A CONDITION FOR BEING CONSIDERED FOR PUBLIC FUNDS BY THE CITY COUNCIL OF SOLANA BEACH.

Page I 3
Fiscal Year 2025
Disconnect Collective/ Platicas de Mejorar
Program Budget for Disconnect Collective Mental Health, Parenting & Support Groups and Community Building Opportunities Expense Item Description Low Estimate High Estimate
Meeting Spaces & Supplies $ 650 $ 800
Community Outreach $ 700 $ 900
Promotional Materials $ 350 $ 400
Computers to Teach Job Training Skills $ 3,000 $ 3,500
Instructors to Teach Skills $ 2,750 $ 5,000
Recreational /Developmenta I Opportunities $ 2,500 $ 3,000 Recreational /Developmental Scholarships $ 2,500 $ 3,000 Community Partnerships $ 1,500 $ 2,000
Estimated Totals $ 13,950 $ 18,600
(
Please note this is both the overall and program budget. (
Disconnect Collective/ Platicas de Mejorar
Statement of Financial Position
31-Dec-24
Assets
Cash $ 1,552
Inventory/ Assets $ 475
Pledges Receivable- Short Term $ 10,000
Liabilities
Accounts Payable $
Net Assets $ 12,027
Please note that the 2024 Tax Return has not been filed yet.

Disconnect Collective/ Platicas de Mejorar
Statement of Financial Activities
31-Dec•24
Revenue
City of Solana Beach Grant $ 2,500
Other Fundraising $ 13,000
Total Revenue $ 15,500
Expenses
Program Expenses $ (8,766)
Scholarship Expenses $ {2,256)
Registration Fees $ (445)
Materials & Supplies $ (503)
Community Outreach $ (900)
Bank/ Transaction Fees $ (64)
Total Expenses $ {12,933)
Change in Net Assets (Surplus/ Deficiency) $ 2,567
( Please note that the 2024 Tax Return has not been filed yet.

L
(
L
Your Business Advantage Fundamentals™
for December 1, 2024 to December 31 . 2024
DISCONNECT COLLECTVE, INC.

Account summary
Beginning balance on December 1, 2024
Deposits and other credits
Withdrawals and other debits
Checks
Service fees
Ending balance on December 31 , 2024
$1,734.19
10,000.00
-181 .99
-0,00
-0.00
S11 ,552.20
li e
/le
li e
11,
Av
1/n
NOTE THIS DEPOSIT IS A DONATION FOR 2025
Submission of Exemption Request
Exemption Based on Internal Revenue Code (IRC) Sections 501(c)(3), 501(c)(4), 501(c)(5), 501(c)(6), 501(c)(7), or 501(c)(19), Federal Determination Letter Enclose a copy of the Federal Determination Letter.

Organization Information
California corporation number/California Secretary of State Ille number C4142642
Web address
■ CALIFORNIA FORM
3500A
Name of organization as shown in the organization's creating document Disconnect Collective, Inc. www. d isconnectcollective. com Street address (suite, room, or PMB no.)
514 Via De La Valle, Ste. 210
City
Solana Beach
Telephone
(213) 235 - 0601
Representative Information
Name of representative
David Stapleton
Representative's mailing address (suite, room, or PMB no.) 514 Via De La Valle, Ste. 210
City
Solana Beach
Telephone
(213) 235 - 0601
Part I - Entity lnlormation. See instructions.

Second telephone
Second telephone
Slate ZIP code
CA92075
Fax
213 235 - 0620
Email address
[email protected]
Slate ZIP code
CA92075
Fax
1 Has the Franchise Tax Board (FTB) previously revoked the entity's tax-exempt status? ... . . .. .. . ... . . . . ... ... . ... ... 1 □ Yes If "Yes," STOP. File form FTB 3500.
2 Is the entity a trust? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 □ Yes Ill No 3 When did the organization establish, incorporate, organize, or conduct business in California? . . ... . .. ... .. .. .. .. . ... 3 0 4 /_!_§_I 2 0 18 4 Provide gross receipts tor the current year and the three immediately preceding taxable years in existence. Gross receipts are defined as the total amounts the organization received from all sources during its annual account period without subtracting any costs or expenses. If the organization has been in existence tor less than one year, provide the projected amount of gross receipts tor the entire year. List the account period beginning to the account period ending. Example: mm/dd/yyyy Current Year or Projected Gross Receipts for the three immediately preceding taxable years:

Gross Receipts
From: 4/16/18 From: From: From:

To: 12/31/18 To: To: To:
6,000
Part II - Group Exemption. See instructions.
5 Is the parent organization applying for a group exemption? .. ... .. . .... . ... . ... . .. . .... . .. .. ... . ..... .. . . . .. . 5 □ Yes [l] No If "Yes," attach the federal group determination letter and a list of all California subordinates. Include each subordinate's name, corporation number, Federal employer identification number (FEIN), address, and affiliation date. 6 Is a subordinate unit applying for tax-exempt status using a parent's IRS group determination letter? If "Yes," see instructions ...... . .... . .... . ....... .. ....... . ..... ... .. .... .. .... .. . . . ...... . ...... . .... 6 □ Yes 0 No Mail form FTB 3500A and a copy of the federal determination letter to:

EXEMPT ORGANIZATIONS UNIT, MS F120, FRANCHISE TAX BOARD, PO BOX 1286, RANCHO CORDOVA CA 95741-1286.

Under penalties of perjury, I declare I have examined this submission for exem ion based on the IRC Sections 501(c)(3), 501(c)(4), 501(c)(5), 501(c)(6), 501(c)(7), or 501(c)(19), federal determination , tter, and to the best o my knowledge and belief, it is true, correct, and complete. 5'f {Lf h 1 ----'--~-'-+-'----'-.c=.-..-c;;::c-\----- _S_ec_re_ta--"ry ____ _ -----D-AT_E.._.t- ,-- NTATIVE TITLE 8091183 FTB 3500A 2018 Side 1 ■
Part m - Purpose and Activity
1 Exemption based on IRC 501(c)(3) federal Determination Letter Check the organization's primary purpose and actfvity:
l2l Charitable □ Educational □ Literary
□ Testing for public safety D Religious □ Scientific
□ Hospital □ Health care center
2 Exemption based on IRC 501(c)(4) Federal Determination Lener Check the organization's primary purpose and activity:
■
□ Prevent cruelty to animals
□ Church
D Qualified sports organization
□ Civic league D Local association of □ Social welfare D Service clubs employees
□ Legislative activities □ Festival organizations □ Municipal building corporation
3 Exemption based on IRC 501 (c)(5) Federal Determination Letter Check the organization's primary purpose and activity:
□ Police, sheriff,
volunteer firemen
association
□ Agriculture □ Horticulture □ Labor □ Agriculture or horticulture county fair □ AFL-ClO D Independent □ Transportation
workers
4 Exemption based on IRC 501(c)(6) Federal Determination Letter Check the organization's primary purpose and activity:
□ Teamsters
D Prevent cruelty to children
0 School
□ Veterans.' organization
□ Quasi governmental
□ Public employees union
□ Board of trade □ Business league □ Chamber of commerce □ Real estate board □ Professional association or society 5 Exemption based on IRC 501(c)(7) federal Determination Leiter Check the organization's primary purpose and activity:
□ Social and recreational □ Golf club □ Camps
□ Car, motorcycle,
trailer club
□ Hunting or
fishing club
□ Common recreational
area
6 Exemption based on IRC 501(c)(19) Federal Determination Letter Check the organization's primary purpose and activity:
□ Veterans' organization
■ FTB 3500A 2018 Side 2 8092183
□ Fraternity or sorority □ Dog or horse club
□ Flying or airplane club
■
ntTERNAL REVENOE SERVICE
P. 0. BOX 2508
CINCINNATI , OH 45201
Date: MAR 1 5 2019

DISCONNECT COLLECTIVE INC

C/O MONICA STAPLETON
PO BOX 433
SOLANA BEACH, CA 92075
Dear Applicant:

DEPARTM.ENT OF THE TREASURY
DLN:
17053260320018
Contact Person:

CHRIS BROWN
Contact Telephone Number:
{87?) 829-5500
Accounting Period Ending:

December 31
Public Cha,rity Status:
170 (b) (1) (A) (vi)
ID# 31503
Form 990/990-EZ/990-N Required:

Yes
Effective Date of Exemption:

April 17, 2018
Contribution Deductibility :

Yes
Addendum Applies:

No
We 1 re pleased to tell you we determined you're exempt f rom federal income tax under Internal Revenue Code (IRC) Section 501 (c) (3). Donors can deduct contributions they make to you under IRC Section 170. You're also qualified to receive tax deductible bequests, devises, transfers or g i fts under Section 2055 , 2106, or 2522 ., This letter aould help resolve questions on your exempt status. Please keep it for your records.

Organizations exempt under IRC Section SOl(c) (3) are further classified as either public charities or private foundations. We determined you're a public charity under the IRC Section listed at the top of this l ,etter.

If we indicated at the top of this letter that you're required to f ile Form 990/990-EZ/990-N, our records show you're required to file an annual infonnation return (Fopn 990 or Form 990-EZ) or electronic notice {Form 990-N, thee-Postcard). If you don't file a required return or notice for three consecutive years 1 your exempt status will be automatical ly revoked.

If we indicated at tne top of this letter that an addendum applies~ the enclosed addendum is an inte.gral part of this letter.

For impor tant information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities. Enter 11 4221-PC11 in the search bar to view Publication 4221-PC, Compliance Guide for SOl(c) (3) Public Charities, which describes your recordlceeping, reporting, and disclosure requirements.

Letter .947

DISCONNECT COLLECTIVE INC
Sincerely,
Director, Exempt Organizations
Rulings and Agreements
Letter 947

INTERNAL REVENUE SERVICE
P. 0. BOX 2508
CINCINNATI, OR 4S201
Date: MAR 1 5 2019

DISCONNECT COLLECTIVE INC

C/O MONICA STAPLETON
PO BOX 433
SOLANA BEACH, CA 9207S
Dear Applicant :

DEPARTMENT OF TaE TREASURY
17053260320018
Contact Person:

CHRIS BROWN
Contact Telephone Number:
(877) 829-5500
Accounting Period Ending :

December 31
Public Charity Status:
l 7 0 (b) ( 1) (A) (vi)
TD# 31503
Form 990/990-EZ/990-N Required:

Yes
Effective Date of Exemption:

April 17, 2018
Contribution Deductibility:

Yes
Addendum Applies:

No
We're pleased to tell you we determined you're exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c) (3). Donors can deduct contributions they make to you under IRC Section 170. You're also qualified to receive tax deductible bequests, devises, transfers or gifts under Section 2055, 2106, or 2S22. This letter could help resolve questions on your exempt status. Please keep it for your records.

Organizations exempt under IRC section S0l(c) (3) are further classified as either public charities or private foundations. We determined you're a public charity under the IRC Section listed at the top of this letter.

If we indicated at the top of this letter that you're required to file Form 990/990~EZ/990-N, our records show you 1 re required to file an annual information return (Form 990 or Form 990 - EZ) or electronic notice (Form 990-N, thee-Postcard). If you don't file a requirect return or notice for three consecutive years, your exempt status will be automatically revoked. !f we indicated at the top of this letter that an addendum applies, t he enclosed addendum is an integral part of this letter.

For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities . . Enter "4221-PC'' in the search bar to view Publication 4221 - PC, Compliance Guide for S0l(c) (3) Public Charities, whi ch describes your recordkeeping, reporting, and disclosure requir~ments .

Letter 947
-2-

DISCONNECT COLLECTIVE INC
Sincerely,
Director, Exempt Organizations
Rulings and Agreements
Letter 947
Form W-9 Request for Taxpayer Give Fonn to the
(Rev. December 2014) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS.

Internal Revenue Service
1 Name (as shown on your Income tax return). Name Is required on this line; do not leave this line blank.

Disconnect Collective, Inc.
<'Ii 2 Business name/disregarded entity name, if different from above <D
0)
n "' 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions (codes apply only to C 0 0 Individual/sole proprietor or D C Corporation D S Corporation 0 Partnership D Trust/estate certain entities, not individuals; see <D ~ single-member LLC instructions on page 3):

Exempt payee code ~f any) j:8 D Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ► ... 0 Note. For a single-member LLC that is disregarded, do not check U.C; check the appropriate box in the line above for Exemption from FATCA reporting 0 2 c en the tax classification of the single-member owner. code (if any) ·c .5 D Other (see instructions) ► (Appli&.i to acc:ooors maJntaJmid ooakfo the U.S.) D. 0 :E
0 5 Address (number, street, and apt, or suite no.) Requester's name and address (optional) Cl)
Q. 514 Via de la Valle, Suite 210 1/1 6 City, state, and ZIP code 3l Cf) Solana Beach, CA 92075
7 List account number(s) here (optional)
-- •• Taxpayer Identification Number {TIN)
Enter your TIN In the appropriate box. The TIN provided must match the name given on line 1 to avoid I Soclel security number I . . . ' . . . . backup withholding. For tnd1v1duals, this 1s generally your social secunty number (SSN). However, for a [IlJ ·-[D -I I I I I resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entitles, It is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. or
Note. If the account is In more than one name, see the Instructions for line 1 and the chart on page 4 for ,..., .,,Em-pl-c-oye--, :-ld:-entiflca-..,,. _::--,tio:--n-n_u_m....,be_ r ___ .., guidelines on whose number to enter.

Certification
Under penalties of perjury, I certify that:
[ - -------
--------- 1. The number shown on this form Is my correct taxpayer Identification number (or I am waiting for a number to be issued to me); and

2. I am not subject to backup wtthholdlng because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service {IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and

3. I am a U.S. citizen or other U.S. person (defined below); and

4. The FATCA code(s) entered on this form (If any) Indicating that I am exempt from FATCA reporting is correct.

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an Individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the Instructions on page 3.

Sign I Signatu,e of
General
Sect
Here
ion references
u.s.

Instructions
penson
are to the
►
Internal
~
Revenue Code unless otherwise noted.

Future developments. Information about developments affecting Form W-9 (such as legislation enacted after we release~) is at www.irs.gov/fw9.

Purpose of Form
An Individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), Individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount pad to you, or other amount reportable on an information return. Examples of Information returns Include, but are not limited to, the following:
• Form 1099-INT (Interest earned or paid)
• Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of Income, priies, awards. or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions) Dato ►
, }
• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN.

If you do not re/um Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on page 2.

By signing the filled-out form. you ;

1. Certify that the TIN you are giving 1s correct (or you are waiting for a number to be issued),

2. Certify that you are not subject to backup withholding , or

3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business Is not subject to the withholding tax on foreign partners' share of effectively connected Income, and

4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATGA reporting? on page 2 for further information.

Cat. No. 10231X Form W-9 (Rev. 12-2014)
Institute of
Contemporary
Art,
San Diego
The City of Solana Beach Community Grant Program 2025 Request for Financial Assistance application MUST BE SUBMITTED by 5:00 PM Thursday, May 29, 2025.

Please submit completed applications via email to [email protected] and copied to [email protected].

If email submission is not possible for an applicant, hard copies may be dropped off at City Hall 635 South Highway 101, Solana Beach, CA. 92075, Attn: Community Grants Program.

All requests will be determined by the following criteria:

Name of Organization: Institute of Contemporary Art, San Diego Contact Person: Shannon Permenter Email address: [email protected] Daytime Phone: _7_6_0-_4_3_6_-6_6_1_1 _______ Evening Phone: _3_0_2-_6_6_8-_4_3_0_3 ------- Mailing Address: _1_4_3_9_E_l_P_ra_d_o ________________________ _ City: San Diego State: _C_A ______ Zip: 92101

1. All the documents below are attached to this application:
[!] W-9
[!] Summary of Organization's Budget
[!I Proposed Program Budget
[!] Financial and Tax Statements (see Application Guidelines) [!] Copy of the California Franchise Tax Board Entity Status Letter, showing exemption under Section 23701 d or Internal Revenue Code section 501 (c)(3)

2. Has your organization received financial assistance from the City before? D Yes I!! No If yes, please state the fiscal year it was received and for the proposed program was:
n/a

3. Title of FY 2025/26 Proposed Program/Service: _T_h_e_V_a_l_is_e_P_r_oJ_· e_c_t ___________ _

4. What is the total amount requested for the FY 2025/26 Proposed Total Program? Includes all estimated costs to conduct proposed activity/program.
$5 000 request: The support of the City of Solana Beach will cover the cost of the Teaching Artist and our Leaming & Engagement staff, transportation costs, all art-making materials for students, and administrative costs for visits specific to Solana Beach schools.

Page I 1

5. Grant funds must be used for services or materials directly associated with the proposed activity.

Please describe how grant funds will be used:

ICA San Diego respectfully requests support in bringing our arts outreach program, the Valise Project, to the children of Solana Beach. This award would support up to 250 children in the 2025-26 academic year. The Valise Project brings contemporary mobile art sculptures about relevant and Common Core curriculum-aligning topics with corresponding hands-on creative projects and group discussion directly into local classrooms with one of our individually designed Valises taught by a professional teaching artist.

6. Anticipated Program Objectives or Accomplishments:

The Valise Project will provide the benefits of arts engagement with Solana Beach students, filling a need for art-based programming lacking in their day-to-day curriculum. Utilizing creativity and critical thinking, students are provided a new way to retain learned material through interactive, art-based lessons. The program provides an educational tool for teachers and offers an outlet for students. We hope that the use of art objects introduces students, who may not have access to onsite museum experiences, to the world of art in a way that makes them feel like they belong.

7. Program Dates/Location:

The Valise Project runs in conjunction with the 2025-26 academic year directly in Solana Beach schools based on the schedules and curriculum alignment of classroom teachers.

8. Estimated number of Solana Beach residents to be served by proposed program:_2 _
5_0 _____ _

9. How will the organization acknowledge the City's financial contribution to the community/ beneficiaries of the proposed activity?
Were !CA San Diego to be awarded, we would include recognition of the support on printed materials related to the Valise Project in the 2025-26 academic year, digital recognition on our website regarding our sponsors and the Valise Project, and inclusion in our annual report, which is distributed to the community and available in perpetuity on the !CA San Diego website. !CA San Diego is open to discussing additional ways to honor any contribution we may receive.

10. Will there be any matching funds or other grants that would be applied to this program or service? If awarded this grant, will that enable other funding sources? The Valise Project is continually seeking funding to provide visits, expand across the County, and develop new curricula that meet the needs oflocal students today. If awarded, this would provide us funds that are dedicated to the students of Solana Beach, allowing us to reach classrooms not often provided free arts experiences. Among other funders we have secured for the upcoming year is the Dickinson Family Foundation, who are supporting free visits to schools in San Diego County.

Through a Solana Beach award, we can increase our presence in Solana Beach classrooms, allowing us to connect with North County, coastal communities, and San Diego County grant funders, donors, and corporate sponsors to help us grow our capacity to reach more students annually.

Page I 2

11. Will volunteers be used for the proposed program or service and, if so, will they reduce expenses? !CA San Diego utilized volunteers when available to assist with the Valise Project. !CA San Diego works closely with volunteer groups, specifically the National Charity League (NCL ), in addition to our internal volunteer corps, known as Engagement Guides, to provide assistance as needed for our Teaching Artists as they prepare the art-making materials for each classroom ahead of each visit, reducing the expenses associated with our staff time.

12. If the proposed program or service is only awarded partial funding, will it still move forward? Will the program/service be scaled back and/or is there a threshold at which it will not move forward? Were !CA San Diego only able to receive partial funding, the program would still be able to move forward. As the program expenses are based on the number of students and classrooms visited, we can scale back the project in the number of students reached without reducing the quality of the experience. Additionally, as we utilize this grant award to expand our reach, bringing arts education into Solana Beach schools, we will build on these relationships with teachers and classrooms and intend to use future funding to continue bringing these offerings to more Solana Beach children year after year.

Acknowledgment of Responsibility:

Authorized Signature assumes all responsibility for developing and implementing proposed activities or events in this application, including public acknowledgment of/he City's financial contribution. Authorized signature will comply with all accounting and budget procedures outlined by the City. Authorized signature and accompanying group will hold harmless the City of Solana Beach from all losses, claims, accidents, and problems associated, directly or indirectly with the development and implementation of proposed / )
//I .It ,;(--· M 22 2025 -c/l-•u,,'./1 ,_. ay ,
Authorized Signature of Organization Date

ALL INFORMATION REQUESTED ON THIS APPLICATION MUST BE COMPLETED AS A CONDITION FOR BEING CONSIDERED FOR PUBLIC FUNDS BY THE CITY COUNCIL OF SOLANA BEACH.

Page I 3

I CA INSTITUTE OF

CONTEMPORARY ART

SAN DIEGO
ICA Central
1439 El Prado
San Diego CA 92101
619-236-0011
2025 Organizational Budget
INCOME
Contributed Revenue
Earned Revenue

TOTAL REVENUE

EXPENSES
Fundraising & Development
ICASanDlego.org I
@ICASanDiego
Individual Contributions
Board Contributions/Dues
Corporate Contributions
Foundation/trust grants
Government Grants
Earned
Gala & Other Events
$2,533,125
Personnel
Program Related
Contract Services
Operational
Marketing
ICANorth
1550 S El Camino Real
Encinitas CA 92024
760-436-6611
$607,500
$328,000
$110,000
$370,500
$215,500
$471,625
$430,000
$379,369
$200
$60,633
$86,913
$11,067

I CA INSTITUTE OF

CONTEMPORARY ART

SAN DIEGO
Programs
Administrative

TOTAL EXPENSES

NET OPERATING REVENUE
Other Expenses
ICACentral
1439 El Prado
San Diego CA 92101
619-236-0011
Personnel
Program Related
Contract Services
Operational
Marketing
Personnel
Staff Related
Contract Services
Operational
$2,200,694
$332,431
Depreciation Expense {$225,000)
NET OPERATING REVENUE (with depreciation) 107,431
ICASanDiego.org I
@ICASanDiego
ICANorth
1550 S El Camino Real
Encinitas CA 92024
760-436-6611
$646,113
$199,800
$31,600
$39,518
$11,000
$380,630
$6,265
$140,304
$207,282
The Valise Project
ICA San Diego
Expenditure
Valise Teaching Artists Salaries
Education Manager Salary
Art-Making Materials for Participants
Vehicle Maintenance and Mileage
Marketing & Promotion
Overhead & Administration
Total
2025 Program Expense Solana Beach Request
$65,500 $3,000
$35,200
$11,000
$3,000
$2,500
$5,800
$123,000
$1,000
$400
$200
$200
$200
$5,000
*Expenditure breakdown for Program expenses reflects annual operation of the program and its growth Solana Beach request is based on the $25 per student cost for visits Institute of Contemporary Art San Diego
Statement of Financial Position 03/26/2025
As of December 31, 2024 Accrual Basis
Dec 31, 24 Nov 30, 24 Change Dec31 , 23 Change
ASSETS
Current Assets
Checking/Savings
1000 • Cash
1005 • Chase (FRB) Checking x5830 87,387.97 67,656.13 19,731.84 61,970.36 25,417.61 1006 • Chase (FRB) Savings x7166 0.00 0.00 0.00 34,051 .75 -34,051.75 1007 • US Bank Savings Acct x5854 531.39 546.37 -14.98 7,665.16 -7 , 133.77 1030 • Pay pal 0.00 0.00 0.00 1,481 .51 -1 ,481 .51
1035 • Venmo 62.00 15.00 47.00 164.00 -102.00
1040 • Petty Cash (ICA North) 502. 58 492.18 10.40 278.98 223.60 1045 • Petty Cash (ICA Central) 437.79 437.79 0.00 179.94 257.85 Total 1000 • Cash 88,921 .73 69,147.47 19,774.26 105,791 .70 -16,869.97 Total Checking/Savings 88,921 .73 69,147.47 19,774.26 105,791 .70 -16,869.97 Accounts Receivable
1100 • Accounts Receivable
1110 • Accounts Receivable 102,661.62 90, 113.40 12,548.22 64,498.53 38,163.09 1115 • Grants Receivable 160,786.32 245,718.10 -84,931.78 128,527.00 32,259.32 Total 1100 • Accounts Receivable 263,447.94 335,831 .50 -72,383.56 193,025.53 70,422.41 Total Accounts Receivable 263,447.94 335,831.50 -72,383.56 193,025.53 70,422.41 Other Current Assets
1400 • Other Current Assets
1290 • Donated Asset 12,381.41 12,381.41 0.00 12,381.4 1 0.00 1450 • Prepaid Expenses 56,846.72 60,749.72 -3,903.00 100,032.91 -43, 186.19 1460 • Gift Store Inventory 4,000.00 4,000.00 0.00 4,000.00 0.00 Total 1400 • Other Current Assets 73,228.13 77,131.13 -3,903.00 116,41 4.32 -43,186.19 1900 • Other Assets
1950 • Funds Held in Trust by Others 618.99 618.99 0.00 0.00 618.99 Total 1900 • Other Assets 618.99 618.99 0.00 0.00 618.99 Total Other Current Assets 73,847.12 77 ,750.12 -3,903.00 116,414.32 -42, 567.20 Total Current Assets 426,216.79 482,729.09 -56,512.30 415,231 .55 10,985.24 Fixed Assets
1600 • Fixed Assets
1520 • Building (ICA North, 1578 ECR)
1521 • Land (ICA North, 1578 ECR) 979,550.00 979,550.00 0.00 979,550.00 0,00 1522 • lmpr & Construction 2,602,195.82 2,602,195.82 0.00 2,602,195.82 0.00 Total 1520 • Building (ICA North, 1578 ECR) 3,581,745,82 3,581 ,745.82 0.00 3,581 ,745.82 0.00 1610 • Building (ICA North, 1550 ECR)
1611 • Land (ICA North, 1550 ECR) 473,158.37 473,158.37 0.00 473,158.37 0.00 1612 • lmpr & Construction 4,070,902.71 4,070,902.71 0.00 4,070,902.71 0.00 Total 1610 • Building (ICA North, 1550 ECR) 4,544,061 .08 4,544,061.08 0.00 4,544,061 .08 0.00 1630 • Furn, Fix& Equip (ICA North) 345,139.69 345,139.69 0.00 345,139.69 0.00 1635 • Furn, Fix & Equip (ICA Central) 140,477.49 140,477.49 0.00 140,477.49 0.00 1640 • Leasehold lmprov(ICA Central} 439,723.13 439,723.13 0.00 439,723.13 0.00 1645 • Vehicles 90,801.39 90,801.39 0.00 71 ,238.08 19,563.31 Total 1600 • Fixed Assets 9,141,948.60 9,141,948.60 0.00 9,122,385.29 19,563.31 1700 • Accumulated Depreciation
1710 • Accumulated Depre(ICA North) -2,959,775.47 -2,943, 100.74 -16,674.73 -2,761 ,224.82 -198 ,550.65

Page 1 ends

Institute of Contemporary Art San Diego
Statement of Financial Position 03/26/2025
As of December 31 , 2024 Accrual Basis
Dec 31 , 24 Nov 30, 24 Change Dec 31 , 23 Change
1720 • Accumulated Depre(ICA Central) -495,095.47 -493,499.54 -1,595.93 -475,944.31 -19,151.16 Total 1700 • Accumulated Depreciation -3,454,870.94 -3,436,600.28 -18,270.66 -3,237,169.13 -217,701.81 Total Fixed Assets 5,687,077.66 5,705,348.32 -18,270.66 5,885,216.16 -198, 138.50 Other Assets
1960 • Construction in Progress
1962 • CIP-Furn,Fix,Equip-lCA Central 60,596.45 10,690.00 49,906.45 0.00 60,596.45 Total 1960 • Construction in Progress 60,596.45 10,690.00 49,906.45 0.00 60,596.45 Total Other Assets 60,596.45 10,690.00 49,906.45 0.00 60,596.45 TOTAL ASSETS 6,173,890.90 6,198,767.41 -24,876.51 6,300,447.71 -126,556.81

LIABILITIES & EQUITY
Liabilities
Current Liabilities
Accounts Payable
20003 • Accounts Payable - COP 3,097.26 3,088.88 8.38 0.00 3,097.26 2000 • Payables
2010 • Accounts Payable 281 ,518.68 237,339.89 44,178.79 46,485.41 235,033.27 Total 2000 • Payables 281 ,518.68 237,339.89 44,178.79 46,485.41 235,033.27 Total Accounts Payable 284,615.94 240,428.77 44,187.17 46,485.41 238,130.53 Credit Cards
2060 • Divvy 544.75 40.00 504.75 79.69 465.06
2040 • Credit Cards Payable - FRB
2051 • FRB CC - Roxana x1559 1,511 .65 1,511.65 0.00 1,511 .65 0.00 2050 • FRB CC - Ana x7946 8,979.19 8,979.19 0.00 8,979.19 0.00 2049 • FRB CC - Jordan x6334 6,237.99 6,237.99 0.00 6,237,99 0.00 2041 • FRB CC - Claudia x9574 33,479.35 33,479.35 0.00 33.479.35 0.00 2042 • FRB CC - Gaela x9952 52,676.21 52,676.21 0.00 52,676.21 0.00 2044 • FRB CC - Victor x4428 7,003.87 7,003.87 0.00 7,003.87 0.00 2045 • FRB CC - Guusje x9067 38,980.28 38 ,980.28 0.00 38,980.28 0.00 2046 • FRB CC - Sarah x5937 127,526.43 115,390,09 12,136.34 53,223.40 74,303.03 2047 • FRB CC - Andrew x9931 120,934.83 118,490,95 2,443.88 70,599.88 50,334.95 2048 • FRB CC - Beau x1693 24,923.69 24,923.69 0.00 21 ,630.55 3,293.14 2040 • Credit Cards Payable - FRB - Other -422,253.49 -407,673.27 -14,580.22 -294,322.37 -127,931 .12 Total 2040 • Credit Cards Payable - FRB 0.00 0.00 0.00 0.00 0,00 Total Credit Cards 544.75 40,00 504,75 79.69 465.06
Other Current Liabilities
CAC Grant Refund 71,000.00 71 ,000.00 0.00 71,000.00 0.00 2100 • Accrued Liabilities
2110 • Accrued Payroll 14,878.92 1,092.74 13,786.18 14,944.27 -65.35 2120 • Accrued Paid Leave 54,972.75 54,257.95 714.80 54,257.95 714.80 2130 • Accrued Payroll Taxes 5,850.48 0.00 5,850.48 5,689.96 160.52 2140 • Accrued Sales Taxes 3,147.80 2,539.27 608.53 293.41 2,854.39 2150 • Accrued Expenses 29,034.10 25,450.00 3,584.10 16,450.00 12,584.10 Total 2100 • Accrued Liabilities 107,884.05 83,339.96 24,544.09 91 ,635.59 16,248.46 2300 • Unearned I Deferred Revenue
2310 • Defer Rev - ICA North
2320 • Defer Rev - Facilty 1,000.00 1,000.00 0.00 1,000.00 0.00

Page 2 ends

Institute of Contemporary Art San Diego
Statement of Financial Position 03/26/2025
As of December 31, 2024 Accrual Basis
Dec 31 , 24 Nov 30, 24 Change Dec 31 , 23 Change
Total 2310 • Defer Rev - ICA North 1,000.00 1,000.00 0.00 1,000.00 0.00 2325 • Defer Rev - ICA Central 0.00 0.00 0.00 8,494.05 -8,494.05 Total 2300 • Unearned I Deferred Revenue 1,000.00 1,000.00 0.00 9,494.05 -8,494.05 2450 • FacilityRentDeposit-lCA North 660.00 660.00 0.00 3,000.00 -2,340.00 2600 • Short Term Loans
2615 • Short Term Loan 80,000.00 80,000.00 0.00 0.00 80,000.00 Total 2600 • Short Term Loans 80,000.00 80,000.00 0.00 0.00 80,000.00 Total Other Current Liabilities 260,544.05 235,999.96 24,544.09 175,129.64 85,414.41 Total Current Liabilities 545,704.74 476,468.73 69,236.01 221 ,694.74 324,010.00 Long Term Liabilities
2700 • Long-term notes&loan payable
2710 • Loan Payable - Auto 10,545.23 10,761 .82 -216.59 0.00 10,545.23 2705 • Loan Payable • ICA North (FRB) 1,003,993.68 1,006,564.42 -2,570.74 1,034,918.87 -30,925.19 Total 2700 • Long-term notes&loan payable 1,014,538.91 1,017,326.24 -2,787.33 1,034,918.87 -20,379.96 Total Long Term Liabilities 1,014,538.91 1,017,326.24 -2,787.33 1,034,918.87 -20,379.96 Total Liabilities 1,560,243.65 1,493,794.97 66,448.68 1,256,613.61 303,630.04 Equity
3000 • Net Asset with No Donor Restri
3010 • Board Restricted Funds
3011 • Boa rd Restricted (TXR) -424,601 .69 -424,601 .69 0.00 -424,601 .69 0.00 3010 • Board Restricted Funds - Other 425,177.96 425,177.96 0.00 432,256.01 -7,078.05 Total 3010 • Board Restricted Funds 576.27 576,27 0,00 7,654.32 -7,078.05 3000 • Net Asset with No Donor Restri • Other 4,633,766,59 4,600,695.03 33,071 .56 5,040,057.11 -406,290.52 Total 3000 • Net Asset with No Donor Restri 4,634,342.86 4,601,271.30 33,071 .56 5,047,71 1.43 -413,368.57 3100 • Net Asset with Donor Restrict 409,491 .24 442,562.80 -33,071 .56 218,120.16 191 ,371 .08 Net Income -430, 186,85 -338,861 .66 -91 ,325.19 -221 ,997.49 -208, 189.36 Total Equity 4,613,647.25 4,704,972.44 -91,325.19 5,043,834.10 -430, 186.85 TOTAL LIABILITIES & EQUITY 6,173,890.90 6,198,767.41 -24,876.51 6,300,447.71 -126,556.81

Page 3 ends

Institute of Contemporary Art San Diego
Profit & Loss Budget vs. Actual 03/2612025
January through December 2024 Accrual Basis
TOTAL
Jan 24 Feb 24 Mar 24 Apr 24 May 24 Jun 24 Jul 24 Aug 24 Sep 24 Oct 24 Nov 24 Dec 24 Jan - Dec 24 Budget Over Budget Ordinary lncomefExpense
Income
4000 • Contributions
4010 • Individual Contributions 7,228 97 19 156 00 2,545.25 2.213 97 40,1 42 91 2 690 78 6.608 91 2,11913 2.55011 75996 15.976 23 30,407 88 132,400 10 760,000 00 -627.599.90 4015 • Board Contributions/Dues 000 57 75000 000 000 000 000 000 50,000 00 159,728 66 5,00000 5,000 00 5,00000 282.47866 290.000 DO -7.521 34 4020 • Corporate Contributions
4045 • Corporate Sponsorship 000 000 0.00 000 15,240 00 000 000 000 0.00 000 000 000 15,240 00 4020 • Corporate Contributions - Other 2.17000 1.00000 000 21,40000 4,800 DO 000 000 000 ODO 19,000 00 000 ODD 48.370 DD 100,000.00 -51 ,630 00 Total 4020 • Corporate Contributions 2.17000 1 000 DO ODO 21.400 00 20,040 DO 000 0 DD ODO 0.00 19,000 OD 000 ODD 63,610 DO 100,00000 -36,39000 4030 • Foundation/trust grants 15 357 75 ODO 15.000 00 7 985 00 6.270 00 210,85000 40 000 00 10,00000 20,00000 16,500 01 155,00000 74,980 00 571,942.76 246.00000 325.942 76 4040 • Government Grants 2,50000 20,000 00 000 92.735 00 47.500 DO 000 000 142,118.00 23.494 05 ODD 53,39000 15,000 DO 396.737 05 143.198 OD 253.53905 Total 4000 • Contributions 27.256 72 97 9C6 DD 17,545 25 124.333 97 113.952 91 213,540 78 46,608.91 204.237 13 205.772 82 41 259 97 229366 23 125,387 88 1,447,168 57 1 539198 00 -92.029 43 51 00 • Program Related Fees
5105 • Youth Class Fees 1.195 DD ODD 1,396 50 77500 ODD 000 1,230 50 1,333 85 1,935 75 ODD 23500 2.471 50 10,57310 4.018 DO 6.55510 5110 • Adult Class Fees 5,534 DD 747 DD 3.789 DD 6.07000 1,22500 3,005 DD 5,953 25 8,534 50 4.776 DD 1,31000 6,325 00 5,945.00 53,213 75 35,910 00 17 303 75 5115 • Other Program Fee Revenue
5117 • Scholarships ODO ODO ODD ODD 000 D DD ODD ODO ODD -35000 ODD ODO -35000 5115 • Other Program Fee Revenue - Other DOD 1,50000 ODD 55000 48000 0.00 -80.00 400,00 000 35000 000 0.00 3,200 DD 101,250 DD -98.050.00 Total 5115 • Other Program Fee Revenue ODO 1 50000 ODO 55000 48000 DOD -8000 40000 ODD DOD 000 000 2.850 DD 101 ,250.00 -98,400 DD 5120 • Ceramic Lab Membership Fees
5122 • Purchases 60060 694 DD 1,607 16 56600 39500 413 OD 602 DD 70500 72800 76900 79800 1,017 DD B 894 76 5120 • Ceramic Lab Membership Fees - Other 5,861 DD 5.812 00 7,202 50 5,102.00 5,590 50 4,292 OD 5.773 00 7,456 00 7,973 OD 8,12200 6 94800 7.768 DO 77.900.00 84,00000 -6.100.00 Total 5120 • Ceramic Lab Membership Fees 6,461 60 6,506 OD 8,80966 5668 DD 5,985 so 4,705 00 6.375 DD 8,161 DD 8.701 DD 8.891 DO 7,746 DO 8,785 DO 86,794 76 84,00000 2,794 76 5130 • Camp Revenue ODO ODO 000 ODO ODD 60.411 96 64,690 45 ODO -3950 ODO ODO ODO 125.062.91 164.374 DO -39.311,09 5205 • Membership Dues 981 DO 1,861 DO 1,023 00 2,135 00 1 22500 3,605 DD 1.065.00 1,30500 98500 2.715 DD 57500 4,515 DO 21 ,99000 51 ,000 DO -29,010 DO 5215 • Admissions 442 40 38854 51393 103,53 25633 60 DD 56824 21 4 18 141 72 24913 8026 148 66 3,166.92 3,833,00 -666.08 5225 • Gallery Guides ODD 000 000 8000 ODO 0 OD 000 ODO ODO DOD ODD 000 8000 3,000 DO -2.920 DD Total 5100 • Program Related Fees 14,614 00 11 ,002 54 15,53209 15,381 53 9,171 83 71 ,786,96 79 802 44 19.94853 16,499 97 13,16513 14,961 26 21,865.16 303,73144 447.385,00 -143,653,56 5300 • Revenue from Investments
531 0 • Interest - Bank 3765 1597 0 34 013 002 0,02 002 002 002 0,00 D 04 002 54.25 5315 · Investments • Unrealized Gain/L ODO ODO ODO ODO ODD 000 000 000 531 24 -1 ,757 27 ODO 0.00 -1,226.03 Total 5300 • Revenue from Investments 3765 1597 034 013 002 0.02 002 002 531 26 - 1.757 27 0,04 002 -1.171.78 5400 • Other Revenue
541 O • Gallery Art Sales- 000 0.00 000 ODD ODO 000 ODD 000 3,00 0.00 34.50500 6,060 DO 40,568 00 ODO 40,568.00 5420 • Gross Sales 000 000 ODO ODD 138.00 948.00 2000 903 50 12000 4000 36500 3,439.50 5,974 00 5430 • Facility Rentals 000 ODD 5.30000 1750 00 2,500.00 4,000.00 2,000 00 1,000.00 7,100 DO 1,000 DO ODO 80000 25.450,00 45.00000 -19.550 00 5490 • Miscellaneous Revenue 0.00 182.26 ODO 0.00 ODO 1.32 D 00 000 000 506 21 ODO 001 689.80 Total 5400 • Other Revenue ODO 182 26 5.30000 1,750 DD 2,638 00 4,949 32 2.020 00 1,903 50 7.22300 1.546.21 34,87000 10.299.51 72,681 80 45.00000 27,681 .80 5800 • Special Events
5810 • Ticket Sales 000 24,000 DD 10.400 DD 6.000 DD 10,500 DO -6,000 DO ODO ODO 12500 4.325 DO 2,890 00 000 52,240.00 170,000 DO -117,760 OD 5815 • Sponsorship, Underwriting 0.00 6,000.00 14,000 DO 20,000 00 77,00000 D DD 19,000 DD ODD 1.500 00 3,00000 DOD 0.00 140,500.00 100,000 00 40,500 DD 5820 • Auction ODO D DD ODO 000 84.47500 ODD 0,00 ODO 0 OD ODD 8,335 DD ODO 92,810,00 230,000.00 -137.190 00

Page 1 ends

Institute of Contemporary Art San Diego
Profit & Loss Budget vs. Actual
January through December 2024
5830 • Raffle
5880 • Other Event Revenue
Total 5800 • Special Events
Total Income
Cost of Goods Sold
5425 • Cost of Goods Sold
Total COGS
Gross Profit
Expense
7000 • Program Related Expenses
7005 • Program & Class Supplies
7010 • Artist Fees/Stipend
7012 • Production Costs
7010 • Artist Fees/Stipend• Other
Total 7010 • Artist Fees/Stipend
7015 • Translation Fees
7020 • Artist Hospitality/Food Exp
7030 • Books, References
7035 • Artwork Shipping
7040 • Artwork Installation
7060 • Honorariums
8615 • Artwork Sales Commission
Total 7000 • Program Related Expenses
7200 • Salaries & related expenses
7210 • Salaries & wages-Officer& Exe
7225 • Salaries & wages -Staff
7227 • Salaries&Wages-Teaching Artists
7230 • Employee benefits
7235 • PTO Expense
7240 • Workers Comp
7250 • Payroll Taxes
7260 • Recruitment
8540 • Slaff Development
8545 • Staff Appreciation
Total 7200 • Salaries & related expenses
7500 • Contract Services Expense
7515 • Janitorial Fees
7516 • Landscaping Fees
7520 • Accounting Fees
7525 • Audit Fees
7530 • Legal Fees
7540 • Professional Fees - Other
Jan 24 Feb 24
000 000
000 000
0 00 30,000.00
Mar 24 Apr24 May 24 Jun 24

0.00 ODO 000
0 00 0 00 0 00 14,305.00
24,40000 26.00000 171 ,975.00 8,30500
Jul 24
000

4.630 00
23,630.00
Aug 24
000
95000
950.00
Sep 24
000

2.55000
4,175 00
Oct 24 Nov 24
ODO 000
000 000
7,325 00 11225 00
Dec 24 Jan - Dec 24

0.00 0.00

0.00 0.00
22,435 00
307,985.00
TOTAL
Budget
000
6,30000
506.30000
41 .908 37 139.106.77 62,777 68 167.465 63 297,73776 298 582 08 152.061 37 227.039 18 234,202 05 61 ,539.04 290,422 53 157.55257 2,130,395.03 2,537,883.00 3,200 00 000 000 0.00 9000 00 000 000 000 000 000 000 779.10 12,979.10 3,20000 000 000 D 00 9.000.00 ODD 0.00 ODD ODO ODD ODD 779.10 12,979 10

38.70837 139,106.77 62,77768 167.46563 288,73776 298,58208 152,06137 227,039.18 234,20205 61 ,53904 290.42253 156,773.47 2.117.415.93 2,537,88300

2.457 25 2.235 78
983 86 13.420 44
39,167 68 28,500.00
40,15154 41, 92044
000 ODD
8143
0 DO
000

0.00 148 36 1,654 73

13.495 31 2,688 69
000 000
000 000
4 744 20 2 342 79 2 497 18 6,707 42
269938 2154
8,000 DO 11,044.00
10,699 38 11 ,065 54
717 88 D DD
000
000
ODD
ODD

2.426 58 000
9,679 40 1.000 00
ODD 0.00
000 000
1605
3,000 DD
3,016 05
ODD
000
000
000
ODD
0 DD
000
ODD
75000
750 00
ODO
2964
0 DD
15814

0.00 60000
000
7,033 49 4 150 90 3,137 67
000
2,834.00
2,834 DD
359.89
0 00

0.00 0 DO 0.00

8.750 DO 24,000 DO
8,750 00 24,000 00
44668
22828
000
24508
4561
000
3,551 68 1 06192 1,11713
1 675 96 4,355 78 898 64
30000 000 000
447 30 0.00 0 DD
56,33389 48,49964 28.267 44 14.408 33 5,513.23 8,245.20 16202 32 18,993.56 29,44413 7,447 88 9,166 64 9 16664 9,16664 9,166.64 4,583 32 13.749 96 4,58332 9,16664 3,405 75 2,994 88 961 28 42 668 59
0 00 0 DO 20,000 00 37 141 27

0.00 16,619 40 9,000.00 151 66508
0 DD 16.619 40 29.000 DO
000 000 0.00
000
4922
32 78

0.00 0 00
000
583 60 396 28 1,961 43
-76 68 29.25 1.000.67

0.00 000 000
0,00 12,900 00 -1 4310
188,806 35
1 769.53
41 7 74
4922
13,059 85

34.747 02
900,00
13,204.20
53,700.00
97,583 00
97,583 OD
3,500 DO
3,433.00
35,200 00
11 ,400.00
3,961 89 32,972 59 32.780 28 295,622.50 204,816.00
9,16664 9,16665 15,468.73 109.99970

63.423 80 76.84028 69.50178 79.300 17 80.868 33 87,347 44 96.022 57 87,61934 76,494 05 78,140 98 75,398 28 93.246.82 964,203.84 1,230.326 DD 305311

5.53467

0.00 22962
8,975 27
35000
21 99
49 80
6,815 73
5,188.14
ODD
281 05
10,551 81
50000
81900
4788

4.534 85

5.18814

0.00 257 38
7,24528
ODD

1.455 99
37316
5,224.50
5654 49
ODD
28591
6 401 08
ODD
88482
211 27
5,041 10
5 987 15
000
32623
7,823 08
ODD
45397
22941
7,279 78
6,253.88

0.00 352 59

8.144 39
ODD
39500
165.73
8,63098

6.886 DD
ODD
47029
9,88815
000
39500
22619
5,193 20

6.092 28
000
38349

7.803 25
ODO
632.05

1.264 62
4,766 25
7,323 81
000
31279
7 118.76
000
37500
10589
4,524 21
3,916 43
000
313 96

7.278.67

0.00 000
15021
4,799 88
5,29617
000
424.69
6 981 08
000
85000
20897
6,581 09
4,591.42
714.80
394 39
9,693.27
000
1,12500
1,701 86
66,444 68

67.912.58
714.80
4,032.39
97,90409
85000

7.407.82
4,734.99

64.200 DD

73.685 00
9,21800
98,42600

1.000 DO
5,000 00
4,515 00
89,086.14 11021053 97,72322 107128.88 109.89591 114,52213 136,26914 113,571 .55 105,66319 103.49110 103,12572 133.517 38 1,324.20489 1,486.370 00

1.62000
2 420 DO
6,055.77
000
000
16106 98
1,500 DD
2,420 00

5.715 76
000
000
9 737 61
1,62000

1.10000
6 213 50
000
000
13,351 94
2,620.00 0 00 950 00
1,10000 1910 00 110000
5 377 97 5,689 03 5,847 36
000 000 ODD
000 000 000
7,317 89 14,97269 17 414 10

2.740 00

1.10000
6 203 85
000
000
11 ,444 64

1.930 00
1,330 10
6,25181
000
ODD
889161
1,970 DO
1,10000
6,185 35
ODD

0.00 7 620 28
1,94000
1,10000
8,775 91
ODO
000

4.823 70

2.510 DD
1,10000
6,061 74
ODO
000
9,999 23
1,820.00
1,352 77
8,801 78
000

0.00 8,51710

21.220 DD
17,13287
77,179 83

0.00 000
130.197 77
9,900 00

14.400 00
60,480.00

22.500 DO
000

92.880 DO
03/26/2025
Accrual Basis
Over Budget
ODO
16,135.00
-198,315 00
-407.487 97
-420.467.07
-11 ,031 41
54,082.08
91,223 35
-1.730 47
-3,015.26
-22,140 15
23,347 02
90,80650
-266,122.16
2,244 68
-5.772.42
-5,18561
-52191
-150 DO

2.407.82
21999
-162,16511
11 ,320.00

2.732 87
16,699.83
-22.50000
ODD
37,317 77

Page 2 ends

Institute of Contemporary Art San Diego
Profit & Loss Budget vs. Actual
January through December 2024
7541 • Professional Fee~ Documentati on
7542 • Professional Fees-Grant Writing
7545 • Professional Fees - Preparator
7550 • Tech/Computer Consulting
Total 7500 • Contract Services Expense
8100 • Operations
8110 • Office Supplies
8115 • Janitorial Supplies
8116 • Landscaping Supplies
8130 • Website&Software Application
8140 • Postage & Shipping
8150 • IT Hardware
8170 - Printing & Copying
8180 • Subscriptions
8100 • Operations - Other
Total 8100 • Operations
8200 • Facility and occupancy expense
8210 • Rent, Storage
8220 • Utilities
8230 • Internet & Telephone
8260 • Equipment Rentals
8290 • Repair & Maintenance
Total 8200 • Facility and occupancy expense
8300 • Travel & Meetings
8310 • Travel
8320 • Conf. Conventions& Meetings
8325 • Lodging
8330 • Meals & Entertainment
Total 8300 • Travel & Meetings
8400 • Advertising & Marketing
8410 • lnter&Social Media Marketing
8415 • Direct Mail
8420 • Print, Billboards
8425 • Digital Advertising
8430 • Broadcast
Total 8400 • Advertising & Marketing
8500 • Other Business Expenses
8240 • Property Taxes
8505 • Bank & Credit Card Charges
8510 • Interest Expense
8520 • Insurance
8605 • Art Restoration
Jan 24 Feb 24
000 0.00
000 000
0 00 2,500.00
000 000
Mar 24
30000
000
000
000
Apr 2.4 May 24
300 00 2.975 00
000 000
000 000
0 00 0,00
Jun 24
0,00
000
000
000
Jut 24
000
0 00
0 00
000
Aug 24
000
000
000
431 25
Sep 24
000
000
000
0 00
Ocl24

0.00 000
2,502 00
000
Nov 24
80000
000
000
35000
Dec 24 Jan - Dec 24

0.00 0.00
0,00

0.00 4,375.00
000
5,002 00
781,25
TOTAL
Budget

9.533 00
000

9.000 00
8,500 00
26,20275 2187337 22,58544 16.715.86 25.546.72 25.31146 21 .48849 18.834.77 16,87563 19,14161 20,82097 20,491.65 255,888.72 227,19300 911 SB 631 89
0,00 000
000 000
988 05 1,007 12
1511 5797
000 000
000 2,962 05
751.82 1,283 30
000 000
2,666 56 5,942 33
52067
000
000
1,007 61
508
000
000
364 42
000
1,897 78
284 39 1.373 43 498.19
000 000 000
000 000 000
107048 1,08688 1,01682
33 50 165 66 33 48

1.52711 000 000
101 07 2.476 08 362 22
944 64 935.95 1,278 26
000 000 000
3,96119 6.038 00 3188 97
820 21 369 35 210 94 576 08 226 21
000 000 000 000 0,00
000 000 000 000 000
960 34 1.214.57 1,203 82 759 85 1,803 45
1941 558 2240 11 82 5 58
000 000 000 o oo o.oo
1 675 52 1 866 57 1,583 94 585 07 89067
908 03 908, 03 1,057 25 1.253,63 957 53
0 00 0 00 0,00 000 000
4,383 51 4,364 10 4,078 35 3,186 45 3,883 44
295.40

0.00 000
1 04713
1045
000
2,297 62
1,216.50
0,00
4,867.10

6.718.34

0.00 000
13,166.12
386.04
1,527 11
14 800 81
11 859.36

0.00 48,457 78
7,850 00
000
000
11 ,994.00
1,20000
000
23,74200
4,452.00
1,60000
50,83800
1,10400 1,10400 1.10400 1,10400 1,15200 115200 1,01700 1,113.00 1.12000 75500 75500 1,850.00 13,33000 37,35600 4,16425 2.703 16 3,68950 8,98401 2,85675 4,01891 2,77772 327771 241955 4,18105 660564 9,99790 55,67615 35,40000 377 98 3,668 64 2.871 81 2,658.65 1,450 22 2,55160 2,100 37 3.106.97 2,61743 3,00977 3,27165 1,43194 29,11703 25,18800 806 08 770 33 1,944 60 806 OB 5,027 48 84108 11 ,05483 80608 000 3,153.49 84460 100,00 26,15465 37,900.00 1 125 20 1,924 59 820 54 792 77 3,934 48 1,263 89 3,359.58 1,544.11 431 83 4.46811 927 37 2,061 05 22,653.52 30.550 00 7,577 51 10,17072 10.43045 14,34551 14.42093 9,827 48 20,309 50 9,847 87 6,588 81 15,567 42 12.404 26 15,440,89 146,931.35 166,394 00 415 49 621 91
0 00 40000
0 00 368 98
4,791 67 3 359 94
5,207 16 4 750 83
1 75000
000
000
000
0,00
1,750 00
000
000
4,20
000

0.00 4.20
000 808634
69415 677 62
2,896 34 2.726 47

2.783.25 2,783 25
118750 000
45773 63752 4,88594 1,46852 8619 6,18710 11 .13613 1,55308 453.84 1,34082 29,24427 1,658 10 257 25 0 00 0.00 0 00 77 78 323 09 0.00 80 70 0 00 2,796.92 000 51410 0.00 000 000 000 000 0,00 45980 000 1,342.88
67668 1.12200 4,683.78 3,19500 46,64975 2.76440 3,36641 10,08190 93357 1,659.55 83,28465 2,79251 2,53087 9,569.72 4,66352 46.73594 9,029.28 14,82563 11 ,63498 1.92791 3,00037 116,66872 000 4999 000
000 ODO 000
0 00 0.00 0,00
0 00 2 010 DO 2,081 98

1.200 00 0 00 0,00
1,200 00 2.059 99 2,081 98
000
000
000
ODO
0 00
0 00
000 000 000 000

4.407 47 1,334,93 6,403 45 1 320 72
2,901 .40 2 790 94 3,300 05 3 214 30

3.93640 1,86904 3,05459 3,11999
0 00 1,900 00 -1 ,900 00 0 00
000 000
000 000
000 000
2,000 00 3 500 00

0.00 1,200 00
2,000 00 4,700 00
000
000
33858
000
600 00
938 SB
000 000 000
1,12291 36384 123248
3,438 41 3,406 55 3,690 69
3,251 09 3.151 06 2,939 42
000 000 000
0,00 0 00 147 56
0 00 000 0.00
o.oo o_oo o.oo
0 00 1,664 00 3,252 90
0 00 0 00 0.00
0,00 1 664 00 3,400 46
0 00 0,00 97 13
1,417.95 1,39054 6,645.81
3,758 81 3,847 04 3.922 07
2,887 88 2,887 88 2,913.88
000 000 000
1,947.55
000
34278
14,50888
3,000.00
19,799 21
8,183 47
27,011 .87
39,89307
35,577 73

1.187 50
7,200 00
5,500 00
40000
27,40000
40,50000

3.00000
8,05000
2,000.00
21,100,00
4,800 00
38,950 00
19,600 00
0,00
34,500 00
24,521 00
000
03/26/2025
Accrual Basis
Over Budge!
-5.158.00
000
-3,998.00
-7,718.75
28,695 72
-1,131 ,66
000
000
1,17212
-813 96
1,52711
-8,941 19
7,407 36
-1,60000
-2,38022
-24.026 00
20,276.15
3,929 03
-11 ,74535
-7,896.48
·19,462 65
22,044.27
-2,703 08
942.88
55,884 65
76,168 72
-1 ,052 45
-8,050 00
-1 ,65722
-6,591 12
-1 ,800 00
-19,150 79
-11,416 53
27,011 87
5,393 07
11 ,056,73
1,18750

Page 3 ends

Institute of Contemporary Art San Diego
Profit & Loss Budget vs. Actual 03/26/2025
January through December 2024 Accrual Basis
TOTAL
Jan 24 Feb 24 Mar 24 Apr24 May 24 Jun 24 Jul 24 Aug 24 Scp24 Oct24 Nov 24 Dec 24 Jan -Dec 24 Budget Over Budget 8530 • Membership Dues 365 31 265.31 265 31 26531 265.31 265,31 98827 473.27 27327 273.27 27327 273.27 4,246.48 3.578 00 668.48 8535 • Licenses, Permits, & Fees 7700 425 75 13360 154 20 244 00 0 00 7710 661 35 7735 11 39 59460 42.50 2.49884 1,225 00 1.273.84 8590 • Other Expenses 1 20 0.00 -001 000 2.49 0 00 002 18.00 000 61 .65 -6165 10300 124.70 15000 -2530 8620 • Sales Taxes 000 000 000 000 0 00 000 000 0.00 171 0.00 000 000 1.71 8680 • Equipment Purchases 000 000 000 000 000 000 171 60 -171.60 53869 660.55 17 30 2,340 88 3,557.42 Total 8500 - Other Business Expenses 8.004 75 14,964 74 11 ,644 17 8,314 42 11 ,369 89 7,920.32 9,049 40 7,90247 8.753 61 9,071 .50 8,948 98 16,338.54 122.28279 83,574.00 38,708 79 Total Expense 196,828 76 216,416 36 176,541 01 169,465 05 184.436.38 173,679 08 256,43830 187,243 60 187.167 93 166.054.95 185,747 87 229,836.67 2,329,855.96 2,298,635.00 31 ,220 96 Net Ordinary Income -158,12039 -77.309 59 -113,763 33 -1 .99942 104 301 .38 124 903 00 -104,376 93 39,795 58 47.034 12 -104,51591 104,674 66 -73,063 20 -212,440 03 239,248.00 -451 ,688.03 Other Income/Expense
Other Expense
77000 - ·exchange Gain or Loss 000 1059 32 52 216 34 41 -6.14 14 72 000 -3685 227 000 --867 4501 9000 • Other Expenses
8270 • Depreciation & Amortization 17,944.61 17 944.61 17.94461 17,944 61 18,028.75 18 270.66 18,270 66 18,270.66 18,27066 18.27066 18,270.66 18,270 66 217,701.81 Total 9000 • Other Expenses 17,94461 17,944 61 17,944 61 17,944 61 18,028.75 18,270 66 18,27066 18,270.66 18,270 66 18,27066 18,270.66 18,27066 217,701 81 Total Other Expense 17,944 61 17,955 20 17,977 13 17,946 77 18,06316 18,264.52 18,285 38 18,27066 18,233 81 18,272.93 18,270 66 18.261 99 217,746.82 Net Other Income -17,944 61 -17,955 20 -1 7,97713 -17,946 77 -18,06316 -18,264 52 -18,285.38 -18,27066 -18,233 81 -18.272 93 -18,270 66 -18,261 .99 -217.746 82 Net Income -176,065.00 -95,264.79 -131,740.46 -19,946.19 86,238.22 106,638.48 -122,662.31 21 ,524.92 28,800.31 -122,788.84 86,404.00 -91 ,325.19 -430, 186.85 239,248.00 -669,434.85

Page 4 ends

Fonn 990
0epanmenl <;>fUle Treasury
tr.rernal Re•Mue Servrce
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Do not enter social security numbers on this form as it may be made public. 0MB No. 1645-0047
2023
Open to Public
Go to www.irs.gov/Form990 for instructions and the latest information. Inspection B Check ii applicable: C Name of organization INSTITUTE OF CONTEMPORARY ART SAN DIEGO D Employer Identification number □ Address change DDlng buslness as SAN DIEGO ART INSTITUTE rv, Number and slre"t (or P.O. box ii mall is not delivered to street address) Room/suite lKJ Name c~arige ______________________ 1439 El Prado ___._ ______ _ E Telephone number D lnilfal return City or town
San Die o
State
CA
ZIP code
D 92101 Fiiwl return/terminated
D Amencted rel\Jm
Foreign counlJ)' name Forei!Jn province/slate/county
D Application pending F Name and address of principal officer:

ANDREW UTT 1439 EL PRADO, San Die o, CA 92101
I Ta,c-eKemptstalus: 00 501(0)(3) □ 501 (c) (insertno.) D 4947(a)(1)or D 527 J Website: WWW.ICASANOIEGO.ORG
K Form cl organization: 00 Corporation D Trust D Association D Olh"r ll>
u
C:

Ill
C:
ai
i)
C)
oa
Ill
.!!
';
:c
u
<
1 2
3 4
5 6
7a
b
8 9
10 11
12 13
14 15
16a
Summa
Briefly describe the organfzatron's mlssion or most significant activities:
artists while fostering cultural e51.u~ty throu_g_h access to meaningful art experi Check this box D if the organization disconfinued its operati ns Number of voting members of the governing body (Part VI, line a Number of independent voting members of the governing bo~ Total number of individuals employed in calendar year 202 P Total number of volunteers (estimate if necessaiy) . . .

Total unrelated business revenue from Part VIII, colum
Net unrelated business taxable income from Form 990-T,
Contributions and grants (Part VIII, line 1 h) .

Program service revenue (Part VIII, line 2g) .

Investment income (Part VIII, column (A), lines ·
Other revenue (Part VIII, column (A), lines 5
Total revenue-arld lines 8 throu h 11 must
, line4).
1e).
, line 12 .

Grants and similar amounts paid (Part I
Benefits paid to or for members (Part
Salaries, other compensation, employ
Professional fundraislng fees Pa
IX, column {A), lines 5-10) .
), line 11 e) .

Total fundraising expenses (P ), line 25) ·-------------567,577 619-236-00t.J
2 083 714
Oves[KJ No
OvesONo
M State of legal domrlllle: CA.
tonal contem_eorary art and __ _______ - __ _
ore than 25% of its net assets.
3 4
5 6
7a
7b
9 9
30 0
Prior Year C urront Year
1,304.628 1,720,957
503,987 300,386
1,009 641
55,888 61 ,730
1,865,512 2,083,714
0 0
0 0
1,218,231 1,271.568
0 In
<I)
Ill
C
<I)

0. ><
w
b
17 18
19 Other expenses (Part IX, co! a-11 d, 11 f-24e) . 1-------83_8..,..,0_4_7 _____ 1.:....;; o....;;.3-'4''-14--'-4 20 21
Sign
Here
Paid
Preparer
Use Only
Total expenses. Add lines ual Part IX, column (A), line 25) . 1--____ 2 __ ._05_6 .... ,2_7_8 ____ __;;;2,:_;;,3....;;.0""'5,c.;_7...;.;;;:;_12 Revenue less ex S_u 18 from line 12. -190,766 -221 ,998 Total asse1
Total liabi •
. Subtract line 21 from line 20
Beginning of Current Year
6,573,019
1,307,187
5,265,832
End of Year
6,300,448
1,256,613
5,043,835
ave e,camined this return, Including accompanylng schedules and slatements, and lo the best of my knowledge e. Declarallon of preparer (other lhan officer) is based on all lnlormation cl which preparer has any knowledge.

I 10/31/2024
Signature of officer Date

ANDREW UTT EXECUTIVE DIRECTOR
Type or print name and title
Print/Type preparer's name Preparets signature I Dale I Check □ it PTIN
Leonard C Sonnenberq Leonard C Sonnenbero 11·/12/2024 self-employed P00287581 Firm's name Sonnenbem & Comoanv CPAs I Firm's EIN II" - _,.

Firm's address 5190 Governor Dr, #201, San Dieqo, CA 92122 I PhoAeno. 858-457-5252 May the IRS discuss this return with the preparer shown above? See instructfons . IX] Yes D No For Paperwork Reductron Act Notice, see the separate instructions. HTA Form 990 (2023)
STATE OF CALIFORNIA RRF-1
(Rev, 0212021 )
MAIL TO:

Regislty of Charilable Tru5ls
P.O. BoM 903447
Sacramenlo, CA 94203-4470
STREET ADDRESS:
1300 I Street
$3cramento, CA 95814
(916) 210-8400
WEBSITE ADDRESS:
www.oag.ca g011lchanlles

ANNUAL REGISTRATION RENEWAL FEE REPORT

TO ATTORNEY GENERAL OF CALIFORNIA
Sections 12586 and 12587, California Government Code
11 Cal, Code Regs. sections 301-306, 309,311, and 312
Failure to s~bmit th1s report annually no later than four months and fifteen days after the end or 1he organization's accounting period may result In the loss of tax exemption and the assessment of a minimum tax or 5800, plus interest, a~dlor fines or filing penalties. Revenue & Taxation Cede secoon 23703: Government Code section 12586.1. IRS extensions wi l be honored.

INSTITUTE OF CONTEMPORARY ART SAN DIEGO Check if:

Name of Organization D Change of address
SAN DIEGO ART INSTITUTE D Amended report
DEPARTMENTOFJUSTlCE PAGE 1 of 5
(For Registry Use Only}
Ust all DBAs and names the organization uses or has used 1439 El Prado
Address (Number and Street)
San Diego, CA 92101
State Charity Registration Number ___ 0_2_5_4_8_4_7 __ _ City or Town, State, and ZIP Code
619-236-0011
Corporation or Organfzation No. ____ 2_03_8_4_64 ___ _
info@icasandiego, erg
Tele hone Number E-mail Address Federal Employer I.D. No. I ,a. --- -- ,,,,,..;-_-_ ...

ANNUAL REGISTRATION RENEWAL FEE SCHEDULE (11 Cal. Code Regs. sections 301-307, 311, and 312) Make Check Payable to Department of Justfce
Total Revenue
Less than $50,000
Between $50,000 and $1 Oo,ooo
Between $100,001 and $250,000
PART A~ ACTIVITIES
$25
$50
$75
Total Revenue
Between $250,001 and $1 million
Between $1,000,001 and $5 million
Between $5,000,001 and $20 million
$100
$200
$400
Total Revenue
Between $20,000,001 and $100 million
Between $100,000,001 and $500 miilion
Greater than $500 million
For your most recent full accounting period (beginning ___ 1/_1/_2_02_3 __ ending __ 12/_3_1_/_20_2_3 __ ) list:

Total Revenue $
$BOO
$1,000
$1,200
(lnciudir,g noncash contributions) 2,083,714 Noncash Contributions $ _______ O_ Total Assets$ ___ _ 6,_,3_0_0,'-4_4_8 Program Expenses $ ____ 8_8_4'-.4_2_2 Total Expenses $ ____ 2;_,3_0_5,._7_12_ PART B • STATEN!ENTS REGARDING ORGANIZATION DURING THE PERIOD OF THIS REPORT Note: All questions must be answered. If you answer "yes" to any of the questions below, you must attach a separate page providing an explanation and details for each "yes" response. Please review RRF-1 instructions for information required.

1. During this reporting period, were there any contracts, loans, leases or other financial transactions between the organization and any officer, director or trustee thereof, either directly or with an entity in which any such officer. director or trustee had any financial interest?

2. During this reporting period, was there any theft, embezzlement. diversion or misuse of the organization's charitable property or funds?

3. During this reporting period, were any organization funds used to pay any penalty, ,fine or judgment?

4. During this reporting period, were the services of a commercial fundraiser, fundraising counsel for charitable purposes, or commercial coventurer used?

5. During this reporting period, did the organization receive any governmental funding?

6. During this reporting period, did the organizatron hold a raffle for charitable purposes?

7. Does the organization conduct a vehicle donation program?

8. Did the organizalion conduct an independent audit and prepare audited financial statements in accordance with generally accepted accounting principles for this reporting period?

9. At the end of this reporting period, did the organization hold restricted nel assets, while reporting negative unrestricted net assets? Yes No
X
X
X
X
X
X
X
X
X
I declare under penalty of perjury that I have examined this report, including accompanying documents, and to the best of my knowledge and belief, the content Is true, correct and complete·.

ANDREW UTT
Signature of Authorized Agent Printed Name

EXECUTIVE DIRECTOR
Tl\le
11/12/2024
Date
~~ IRS Dcpnrtn11:n1 l'l'lli.: Tr.:ai11ry ~rfhY/j/ l11ln111,I R,•,•1•11\ll' Sn,·lc~ 0041 85
P.O. Box 2508, Room 4010
Cincinnati OH 45201

SAN DIEGO ART INSTITUTE
¾ MISSION VALLEY CENTER
1459 EL PRADO
SAN DIEGO CA 92101-1617390
Employer Identification Number:

In reply refer to: 4 077552510
Nov. 06, 2008 LTR 4168C 0
95-1816068 000000 00 000
00021245
BODC: TE
Person to Contact: Michelle Jones
Toll Fre e Telephone Number: 1-877-829-5500
Dear Tax payer:

This is in response to your request of Oct . 15, 2 0 08, regardihg your tax -exempt status.

Our records indicate that a determination letter was i ssued i n May 1966, that recognized you as e x empt from F e deral income tax . and discloses that you are currently e x empt under section 501(c)C3) of the Internal Revenue Code,
Our records also indicate ~ou are not a private foundation within the meaning of section 509Ca) of the Code becaus e you are de s cribed in secti onCs) 509(a)(l) and 170(b)(l)CA)Cii),
Donors may deduct contributions to you as provided in section 170 of the Code, Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes i f they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code.

If you have any questions, please call us at the telephone number shown in the heading of this letter.

Sincerely yours .

Cindy Westcott
Manager, EO Determinations

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
SACRAMENTO, CALIFORNIA 95857
February 2 0, 1985
San Diego Art Institute
Attn: Betty McGill
3154 Groton Way Apt 1
San Diego Ca 92110
Puz:pose
Oz:ganization Mame
Organization Humber
In reply refer to
342:ATS:54:BOE
Certification of Exempt Status

SAH DIEGO ART INSTITUTE
0254847
The following certification is provided in response to your letter requesting evidence of your income tax exempt status.

Certi:fication
According to the records of the California Franchise Tax Board, the organization referred to above is qualified as an organization which is exempt from Bank and Corporation taxes under section 23701Cd) of the Revenue and Taxation Code.

This statement is confirmation of your exempt status and is made with the understanding that your present operations are the same as those described on your original application. A copy of this lett~r should be retained in your official files as evidence of your exemption from state franchise or income tax.

Any change in the operations, character or purpose of this organization must be reported to this department immediately so the effect on your exempt status may be determined.

If a change in your state exempt status is desired, a new exempt application (FTB 3500) must be submitted with payment of the necessary fees. Any new application should also be accompanied by a copy of your :federal determination letter.

Exempt Audit Unit
(916) 355-0392
Enc.

FTB 4490-ATS (Hew 02-85)
Southern California
(Area Codes 213, 619, 714, 805, 818)
(800) 852-5711

TELEPHONE ASSISTANCE
Northern California
(Area Codes 209, 408, 415, 707, 916)
(800) 852-7050
For hearing impaired with TDD {800) 822-6268
Sacramento Metropolilan Area
and Out of Siale
(916) 355-0370
Fonn W•9
(Rev. October 2018)
Department of the TreasUI)'
Infernal Revenue Service
Request for Taxpayer
Identification Number and Certification
► Go to www.irs.gov/FormW9 for instructions and the latest information. 1 Name (as shown on your income 1ax return). Name Is required on this line; do not leave this line blank.

San Diego Art Institute
2 Business name/disregarded entlty name, ff different from above Institute of Contemporary Art, San Diego
Give Form to the
requester. Do not
, send to the IRS.

Mi----------------------------------------,------------- 0) 3 Check appropriate box for federa11ax classiticatlon of the person whose nar:ne ls entered on line 1. Check only one of the 4 Exemptions (codes apply only 10 ~ foffowing seven boxes. certain entities, not individuals: see

0. instructions on p~e 3):
5 D lndlvidual/sole proprietor or D C Corporation D S Corporation D Partnership O TrusVestate ai :g single-member LLC
J ~ D Limited liability company, Enter the tax classification (C"C corporation, S" S corporation, P:oPartnershlp) ► ___ _ o S Note: Cheok the appropriate box 1n the line above for the lal( classification of the s1ngle-member owner. Do not check l: 0 LLC If the LLC is classified as a single-member LLC that Is dlsregarded from the owner unless lhe owner of the LLC is ·.::- .!: another LLC that rs not disregarded from the owner for U.S. lederal \al( purposes, Otherwise, a single-member LLC that CL ~ is disregarded from the owner should check the appropriate box for the tax classification of its owner.

Exempt payee code Of any) ___ _
-Exempt1on from FATCA reporting
code (ii any)
•0 0 Olher(seeinstructions) ► 501(c)(3)non-profit /,V>~(0 01l"°""f.t"'•m1.>tocdw1Molfic U,SJ !,....-'5=A~d-d-re-ss-(n_u_m_b_e-r,-sl-re_e_t,-a-n"""d-a-pt-.-or_s_u.,...lte-no-.)'""'S::-e-e..,.in_s.,.ln.i-ct.,.. io-n-s.-~~~-~-------r-=R-eq_u_e-st-e...,r's_n_a_m_e_a~n--,d:-a-cd--:-dr_e_ss_(,_o-pt.,.io_n_a"'"I) ____ _ ~ 1439 El Prado 001---------------------------------------; 6 City, state, and ZJP code San Diego, CA 92101
7 llst account number(s) here (optional)
•~ •• Taxpayer Identification Number (TIN)
I Social securtty number Enter your TIN in the appropriate box. The TIN provided must match the name glven on line 1 to avoid I backup withholding. For individuals, this rs generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer 1dentification number (EIN). If you do not have a number, see How to get a· TIN, later.
[[D -[I] -I I I I I
Note: lflhe account is In more than one name, seethe instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter, Certification
Under penalties of perjury, I certify that
1 . The number shown on this form is my correct taxpayer identification number (or I am Wpitlng for a number to be issued to me): and

2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service {IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and

3. I am a U.S. citizen or other U.S. person (defined below); and

4. The FATCA code(s) entered on this ·form ~f any) indicating that I am exempt from, FATCA reportin,g is correct.

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all Interest and dividends on your tax return. For real eslate transactions, item 2 does not apply, For mortgage interest paid, acquisition or abandonment of secured proper1y, cancellalfon i>f debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dfvidends, you are not requfred to sign the certiiication, but ll must provide your correct TIN, See the instructions for P.irt II, later.

Sign
Here Signature of
I U.S. person ►
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.

Future developments, For the latest fnformation about developments related to Form W-9 and its instructions, such as legislation enacied after they were published, go to www.irs.gov/FormW9.

Purpose of Form
An individual or entity (Form W-9 requester) who rs required to file an i nformation return with the IRS m1.Jsl obtain your correct taxpayer Identification number (TIN) which may be your social, secuflty number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identrficatlon number (EIN), to report on an information return the amount paid lo you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the follow Ing. • Form 1099-INT (interest earned or paid}
Cat. No, 10231X
Date ► July 7, 2021
• Form 1099-DIV (dividends, including those from stocks or mutual funds)
• Form 1099-MISC (various types of Income, prizes, awards, or gross proceeds)
• Form 1099-8 (stock or mutual fund sales and certain other transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-t< (merchant card and third party network transactions} • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T ,(tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property) Use Form W-·9 only If you are a U.S. person (Including a resident alien), to provide your correct TIN.

If you do not retum Form W-9 to the requester With a TIN, you might be subject to backup withhol'ding. See Wl}at js bacf,\up withholding. later.

Form W-9 (Aev.10-2018)
Jaliscience
Folkloric
Academy
The City of Solana Beach Community Grant Program 2025 Request for Financial Assistance application MUST BE SUBMITTED by 5:00 PM Thursday, May 29, 2025.

Please submit completed applications via email to [email protected] and copied to [email protected].

If email submission is not possible for an applicant, hard copies may be dropped off at City Hall 635 South Highway 101 , Solana Beach, CA. 92075, Attn: Community Grants Program.

All requests will be determined by the following criteria:

Jaliscience Folkloric Academy Name of Organization: _______________________ _ ____ _ Elba Montes [email protected] Contact Person: Email address: --------------- ---------- 760 -613 -2059 760-613-2059 Daytime Phone: _____________ Evening Phone: ___________ _ _ 3629 9th st.

Mailing Address: ________ ______________________ _
San Marcos Ca 92078 City: ______________ State: ________ Zip: ________ _

1. All the documents below are attached to this application:
[!] W-9
[!] Summary of Organization's Budget
I!! Proposed Program Budget
I!! Financial and Tax Statements (see Application Guidelines) I!! Copy of the California Franchise Tax Board Entity Status Letter, showing exemption under Section 23701 d or Internal Revenue Code section 501 (c)(3)

2. Has your organization received financial assistance from the City before? Ill Yes D No If yes, please state the fiscal year it was received and for the proposed program was:
keep the kids and families together

3. Title of FY 2025/26 Proposed Program/Service: _________________ _

4. What is the total amount requested for the FY 2025/26 Proposed Total Program? Includes all estimated costs to conduct proposed activity/program.
5,000
we need to finish the storage we start with cost of $1 000.00, we need shoes for dancers $1,200.00 we need fo lkloric Chiapas vestments, $2,500.00 Accessories, Hats, Ribbons $800.00 Page I 1

5. Grant funds must be used for services or materials directly associated with the proposed activity.

Please describe how grant funds will be used:
will be use for the group storage and vestments, accessories

6. Anticipated Program Objectives or Accomplishments:
integrate the kids into programs and the families, unite the families to the Mexican culture, continue the tradition

7. Program Dates/Location:
mondays from 5:30pm to 7:00 pm

8. Estimated number of Solana Beach residents to be served by proposed program: ~~tN_e_e~, ~5 to

9. How will the organization acknowledge the City's financial contribution to the community/ beneficiaries of the proposed activity?
we promote the city of Solana all the time we present at different cities

10. Will there be any matching funds or other grants that would be applied to this program or service? If awarded this grant, will that enable other funding sources? no
Page I 2

11. Will volunteers be used for the proposed program or service and, if so, will they reduce expenses? we are volunteers

ALL INFORMATION REQUESTED ON THIS APPLICATION MUST BE COMPLETED AS A CONDITION FOR BEING CONSIDERED FOR PUBLIC FUNDS BY THE CITY COUNCIL OF SOLANA BEACH.

Page I 3
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l
Budget Jaliscience Folkloric Academy
2025-2026
product cost total
Material for shed 1,500.00 1,500.00
shoes 1,200.00 1,200.00
Folkloric vestments 2,500.00 2,500.00
Accessories, ribbons, 800.00 800.00
hats,
Total 6,000.00
La Colonia
Community
Foundation
The City of Solana Beach Community Grant Program 2025 Request for Financial Assistance application MUST BE SUBMITTED by 5:00 PM Thursday, May 29, 2025.

Please submit completed applications via email to [email protected] and copied to [email protected] .

If email submission is not possible for an applicant, hard copies may be dropped off at City Hall 635 South Highway 101, Solana Beach, CA. 92075, Attn: Community Grants Program.

All requests will be determined by the following criteria:

N f O . t· La Colonia Community Foundation
ame o rganiza ,on: ___________________________ _
Brittney Canales 760-533-1746 Contact Person: _______________ Email address: _________ _ Daytime Phone: ____________ Evening Phone: ___________ _ M .1
. Add 153 S. Sierra Space 1572
a, ing ress : -,--------------=---------__,,.~.,.....,..------ City: %HIIDfu~h State:-~------ Zip: ~

1. All the documents below are attached to this application:
0 W-9
!ll Summary of Organization's Budget
0' Proposed Program Budget
0' Financial and Tax Statements (see Application Guidelines) j2f Copy of the California Franchise Tax Board Entity Status Letter, showing exemption under Section 23701d or Internal Revenue Code.section 501(c)(3)

2. Has your organization received financial assistance from the City before? D Yes D No If yes, please state the fiscal year it was received and for the proposed program was:
~~-~ '

3. Title of FY 2025/26 Proposed Program/Service: _ffli_._l~_1I!_m_·~_HllieH __ t _________ _

4. What is the total amount requested for the FY 2025/26 Proposed Total Program? Includes all estimated costs to conduct proposed activity/program.
$6,000.00
The total amount requested for the FY 2025/26 Proposed Total Program is $6,000.00, encompassing all estimated expenses essential for the successful execution of our envisioned activities.

Page I 1

5. Grant funds must be used for services or materials directly associated with the proposed activity.

Please describe how grant funds will be used:

We respectfully request $6000 to support a renewed series of impactful workshops designed to uplift her community through education, creativity, and connection. This year's program will explore fresh topics while continuing to provide essential resources and experiences. Our budget includes: $400 for a bilingual interpretation, $1500 for nourishing meals, $ I 600 for facilitation or guest speaker fees $700 for new stem and cultural activity supplies, $700 for updated learning materials and resource 0

6. Anticipated Program Objectives or Accomplishments:

Our goal this year is the build upon the success of our previous series by offering a fresh lineup of workshops that engage participants in meaningful, real world learning. Each session is designed to support personal growth and community building through practical tools and areas such a creative expression, economic, empowern1ent, health, and wellness and community history. With a blend of new topics and familiar framework, the program continues to reflect our mission of nurturing both 1nrl1u1rln,;il ,;inrl l"'A11P.--t1,ri:> nAtPntl-::il h,r n,,;ilrinrr rP(."f'\lll"f'P(." '.:lf'f"P.<.:>C'ihlP •::n,rl f'11lt11r-=ilh1 rPlPuant D

7. Program Dates/Location:

We plan to have a series of events that will span from early July to May 2026

8. Estimated number of Solana Beach residents to be served by proposed program: 25 in each

9. How will the organization acknowledge the City's financial contribution to the community/ beneficiaries of the proposed activity?
This city of Solana Beach logo will be displayed on all conference marketing materials, conference t-shirts, and recognized as our valued sponsor during opening session of each event.

10. Will there be any matching funds or other grants that would be applied to this program or service? If awarded this grant, will that enable other funding sources? No
Page I 2

11. Will volunteers be used for the proposed program or service and, if so, will they reduce expenses? Volunteers will be used for all workshop events and will effectively reduce the cost to $6000.

Acknowledgment of Responsibility:

ALL INFORMATION REQUESTED ON THIS APPLICATION MUST BE COMPLETED AS A CONDITION FOR BEING CONSIDERED FOR PUBLIC FUNDS BY THE CITY COUNCIL OF SOLANA BEACH.

Page I 3
La Colonia
;~~{~
Income
Total Income
Expenditures
Treasurer's Report

LA COLON/A COMMUNITY FOUNDATION
General Membership Meeting
For the period April 1st, 2025 to April 30th, 2025
Administrative and Operations

GENERAL & ADMINISTRATIVE
Advertising and Promotion
Storage Unit
Total Expenditures
Opening balance as of April 1st, 2025:

Balance on hand as of April 30th, 2025:

LA COLONIA COMMUNITY FOUNDATION
$79.94
$235.47
$120.60
$0.00
$436.01
($436.01)
$43,904.79
$43,468.78
$43,468.78
_______________________ Treasurer's Signature
LA COLONIA COMMUNITY FOUNDATION Page 1 of 1
\
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(
L
~of& IRS DEPARTMENT OF THE: TREASURY ~~ INTERNAL REVENUE SERVICE CINCINNATI OH 45999-0023
Ll\ COLONIA COMMUNITY VOUNDATION
1092 GOLDEN RD
ENCINITAS, CA 92024
Date of this notice: 11-09-2018
Fenn: SS-4
Number of this notice: CP 575 B
tor assistance you may cal-1 us at:
1- 800- 829-4933

IF YOU WRITE, ATTACH THE
STUB AT THE END OF 11'.HIS NOTICE.

WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER
Thank you for applying for an Employer Identification Number (E!N). We assigned you EIN 83- 2489325. This EIN will identify you, your business accounts, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent record&.

When filing tax doc\lll\ents, pal/lllents, and related correspondence, it is very important that you use your EIN and complete name and addxess exactly as shown above.

Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the infoonation is not correct as shown above, please make the correction using the attached tear-off stub and return it to us.

When you submitted your application for an EIN, you checked the box indicating you are a non-profit organization. Assigning an EIN does not grant tax-exempt status to non-profit organizations. Publication 557, Tax-Exempt Status for Your Orga."lization, has details on the application process, as well as in£oxmation on returns you may need to file. To apply for recognition of tax- exempt status under Internal Revenue Code Section 501 (c) (3), organizations mus~t complete a Form 1023-series application for recognition. All other entities should file Form 1024 if they want to request recognition under Section SOl(a) .

Nearly all organizations cl aiming tax-exempt status must £Lle a Form 990-series annua~ information return (Form 990, 990-EZ, or 990-PF) or notice (Form 990-N) beginning with the year they legally fonn, even if they have not yet applied for or received .recognition of tax-exempt status.

Unless a filing exception applies to you (search www.irs. gov for Annual Exempt Organization Return: Who Must File), you will lose your tax-exempt status if you fail to file a required return or notice for three consecutive years. We start calculating this three-year period from the tax year we assi~ed the EIN to you. If that first tax year isn ' t a full twelve months, you're still responsible for submitting a return for that year. If you didn't legally form in the same tax year in which you obtained your EIN1 contact us at the phone number or addre~s listed at the top of this letter.

For the most current information on your filing requirements and other importanc . information, vii,i t www.irs .gov/charities.

Form W-9 Request for Taxpayer GiveFonn to the
(Rev. Oclobot 2018) Identification Number and Certification requester. Do not OopmmM! of Ille Trcasu,y
lnlam41 Revenue Se<vic• ► Go lo www.Jrs.gov/FormW9 for Jns1ructlons and the l~est Information. send to the IRS. • 1 Namo (as llhoM'I on your Income lllx rotomJ. NBmo Is roqu1rod on lhlll lino; <10 not I04vo lht~ Ii/lo blanl\.

La Cotonla Community Foundation
2 Buslnt!SS N1mQ/d1or0<Jarde<l on~ty ,iamo, II dillc1en1 1,om obovo 153 S. Sierra Ave, Space 1572
..;
.. 3 Cheek oppropt1ale box for lodoral lllx clos:il1 ,caMn cf the poroon who~o n.uno 1G anl~rcd en /lno I. Ch<lck only one of Jho 4 fxe!TIPfi~ (Codo~ ®ply Only 10 C, lollowing IIOVCO boxe&. " cenain ont,Ue~ not lnd!Vlduals: eeo Q. tnottuctlOf\a on plijJIJ 3): C 0 0 lndivt<lua!/oolo proprialor or D C Co,pofo1lon 0 S Ccrpora11on 0 Partno~rup 0 Tru•Vnta!Q 0 ~ SlnQhHnembor LLC ~empl P~• codt or ""i'l i .2
,:; 0 Umilod ~llbllily compooy. Entor tho tax ci.uslfic.allon {O,.C co,poraUon, SQS co1po,at1on. PAPartnor.m{p),. ___ ~ .5 .. "' No101 ChecJ, tho app,oprlalo box In tho lino above 10, 111e lax e1Ase1ficaUon or lh• •IJl.glo-mombot owner. Do not C/leek LLC 1111\o LLC Ill ciMS1f,eo as a sini,lo-membot LLC that Is dl5togan:tod 11cm tho cwno, un!o&S lho ownor o! !ho UC Is wmpllOn lrom fATCA mpcl'llng
c: e codo~iany) "C - llllO!rnlr LLC lhel ,s not dittogarded r,om lho ownc, for U.S. federal laJ( pUfJ)Ollos. Olh<l,wiso, a s,nglo,-member UC Iha! Q, 0 1': Is d1i;r19ordod lror,, the ownor ~ould chock tho apl)lopr!e1e bo~ ror tho tax cta,~1f1cauon cf~ ownot ;:; 0 Olhor (sea 1nstruct1011s) ► ~., __ ...,._...,.,SJ C> IA 5 Addl811S (numbcr. SIIOGI. and <IPL or SUrlO no.) Soc, ln~lruct,on~. Roqu~slor's namo and ooo,ess (opUoool) gJ 153 S. Sierra Ave. Space 1572 City of Solana Beach (/J If Clly,.:i\oto, and ZIP code
Solana Beach. CA
7 us! aceo1.1nt numbar(s) hero (opllon.il)
mm . D Taxpayer Identification Number mNl
.nter your Tlfl! !n tne appro~ri~te box. '!ho TIN provided must match t~o name given on lino 1 lo avoid f Sodol security number E I backup wl!hholdlng. for Individual!!, this Is genemlly your social secunty r. numl>cr (SSN). However, for a DI] [D j I I I I resident alien, solo proprietor, or disregarded entity, i:oo the instructions ror Part I, later. for other - - entities, ii Is your employer ldonllflcation number (EIN). If you do not have a number, see. How ro 9e1 a . _ _ _ _ TIN. later.

Noter If the account i:. In more than one name.see the ln5truetions for !Ina 1. Also see What NBme and Number To Give fho ABquester for guidelines on whose number to enter.

Certification
Under penalties or perjury, I certify that:
1, The number shown on thin form Is mr corroot taxpayer ldentlficotlon number (or I am walling for a number to bo issuo<! \o rno): and

2. I am not subject to backup withholding because: (a) I am oxompt from backup wilhholding. or {b) I have not boon notlfied by the Internal Rovenuo Service (IRS) that I am subject to backup withholding as a rosull or a falluro lo report ail llilerost or dividends, or (c) the IRS hall notified me that I am no longer subject 10 backup wllhholding; one!

3. I am a U.S. citizen or other U.S. parson (definod below): and

4. The fATCA codo(s) entered on this form 01 any) lndlcotlng that I am eJ<empt from fATCA reporting Is correct.

Ccrtlllcatlon Jnstructlona. You most cross out ilem 2 above If you have been notified by !he IRS Ilia! you wo cummlly subject to backup withholding becaus.., you have failed to report all fnterest and dividends on your tax return. For roal estote ttansacilons, item 2 docs not apply. For mortgage Interest paid. 11cqulslllon or obo.ndonmenl of secured propeny, cancellation of deb\, conllibullons to an individual retirement arrangement (IRA), and gllllerally. paymonts other lharl interest and dividends, you aro not r&qU/f'Cd to sign tho cerllncatron, bu! you must provido your coirocl TIN. Sae the instructions to, Part II. 1lat1u.

Sign
Here Signature or
U.S pCl'llon ►
General Instructions
Section role1onces are to lhe Internal Revenue Code unless otherwise noted.

Future dovelopments. For tho latest lnfonnation about developments related to form W-9 and lt!.instruct1ons, such as !eglslalion enacted alter they were published, go to www.frs.gov/FomiW9.

Purpose of Form
An individual or entity (Form W-9 requester) v1ho 1s requ!1od to file an intorrnation return with the IRS must obt.!lln your correct taxpayor ldonlilicallon number (TIN) which may be your social security number (SSNJ. Individual taxpayer Identification number (ffiN), adoption taJIPayor dentificatlon number (ATIN), or employer Identification number (EIN), to roport on an information return 1he amount pald to you, or other amount reportable on on lnformallon return. Examples of information 1otums includo, but are not limited to, tho following.
• Form 1099-INT Qnterest earned or paid)
Cal. No. 10231X
Dalo ► ~ l
• Form 1099-DlV (dividends, Including those from stocks or mutual runds)
• Form 1099-MISC (various types of inoomo, prizes, awnrds, or gross proceeds)
■ Form 1099-B (stock or mutual lund $&lea and cert;iin other transactions by brokers)
• Form 1099-S (proceeds from real oslate transactions)
• Form 1099-K (mercfianl card afld third parfy network tran~ctions) • Form 1098 jhome mortgage interest), 1098•E (s(udenl ·foan interest), 1098-T (tuition)
• Form 1099-C (canceled deb!)
• Form 1099-A (ecqulsltlon or ab.indonment of secured property) Use Form W-9 only if you are a U.S. person ~ncluding a resident alien), to provide your correct TIN.

If you do not rotum Form W-9 to the requester with a TIN, you might l;,e subject lo backup wllhho/dlng. See What is backup Witnholdin.g, later.

Form W-9 (R9\I, 10-2018)
North Coast
Repertory
Theatre
The City of Solana Beach Community Grant Program 2025 Request for Financial Assistance application MUST BE SUBMITTED by 5:00 PM Thursday, May 29, 2025.

Please submit completed applications via email to [email protected] and copied to [email protected].

If email submission is not possible for an applicant, hard copies may be dropped off at City Hall 635 South Highway 101 , Solana Beach, CA. 92075, Attn: Community Grants Program.

All requests will be determined by the following criteria:

North Coast Repertory Theatre Name of Organization: ____________________________ _ Contact Person: Geoffrey Geissinger Email address: [email protected] -------------- - (858) 481-2155 x2 11 (858) 481 -2155 x2 11 Daytime Phone: _____________ Evening Phone: _ ___________ _ 987 Lomas Santa Fe Drive, Suite D
Mailing Address:-------------------------------
Solana Beach CA 92075 City: ______________ State: _ ___ ____ Zip: ________ _

1. All the documents below are attached to this application:
~ W-9
[!] Summary of Organization's Budget
~ Proposed Program Budget
~ Financial and Tax Statements (see Application Guidelines) ~ Copy of the California Franchise Tax Board Entity Status Letter, showing exemption under Section 23701 d or Internal Revenue Code section 501 (c)(3)

2. Has your organization received financial assistance from the City before? Ill Yes D No If yes , please state the fiscal year it was received and for the proposed program was:

Please see attached sheet - Previous Funding
Theatre School Productions: Henry IV/The Legend of Sleepy Hollow 3. Title of FY 2025/26 Proposed Program/Service: _________________ _

4. What is the total amount requested for the FY 2025/26 Proposed Total Program? Includes all estimated costs to conduct proposed activity/program.

We are humbly requesting $6,000 from the City of Solana Beach to support two upcoming Theatre School productions: Henry IV and The Legend of Sleepy Hollow, for which the total program budget is $24,000. For a complete breakdown of the Program Budget, please see the attached program budget.

Page 11 ends

5. Grant funds must be used for services or materials directly associated with the proposed activity.

Please describe how grant funds will be used:

All of the grant funds will be used exclusively to cover the production expenses of the eight public performances of Henry IV and the seven performances of The Legend of Sleepy Hollow. Incurred production expenses include things like paying the professional director, hiring adult actor/stage manager mentors, bringing in a costume and prop designer, purchasing prop and costume materials, renting the venue and rehearsal space, and securing the rights for productions.

6. Anticipated Program Objectives or Accomplishments:

On an artistic and academic level, our Theatre School program fosters a deepened interest and appreciation of literature and language by inviting students to engage with rich literary texts. On a personal level, by working with their fellow students in such a collaborative medium, our students build up crucial soft skills like adaptability, communication, creative thinking, dependability, listening, and teamwork. For the general public, our Summer Shakespeare Series provides free performances of the Bard's work to our community, increasing accessibility to the arts in Solana Beach!

7. Program Dates/Location:

Please see attached sheet - Program Dates and Locations

8. Estimated number of Solana Beach residents to be served by proposed program:_1_D_O_O ____ _

9. How will the organization acknowledge the City's financial contribution to the community/ beneficiaries of the proposed activity?
The City of Solana Beach's support would be graciously acknowledged in all Mainstage and Theatre School programs, on the Donor Board in the Theatre Lobby, in our annual Mainstage and Theatre School brochures, and on our Mainstage and Theatre School websites.

10. Will there be any matching funds or other grants that would be applied to this program or service? If awarded this grant, will that enable other funding sources? The City of Encinitas has generously agreed to support our Shakespeare programming with a grant of$3,050, of which approximately $1,525 will be used in support of this summer's production of Herny IV. Other funding for our seasons comes from the emollment fees of participating students, charitable donations from community members, and ticket revenue from performances in the Theatre School Space. To ensure that arts education is accessible to all students regardless of their background, we have a partnership with the US Bank Foundation that allows us to offer scholarships to deserving students who might not be able to afford to participate otherwise.

Page I 2

11. Will volunteers be used for the proposed program or service and, if so, will they reduce expenses? We have a vibrant community of volunteers who kindly donate their time and energy to our mission. On performance days, they can be found ushering, taking tickets, working the concession stand, handing out programs, and filling in wherever is needed. Backstage, volunteers will use their expertise to sew/repair costumes or help construct/strike a set.

12. If the proposed program or service is only awarded partial funding, will it still move forward? Will the program/service be scaled back and/or is there a threshold at which it will not move forward? Both productions will still move forward even if we only receive partial funding, but receiving partial funding might impact the number of students we would be able to offer scholarships to and might affect the overall production value of the costumes, sets, and props.

Acknowledgment of Responsibility:

ALL INFORMATION REQUESTED ON THIS APPLICATION MWST BE COMPLETED AS A CONDITION FOR BEING CONSIDERED FOR PUBLIC FUNDS BY THE CITY COUNCIL OF SOLANA BEACH.

Page I 3
See Attached from Question 2
City of Solana Beach Community Grant Program
Previous Funding
• 2004 - Educational Outreach Program, "Behind the Mask" • 2005 - Planning costs for Cedros Crossing
• 2006 - Educational Outreach Program, "Behind the Mask" • 2008 - Educational Outreach Program, "Behind the Mask" • 2010 - Education Play about Solana Beach
• 2011 - Educational Outreach Program, "Behind the Mask" • 2012 - Education Outreach Program, "Anti-Bullying"
• 2013 - Theatre School Holocaust Production, "Anne Frank" • 2014 - Theatre School Literacy Project, "Seussical"
• 2015 - Theatre School Literacy Project, "Aladdin Jr." • 2016 - Theatre School Literacy Project, "Peter and the Starcatcher" • 2017 - Theatre School Student Production, "The Secret Garden" • 2018 - Theatre School Student Production, "She Kills Monsters" • 2019 - Theatre School Student Productions, " Comedy of Errors" & "The Three Musketeers"
• 2020 - Theatre School Student Productions, "The Tempest" & "The Neverending Story"
• 2021 - North Coast Repertory Theatre's 40th Anniversary Season • 2022 - Theatre School Student Productions, "Much Ado About Nothing" & "Frankenstein"
• 2023 - Theatre School Productions, "As You Like It" & "War of the Worlds" • 2024 - Theatre School Productions, "Hamlet" & "Shuddersome"

NORTH COAST
~
See Attached from Question 7
City of Solana Beach
Community Grant Program
Program Dates and Locations
Auditions/Callbacks: June 10-12, 2025
Rehearsals: June 17-July 11, 2025
July 17-18, 2025
San Diego Botanic
Garden
300 Quail Gardens Dr.

Encinitas, CA 92024
Performances
July 24-26, 2025
Birdwing Open Air
Classroom
3201 Via de la Valle
Del Mar 92014
July 31 - August 2, 2025
La Colonia Park
Courtyard
715 Valley Ave
Solana Beach, CA 92075
NORTH COAST 1-
See Attached from Question 7
City of Solana Beach
Community Grant Program
Program Dates and Locations
Auditions/Callbacks: September 2-4, 2025
Rehearsals: September 9- October 10, 2025
Performances: October 14-15, 2025
Theatre School Studio Space
987 Lomas Santa Fe Drive, Suite D
Solana Beach, CA 92075

NORTH COAST
•
111E 1HEAIR£
SCHOOL@ BUDGET BUDGET NORTH COAST ·- HENRY IV THE LEGEND BUDGET I ~.~:) OF SLEEPY HOLLOW TOTAL
~ - SHAKESPEARE STUDENT PRODUCTION SUMMER & FALL
IN THE PARK October 2025 2025
Director $2,500 $2,500 $5,000
Light Designer $0 $200 $200
Sound Designer $0 $250 $250
Lights & Sound Equip $0 $150 $150
Painting Labor/Materials $0 $200 $200
Set Design - labor $0 $500 $500
Set Materials $0 $100 $100
Projections Designer $0 $0 $0
Stage Manager/ AD Mentor $2,000 $1,250 $3,250
Directing/Writing Mentor $0 $0 $0
Assistant Director $1,500 $1,250 $2,750
Actor/ Mentor $1,500 $0 $1,500
Costume Designer $750 $750 $1,500
Costumes - materials/rent $1,000 $1,000 $2,000
Costume cleaning $300 $300 $600
Prop Designer $500 $500 $1,000
Props - materials $150 $1,000 $1,150
Dramaturg / Dialect $0 $0 $0
Stage Combat $750 $500 $1,250
Graphic Designer $100 $100 $200
Choreographer $0 $0 $0
Accompaniment $0 $0 $0
Misc/ Materials $850 $875 $1,725
Royalties $0 $500 $500
Rental Fee for Materials $0 $150 $150
Script copies $100 $100 $200
Shipping $0 $325 $325
Production Total $12,000 $12,500 $24,500
• ' ' 5.21 .2025
-NORTH COAST OPERATING FUND & OTHER FUNDS
i~l:t Preliminary Draft Budget for FY 2025-26 (S44) vs.

Current Actuals/Projections for FY 2024-25 (S43)
- PRELIM CURRENT VAR
543 Actuals: Sep - Mar BUD ACT/PROJ ANNUAL
543 Prajecr:ions: Apr-Aug 25-26 24-25
S44 S43 S44 VS S43 ,~ - UNRESTRICTED OPERATING FUND

SUPPORT AND REVENUE
Contributions 1,500,500 1,487,798 12,702 a
Ticket Revenue - Mainstage 2,169,750 1,836,568 333,182 b Ticket Revenue - Variety 388,440 341,639 46,801 C
Theatre School Revenue 201,250 203,651 {2,401) d
Other Revenue 237,027 250,746 {13,719) e
Patron Service Revenue 135,406 125,332 10,074 I
Production Fee (Laguna Playhouse) 77,500 116,000 {38,500) g ]Total S,ppo,t & Reven"' I 4,709,873 4,361,733 348,140

EXPENSE S
Personnel Expenses :

Personnel - Ad min X 1,639,884 1,601,365 38,519 h.1
Personnel - Artistic X 649,468 584,711 64,757 h.2
Personnel - Taxes & Benefits X 484,050 450,668 33,382 h.3 Cost of Tix & CC Donations X 289,499 293,777 {4,278) i.1 General & Admin Expenses X 505,793 498,483 7,310 1.2
Development Expenses X 265,250 279,929 (14,679) j
Marketing Expenses X 533,262 473,987 59,275 k
Production Expenses X 279,850 258,565 21,285 I
Theatre School Productions X 67,000 63,564 3,436 m
Variety Night Expenses & Spec Proj X 172,211 169,689 2,522 n ITotal Expenses I I 4,886,269 1 4,674,739 1 211,530 I
p I NET CHANGE. OPERATIONS I I (176,396) 1 (313,005) 1 136,609 1 p accrual based budget
543 Actuals: Sep - Mar
543 Projections: Apr-Aug

NON OPERATING AND RESTRICTED FUNDS

SUPPORT AND REVENUE
Capital Grant Income
ltex Trade $ in
Income from Investments
Donations to New Venue
Unrealized Gains/ Losses
Total Support & Revenue (NON OPERATING)

EXPENSES
Capital Grant Expense
ltex Trade $ out
Contingency
Depreciation Expense
Restricted Expenses
I Total Expenses (NON-OPERATING)

I NET CHANGE - OTHER FUNDS
s I NET CHANGE - ALL FUNDS
EXTRAORDINARY ITEMS:

NET OF EXTRAORDINARY ITEMS:

NET CHANGE - ALL FUNDS+ EXTRAORDINARY
X
X
X

5.21 .2025

OPERATING FUND & OTHER FUNDS
Preliminary Draft Budget for FY 2025-26 (S44) vs.

Current Actuals/Projections for FY 2024-25 (S43)
PRELIM
BUD
25-26
S44
a
a
a
a
60,000
60,000 I
a
a
10,000
100,000
0 110,000 I
(50,000) I
(226,396)1
297,000
70,604

CURRENT

ACT/PROJ
24-25
S43
70,925
9,670
a
a
19,286
99,881 I
70,925
669
10,000
100,000
0 181,5931
(81,713)1
{394,718)1
802,124
407,407
VAR
ANNUAL
S44 vs S43
{70,925)
(9,670)
a
a
40,714
(39,881) I
(70,925)
(669)
0 0
0 (71,593)1
31,7131
168,3221 s
(505,124)
North Coast Repertory Theatre,
A Non-Profit Corporation
Financial Statements
and
Independent Auditor's Report
For the Year Ended August 31, 2024
Table of Contents
Independent Auditor's Report .......................................................................................... 1-2 Financial Statements:

Statement of Financial Position ............................................................................... 3 Statement of Activities and Change in Net Assets ...................................... .4 Statement of Cash Flows ......................................................................................... 5 Statement of Functional Expenses ........................................................................... 6 Notes to the Financial Statements .................................................................................. 7-14 ..'A. :M. Owens, CP ..'A.
-~~'il 'l'rofessi.ona( Corporalion,jf;_ ~, • - '~
10340 'Paseo 'Parli Vrive Laliesiae, CJ\ 92040 'Plione anaJ"ax (619)698-2401 To the Board of Directors
North Coast Repertory Theatre
Opinion

INDEPENDENT AUDITOR'S REPORT
I have audited the accompanying financial statements ofN011h Coast Repertory Theatre, which comprise the balance sheet as of August 31, 2024, and the related statements of activities, functional expenses, and cash flows for the year then ended, and the related notes to the financial statements.

In my opinion, the financial statements referred to above present fairly, in all material respects, the financial position of North Coast Repertory Theatre, as of August 31, 2024, and the changes in its net assets and its cash flows for the year then ended in accordance with accounting principles generally accepted in the United States of America.

Basis for Opinion
I conducted the audit in accordance with auditing standards generally accepted in the United States of America. My responsibilities under those standards are further described in the Auditor's Responsibilities for the Audit of the Financial Statements section ofmy report. I am required to be independent of North Coast Repertory Theatre, and to meet my other ethical responsibilities in accordance with the relevant ethical requirements relating to my audit. I believe that the audit evidence I have obtained is sufficient and appropriate to provide a basis for my audit opinion.

Responsibilities of Management for the Financial Statements Management is responsible for the preparation and fair presentation of the financial statements in accordance with accounting principles generally accepted in the United States of America, and for the design, implementation, and maintenance of internal control relevant to the preparation and fair presentation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, management is required to evaluate whether there are conditions or events, considered in the aggregate, that raise substantial doubt about North Coast Repertory Theatre's ability to continue as a going concern within one year after the date that the financial statements are available to be issued.
-1-
Auditor's Responsibilities for the Audit of the Financial Statements My objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor's report that includes my opinion. Reasonable assurance is a high level of assurance but is not absolute assurance and therefore is not a guarantee that an audit conducted in accordance with generally accepted auditing standards will always detect a material misstatement when it exists. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control. Misstatements are considered material if there is a substantial likelihood that, individually or in the aggregate, they would influence the judgment made by a reasonable user based on the financial statements. • In performing an audit in accordance with generally accepted auditing standards, I:
• Exercise professional judgment and maintain professional skepticism throughout the audit. • Identify and assess the risks of material misstatement of the financial statements, whether due to fraud or error, and design and perform audit procedures responsive to those risks. Such procedures include examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements.
• Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of North Coast Repertory Theatre's internal control. Accordingly, no such opinion is expressed.
• Evaluate the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by management, as well as evaluate the overall presentation of the financial statements.
• Conclude whether, in my judgment, there are conditions or events, considered in the aggregate, that raise substantial doubt about North Coast Repertory Theatre's ability to continue as a going concern for a reasonable period of time.

I am required to communicate with those charged with governance regarding, among other matters, the planned scope and timing of the audit, significant audit findings, and certain internal control related matters that I identified during the audit.

A M Owens, CPA
A Professional Corporation
Lakeside, CA
February 6, 2025
-2-
ASSETS
North Coast Repertory Theatre,
A Non-Profit Corporation
Statement of Financial Position
August 31, 2024
With Comparative Totals as of August 31, 2023
Cash
- without donor restrictions
- with donor restrictions
Investments
- without donor restrictions
- with donor restrictions
Accounts Receivable
- without donor restrictions
Prepaid expenses
Prepaid production costs
Deposits
ASSETS
Right of use of asset net of depreciation
$
2024
201,670
0 5,172,959
55,497
32,247
134,828
194,351
13,521
348,222
6,153,295

PROPERTY AND EQUIPMENT
Less: Accumulated Depreciation
(Note 2)
Total Assets $
285,970
6,439,265

LIABILITIES AND NET ASSETS

CURRENT LIABILITIES
Accounts payable, trade
Accrued wages and expense
Defe1Ted revenue (Note 3)
Accrued vacation payable
Lease liability
Total Current Liabilities

LONG-TERM DEBT

NET EQUITY (DEFICIT)
Net assets with donor restrictions
Net assets without donor restrictions
Total Net (Equity)
Total Liabilities and Net Assets
$
$
76,623
0 1,053,403
63,285
348,222
1,541,533
0 55,497
4,842,235
4,897,732
6,439,265
See the Accompanying Notes to the Financial Statements. -3-
$
$
$
$
2023
1,180,988
28,342
1,432,656
51,642
4,310
129,879
202,673
9,745
0 3,040,235
305,566
3,345,801
45,413
6,680
1,105,515
69,272
0 1,226,880
0 79,984
2,038,937
2,118,921
3,345,801
North Coast Repertory Theatre,
A Non-Profit Corporation
Statement of Activities and Changes in Net Assets
For the Year Ended August 31, 2024
With Comparative Totals as of August 31, 2023
Without With
Donor Donor
Restrictions Restrictions

SUPPORT AND REVENUE
Public Support:

Admissions $ 2,379,559 $ 0
Theatre school 216,000 0
Concessions and other support 227,847 0
Contributions (Note 12) 4,319,162 0
Investment income (Note 6) 251,489 6,547
Other miscellaneous income 17,340 0
7,411,397 6,547
Net Assets Released From Restrictions 31,034 ( 31,034 ) Total Support & Revenue 7,442,431 ( 24,487 )

EXPENDITURES
Production costs 3,728,244 0
General and administrative 328,693 0
Fundraising 582,196 0
Total Expenditures 4,639,133 0
Change in net assets 2,803,298 ( 24,487 )
Net Assets (Deficit), Begin of Year 2,038,937 79,984
Net Assets {Deficit), End of Year $ 4,842,235 $ 55,497
$
$
See the Accompanying Notes to the Financial Statements. -4-
2024 2023
Combined Combined
Totals Totals
2,379,559 $ 2,052,600
216,000 251,000
227,847 96,462
4,319,162 1,419,732
258,036 107,076
17,340 12,658
7,417,944 3,939,528
0 0
7,417,944 3,939,528
3,728,244 3,250,592
328,693 259,994
582,196 433,898
4,639,133 3,944,484
2,778,811 ( 4,956 )
2,118,921 2,123,877
4,897,732 $ 2,118,921
North Coast Repertory Theatre,
A Non-Profit Corporation
Statement of Cash Flows
For the Year Ended August 31, 2024
With Comparative Totals as of August 31, 2023
2024

CASH FLOWS FROM OPERA TING ACTIVITIES
Change in Net Assets $ 2,778,811
Adjustments to reconcile change in net assets to
net cash provided by operating activities:

Depreciation 150,362
(Increase) Decrease in Operating Assets:

Receivables ( 27,937)
Prepaid expenses ( 4,949)
Prepaid production costs 8,322
Deposits ( 3,776 )
Right of use asset ( 348,222)
Increase (Decrease) in Operating Liabilities:

Accounts payable 31,210
Accrued wages ( 6,680 )
Deferred Revenue ( 52,112)
Accrued vacation ( 5,987 )
Right of use liability 348,222

NET CASH PROVIDED (USED) BY
OPERA TING ACTIVITIES 2,867,264

CASH FLOWS FROM INVESTING ACTIVITIES
Purchases of property and equipment ( 14,797)
Investments purchased/sold ( 3,860,127 )
NET CASH USED BY INVESTING ACTIVITIES ( 3,874,924)
NET CASH USED BY FINANCING ACTIVITIES 0
NET CHANGE IN CASH AND CASH EQUIVALENTS ( 1,007,660)
BEGINNING CASH AND CASH EQUIVALENTS 1,209,330
ENDING CASH AND CASH EQUIVALENTS $ 201,670
Interest Paid $ 0
Taxes Paid $ 0
See the Accompanying Notes to the Financial Statements. -5-
2023
$ ( 4,956)
29,484
3,984
( 4,419 )
( 57,837 )
( 1,836 )
0 ( 71,670 )
2,556
237,229
19,935
0 152,470
( 98,752)
( 1,221,697)
( 1,320,449)
0 ( 1,167,979)
2,377,309
$ 1,209,330
$ 0
$ 0
North Coast Repertory Theatre,
A Non-Profit Corporation
Statement of Functional Expenses
For the Year Ended August 31, 2024
With Comparative Totals as of August 31, 2023
Production General FundCosts Admin. Raising
Salaries $ 1,439,718 $ 184,165 $ 284,570 $
Payroll Taxes 134,711 17,232 26,626
Employee Benefits 237,654 30,400 46,974
Total Payroll Expenses 1,812,083 231,797 358,170
Outside Contractors 102,590 642 992
Professional Services 0 9,240 6,038
Occupancy 87,397 4,855 4,855
Utilities 38,443 4,806 4,806
Janitorial 13,232 1,654 1,654
Supplies/Misc. 29,254 8,894 4,194
Concession Supplies 30,832 0 0
Communications 5,601 700 700
Postage and Shipping 0 3,389 14,390
Printing and Copying 64,759 9,576 2,236
Travel and Meals 0 27,670 4,194
Credit Card Processing/Bank Fees 149,121 6,307 0
Insurance 15,199 1,900 1,900
Membership Dues 2,781 0 0
Repairs and Maintenance 16,032 0 0
Advertising and Marketing 428,722 0 991
Royalties 177,638 0 0
Special Events 0 0 172,5 l 7
Mainstage Events/Equipment 459,078 0 0
Theatre School 63,063 0 0
Taxes/Licenses 0 2,296 0
Interest expense 0 10,408 0
Right of use depreciation 82,057 4,559 4,559
Total Expenses
Before Depreciation 3,577,882 328,693 582, l 96
Depreciation 150,362 0 0
Total Expenses $ 3,728,244 $ 328,693 $ 582, I 96 $
See the Accompanying Notes to the Financial Statements. -6-
2024 2023
Total Total
1,908,453 $ 1,680,435
178,569 160,795
315,028 268,536
2,402,050 2, I 09,766
l 04,224 91,085
15,278 23,358
97,107 184,643
48,055 37,266
16,540 4,525
42,342 38,578
30,832 33,096
7,001 6,811
17,779 l 0,908
76,571 104,371
31,864 20,505
155,428 115,703
18,999 15,956
2,781 3,635
16,032 43,121
429,713 337,918
177,638 126,134
172,517 184, I 3 I
459,078 351,268
63,063 69,917
2,296 2,305
10,408 0
91,175 0
4,488,771 3,915,000
150,362 29,484
4,639,133 $ 3,944,484
North Coast Repertory Theatre,
A Non-Profit Corporation
Notes to Financial Statements
For the Year Ended August 31, 2024
Note 1 - Summary of Significant Accounting Policies
General
North Coast Repertory Theatre, a Non-Profit Corporation (the Theatre) is a non-profit organization incorporated in California in 1982. Its stated purpose is to educate the public in an appreciation of the theatre arts through stage productions of consistent quality, to be recognized as the premier professional regional live theatre in San Diego North Coastal County, to provide educational services for audiences of all ages, focusing on the youth of the community and to provide an opportunity for actors and theatre professionals to develop their artistic skills through participation in the Theatre's productions.

During the fiscal year ended August 31, 2024, the Theatre entered into a strategic alliance with Laguna Playhouse. Under this arrangement, several productions will be transferred from the Theatre to Laguna Playhouse and Laguna Playhouse will reimburse the Theatre for some production costs. In addition, the artistic director of the Theatre has been hired by Laguna Playhouse. The director will run both theatres simultaneously. Benefits of the director will be shared between both theatres with Laguna Playhouse reimbursing the Theatre. This alliance will be a financial benefit to the Theatre and help with the continued rebound from the impacts of the Covid shut down.

Accounting Method
The accompanying financial statements have been prepared using the accrual method of accounting. Management uses estimates and assumptions in preparing the financial statements in accordance with accounting principles generally accepted in the United States of America.

Actual results could vary from estimates that were used due to inherent unce1tainties in estimates and actual results may vary from those estimates in the near term.

Financial Statement Presentation
The Theatre is required to report information regarding its financial position and activities according to two classes of net assets: net assets without donor restrictions and net assets with donor restrictions:
• Net assets without donor restrictions represent expendable funds available for operations that arc not otherwise limited by donor restrictions.
• Net assets with donor restrictions consist of contributed funds subject to specific door-imposed restrictions contingent upon specific performance of a future event or a specific passage of time before the Theatre may spend the funds (irrevocable donor restrictions requiring that the assets be maintained in perpetuity to generate investment income.) Use of Estimates
The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates.

Significant estimates used in the preparation of these financial statements include the functional allocation of expenses.
-7-
North Coast Repertory Theatre,
A Non-Profit Corporation
Notes to Financial Statements
( continued)
For the Year Ended August 31, 2024
Note I - Summary of Significant Accounting Policies (continued) Contributions
Contributions received arc recorded as net assets without donor restrictions or net assets with donor restrictions, depending on the existence or nature of any donor restrictions. Net assets with donor restrictions are repo1ted in Note 4. All donor-restricted contributions are reported as net assets with donor restrictions. When a restriction expires (that is, when a stipulated time restriction ends or purpose restriction is accomplished), net assets with donor restrictions are reclassified to net assets without donor restrictions and reported in the statement of activities as net assets released from restrictions. Contributions in-kind are recorded at their fair market value at the time of receipt. All donor restricted support is reported as an increase in net assets with donor restrictions. When a restriction expires (that is, when a stipulated time restriction ends or purpose restriction is accomplished), net assets with donor restrictions are reclassified to net assets without donor restrictions and reported in the statements of activities as net assets released from restrictions.

Promises to Give
Unconditional promises to give are recognized as contribution revenue in the period received and as assets, decreases ofliabilities, or expenses depending on the form of the benefits received. Promises to give are recorded at net realizable value if expected to be collected in one year and at fair value if expected to be collected in more than one year. Conditional promises to give are recognized when the conditions on which they depend are substantially met.

Contributed Services
The Theatre generally pays for services requiring specific expertise. However, sometimes individuals volunteer their time and perform a variety of tasks that assist the Theatre. For the year ended August 31, 2024, none of these services met the criteria for recognition as contributed services.

Revenue and Revenue Recognition
Revenue is recognized when earned. When applicable, program service fees and payments under cost reimbursable contracts received in advance arc deferred to the applicable period in which the related services are performed or expenditures arc incurred, respectively.

Contributions are recognized when cash, securities or other assets, an unconditional promise to give, or notification of a beneficial interest is received. Conditional promises to give are not recognized until the conditions on which they depend have been substantially met.

The Theatre records deferred revenue situations when amounts are invoiced or paid but the revenue recognition criteria above are not met.
-8-
North Coast Repertory Theatre,
A Non-Profit Corporation
Notes to Financial Statements
( continued)
For the Year Ended August 31, 2024
Note I - Summary of Significant Accounting Policies (continued) Grant Revenue
Grant revenue is recognized when the qualifying costs are incurred for cost-reimbursement grants or when a unit of service is provided for performance grants and all conditions of the grants have been satisfied. Grant revenue from federal agencies is subject to independent audit and review by grantor agencies. The review could result in the disallowance of an expenditure under the terms of the grant or reductions of future grant funds. Based on prior experience, the Theatre's management believe that costs ultimately disallowed, if any, would not materially affect the financial position of the Theatre.

Summary of Government Grants
City of Carlsbad
State of California
City of Solana Beach
Property and Equipment
$
$
7,698
42,471
6,000
56,169
Depreciation of buildings and equipment is provided over the estimated useful lives of the respective assets using the straight-line method.

Acquisitions of property and equipment in excess of $2,500 are capitalized. Donated equipment is recorded at fair market value at the date of the donation. Purchased equipment is recorded at cost.

Ticket Sales
Ticket sales received prior to the fiscal year to which they apply are not recognized as revenues until the year earned.

Cash and Cash Equivalents
For purposes of the statement of cash flows, cash equivalents include time deposits, certificates of deposit and all highly liquid debt instruments with original maturities of three months or less.

Income Tax Status
The Theatre is classified as a Section 50l(c) (3) Organization under the Federal Internal Revenue Code and Section 13.2210 (e) of the State Revenue and Taxation Code. As a result, it has been determined to be exempt from federal income and state franchise taxes. The Theatre is not classified as a private foundation under 509(c)(2). Tax years 2020-2022 are open to examination by taxing authorities.
-9-
North Coast Repertory Theatre,
A Non-Profit Corporation
Notes to Financial Statements
(continued)
For the Year Ended August 31, 2024
Note I - Summary of Significant Accounting Policies (continued) Expense Allocation
The costs of providing the various programs and activities have been summarized on a functional basis in the Statement of Activities and in the Statement of Functional Expenses.

Accordingly, certain costs have been allocated among the programs and supporting services benefited.

Investments
Investments with readily determined market value are carried at market value and unrealized gains and losses are treated as current items in the year in which they occur. Investments without readily determined market values are carried at cost.

The FASB issued authoritative guidance relating to fair value measurements which establishes a common definition for fair value to be applied to U.S. generally accepted accounting principles requiring use of fair value, establishes a framework for measuring fair value, and expands disclosures about such fair value measurements.

The Theatre measures fair value at the price that would be received upon sale of an asset or paid to transfer a liability in an orderly transaction between market and participants at the measure date. The guidance establishes a hierarchy for ranking the quality and reliability of the information used to determine fair values.

A summary of the fair value hierarchy under the authoritative guidance is described in Note 6.

Comparative Totals for August 31. 2023
The financial statements include certain prior year summarized comparative information in total but not by net asset class. Such information does not include sufficient detail to constitute a presentation in conformity with generally accepted accounting principles. Accordingly, such information should be read in conjunction with the Theatre's financial statements for the year ended August 31, 2023, from which the summarized information was derived.

Note 2 - Property and Equipment
The following is a summary of property and equipment, less accumulated depreciation and amortization at August 31, 2024:

Leasehold improvements
Furniture and equipment
Automotive
Accumulated depreciation and amortization
Property and Equipment - Net
-10-
$
$
(
2024
230,967
504,960
48,672
784,599
498,629)
285,970
Note 3 - Deferred Revenue
North Coast Repertory Theatre,
A Non-Profit Corporation
Notes to Financial Statements
( continued)
For the Year Ended August 31, 2024
The Theatre had received $892,140 at August 31, 2024, on advance ticket sales for the next theatre season. As each production is presented, the portion of the advance sales collections that pertains to that production will be recognized as revenue. In the event any of the scheduled productions for the season are not presented, the advance ticket collections for that production will be available for refund to the ticket holders. In addition, The Theatre had received $161,263 in other deferred revenue from tuition, gift certificates, donations and reimbursement for productions in the next fiscal year.

Note 4 -Net Assets with Donor Restrictions
Net assets with donor restrictions represent contributions received by the Theatre that are limited in their use by donor-imposed stipulations.

Net assets with donor restrictions are available for the following purposes as of August 31, 2024: 2024
Purpose Restrictions
Endowment Funds
Total
Note 5 -Endowment Funds
55,497
$ 55,497
Endowment funds were $55,497 as of August 31, 2024. These funds are held in an agency endowment fund at The Jewish Community Foundation (JCF).

No later than April 1st of the year commencing after the fair market value of the fund reached the amount of $50,000, JCF shall distribute to the Theatre an amount equal to the JCF payout rate multiplied by the fair market value of the fund (the "available amount"). The term "fair market value of the fund" shall mean the value of all cash and securities held by the fund, including all earnings and unrealized appreciation thereon, as determined by JCF. The term "JCF payout rate" shall mean the percentage rate determined by the Board of Directors of JCF pursuant to California law with respect to distributions from endowment funds. The fair market value of the fund reached $50,000 in August of 2023 and the first distribution was received in February 2024.

JCF shall have all powers necessary to carry out the purposes of the fund, including, but not limited to, the power to retain, invest and reinvest the fund in any manner consistent with the California Uniform Prudent Management of Institutional Funds Act, and shall have the power to commingle the assets of the fund with those of other funds for investment purposes, provided that such commingling shall not contravene the purpose and limitations set forth in this agreement. JCF shall have the ultimate authority and control over all property in the fund, and the income derived therefrom, subject to the terms of this agreement and the standards for investment governing nonprofit public benefit corporations under California Corporations Code Section 5240. The fund shall be administered under and subject to the procedures and/or rules for the operation of permanent endowment funds as the same may be adopted, or modified from time to time, by JCF.
-11-
North Coast Repertory Theatre,
A Non-Profit Corporation
Notes to Financial Statements
( continued)
For the Year Ended August 31, 2024
Note 5 -Endowment Funds (continued)
The fund shall be administered under and subject to the Bylaws, Articles of Incorporation and the endowment policies of JCF in effect from time to time. JCF shall have the power to modify and restriction or condition on the distribution of funds for any specified charitable purpose or to any specified organization if, in the sole discretion of the Board of Directors (without the necessity of the approval of the Theatre or any beneficiary organization), such restriction or condition becomes unnecessary, incapable of fulfillment, or inconsistent with the charitable needs of the community or area served. All money and property in the fund shall be assets of JCF, and not a separate trust, and shall be subject only to the control of JCF. Even though the fund may not be segregated, separate accounting records will be maintained for the fund.

Nothing in this agreement is intended to be inconsistent with the status of JCF as an organization described in Sections 50 I ( c )(3) and 509(a) of the Internal Revenue Code of 1986.

JCF is authorized to amend this agreement to conform to the provisions of any applicable Jaw or government regulation in order to caiTy out the foregoing intention.

For the year ended August 31, 2024, the Theatre received $2,692 in distributions from the fund.

Note 6 - Fair Value Measurements
The Fair Value Measurements Topic of the FASB Accounting Standards Codification establishes a fair value hierarchy that prioritizes inputs to valuation techniques used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level I measurements) and the lowest priority to unobservable inputs (Level 3 measurements). The three levels of the fair value hierarchy are described below:

Level I: Inputs to the valuation methodology are unadjusted quoted prices for identical assets or liabilities in active markets.

Level 2: Inputs to the valuation methodology include quoted prices for similar assets and liabilities in active markets, and inputs that arc observable for the assets or liability, either directly or indirectly, for substantially the full term of the financial instrument.

Level 3: Inputs to the valuation methodology are unobservable and significant to the fair value measurement.

A financial instrument's level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. -12-
North Coast Repertory Theatre,
A Non-Profit Corporation
Notes to Financial Statements
( continued)
For the Year Ended August 31, 2024
Note 6 -Fair Value Measurements (continued)
The following details the level within the fair value hierarchy of the Theatre's assets as fair value as of August 31, 2024. Level I investment consists of equities and totaled $5,063,354. There were no Level 2 assets. The Level 3 asset is Portfolio Investors II, L.P. a Delaware limited partnership holding rental real estate assets in San Diego County. Since quoted prices are not available as this is not a liquid investment and the Theatre does not have the ability to access value at the measurement date, this investment is classified as a Level 3 asset and recorded at cost. The second Level 3 asset is a hedge fund, Ironwood Institutional MS, LLC, held via Morgan Stanley, which provided the estimated value.

Investments at fair market value at August 31, 2024, consist of the following:

Adjusted Fair Market Fair Value
Cost Value (Level 1)
Level 1 funds
Fund at JCF $ 47,159 $ 55,497 $ 55,497
Mutual Funds 3,685,377 3,713,936 3,713,936
ETF's & CEF's 424,882 S 17,521 517,521
Fixed income preferred 754,162 776,490 776,400
Level 3 funds
Portfolio Investors II, LP 80,468 NIA 80,468
Ironwood Inst. MS LLC 84,091 84,634 84,634
Investment return for the year ended August 31, 2024 included in the statements of activities is comprised of the following:

Realized and unrealized gains (losses)
Interest and dividends (net of fees of $14,238)
Note 7 - Cash and Equivalents
At August 31, 2024, cash was held in the following institutions:

Change Funds
US Bank (2 accounts)
Wells Fargo (1 account)
Morgan Stanley (3 accounts)
-13-
$
$
$
$
2024
115,373
142,663
258,036
550
148,973
44,403
7,744
201,670
North Coast Repertory Theatre,
A Non-Profit Corporation
Notes to Financial Statements
( continued)
For the Year Ended August 31, 2024
Note 7 - Cash and Equivalents (continued)
Concentration of Credit Risk
The Theatre maintains its cash in bank accounts and brokerage accounts, which, at times, may exceed federally insured limits. The Theatre has not experienced any losses in such accounts.

The Theatre believes it is not exposed to any significant credit risk on cash and cash equivalents.

Accounts are insured by the FDIC for amounts up to $250,000.

Note 8 - Restricted Assets - San Diego Foundation
Total assets with a fair market value of$39,729 are held in the North Coast Repertory Theatre endowment fund of the San Diego Foundation and invested by the Foundation. The Theatre has no ownership rights over the principal and does not include these funds on the statement of financial position. However, the Theatre receives investment income annually from these assets. Total income received from the San Diego Foundation for the year ended August 31, 2024 was $1,578.

Note 9 - Operating Lease
The Theatre has conformed to the new leasing standards under generally accepted accounting standards as indicated under ASC 842.

The Theatre leases its theatre, theatre school and administrative facilities under a lease agreement dated October 3, 2023. Monthly payments are $12,697.88 per month as of August 31, 2024. Total rental expense was $ I 98,210 for the year ended August 31, 2024. The Theatre has recorded a right of use asset and a corresponding lease liability of $348,222 as of August 31, 2024. This represents the present value of payments under the lease due through December 31, 2026 at an interest rate of 4.09% which is equal to the risk-free rate as determined by the daily Treasury rate of August 31, 2024.

Future Lease Obligations are:

August 31, 2025
August 31, 2026
August 31, 2027
August 31, 2028
August 31, 2029
$ 154,570
157,742
52,927
0 0
The Theatre has one outstanding operating lease for office equipment with a lease end date of December 2024. Since the remaining lease term is less than 12 months, ASC 842 has not been applied to this lease. Lease payments expensed for the year ended August 31, 2024 were $18,760.
-14-
Note I 0-Retirement Plan
North Coast Repertory Theatre,
A Non-Profit Corporation
Notes to Financial Statements
( continued)
For the Year Ended August 31, 2024
The Theatre maintains a tax deferred contribution plan qualified under Section 403(b) of the Internal Revenue Code. Eligible employees may contribute a percentage of their compensation to the Plan. Employer contributions totaled $18,650 for the year ended August 31, 2024.

Note I I -Liquidity and Availability of Financial Assets The table below represents financial assets available for general expenditures within one year at August 31, 2024:

Financial assets at year end:

Cash and cash equivalents without restrictions
Accounts receivable within one year
Liquid investments
Note 12-Contributions
$
$
201,670
32,247
4,533,332
4,767,249
During the fiscal year ended August 31, 2024, the Theatre received a generous donation from the estate of John Schooley in the amount of $2,590,378. This amount resulted in a substantial increase in total support and revenue for the year. Subsequent to this report, the Theatre was notified that an additional $1,000,000 will be received in the fiscal year ended August 31, 2025 and approximately $300,000 will be received in the fiscal year ended August 31, 2026.

Note 13-Subsequent Events
Events subsequent to August 31, 2024 have been evaluated through February 6, 2025, the date these financial statements were available to be issued, to determine whether they should be disclosed to keep the financial statements from being misleading. Management found no subsequent events.
-15-
990 Return of Organization Exempt From Income Tax 0MB No, 154~7 Forrn Under section 501 (c), 527, or 4947(a)(1) of the Internal Revenue Code (e,ccept private roundatrons) 2023 Oepartmenl or lhe Tteas"'Y Do not enter social security numbers on this form as It may be made public. O~en to Public Internal Re,anue Service Go to www.lrs .. ao11IF0rm990 for instructions and the latest Information. lnsoection A For the 2023 calendar vear or tax vear beoinnlnc/) 9 / 01/23 . and endina O 8 / 31/24 B Check if <1ppllcable: C Name of organization D Employer ldnn11neaUon number 0 Address Change NORTH. COAST REPERTORY THEATRE
0 Name ci)aage Oolng bus in ass as ~ - - Numbef and street (or P .. O. box ~ mail ,s nol delivered 10 slroet address] I Roomlw~e E Telepnone number D Initial relurn 987-D LOMAS SANTA FE DRIVE 858-481-2155 D F111al return/ City or tc,,llf\, state a, pro,m,;e, QO\Jnlry, and ZIP or foreign postal code 1enninated SOLANA BEACH CA 92075 7,316,643 D Amended return G Gross rece~
F Name and address of pllncipal clflCO!r D H!•I Is lhis a groop return I« subordinaiesQ Yes [!j No AjlplicaiJon peod,ng MARC TAYER 987 LOMAS SANTA FE H(bJ Are all subordinates iicludad? DY• ONo SOLANA BEACH CA 92075 Ir "No." 81\ach a list See insll\/Cllons I Tax.,,xernot sllltus_ IXI 5011cW3) I I 501(c) ( l o~sert_ no,> I I 4947{all1) or 1 ls21 J Website: WWW.NORTHCOASTREP .ORG H(cl Group i!lcempticn number K Form ot omanizatlon: IXI CorMratioo I I Tru5I I I Association I I Olhe1 I l Year of foonatlon: 19 8 2 IM Slate or le!lal doln/de: CA Part I Summarv
1 Brieny describe the organization's mission or most significant activities: . .. "' -- - . ' ' . -.. " . . ~ . ' .. " ... ---· 41 0 TO OPERATE A NOT-FOR-PROFIT PROFESSIONAL THEATRE FOR THE PROMOTION OF THE e - - • I 4 - , • , • • • • • , • • , • • , • < • , • , , - , • • • • • • • • • • • • • • , • • , • • • • • • • , , • • ··- , _ .. , .... ,, ·- -- -. n, PUBLIC APPRECIATION AND EDUCATION REGJ\RDING THEATRE ARTS. C - . . , .. . . ., ,, , ,, , ,, .. . .. ,,, ,. _ , _ , _ . .,, .. , ,, ', ,, _ ' " · • · · ...... , . ... ,, .. 41 ~ Ch~~ 'thi;-b~X O 'ii lh~ ~rg~~i-~~iion ~jj~~o,~ti~~ed 'iis 0 0pe~iio,~s ~~ di;posed of -~-~r~ ·th~~ 25o/o. ~f iis 'net ~~~is: - .. .. (!I 2
oil 3 Number of voling members of the governing body (Part VI, line 1 a) 3 19 . - ... - .. - ' . , - - -,-,-, - -·- -,------, ill 4 Number of Independent voting members of lhe govemtng body (Part VI, line 1b) ., ~" L ' • 4 19
E ,. -•- · ·
> 5 Total number of individuals employed Tn calendar year 2023 (Part V, line 2a) .. _ , , . , . 5 151 !fi ... ,. , . •·-· .. 6 Total number of volunte~rsr(es~mate if n~cessary>-_ , t. , . , :. ~. '-'. ;-. .,, - - 6 0 <C , . ... , , .. , ' '~.-.... ~. - ,""r, ' - • - • ' • ,. "._~ • •·t-• ..... 7a Total unrelated business,:revenue om P~rt ~ I!, .g:ilu711f ~(~)1' line 12 7a 0 ,, ' ' b Net unrelated business taxablej ncome from fonn 990-T. eart I, line 11 . - . ,; __ . :~. '~_ :: -:i: t:~~-/: .• •. ·~-:: 7b 0 -- ~ - ----·- - - ~ - ··~ . Prior Yoor Current Year
QI 8 Contributions and grants (Part VIII, line 1h) ____ ., .. . . --- •- - .. . . .. 1,419,732 4,319.162 ::, C 9 Program service revenue (Part VIII, line 2g) . . _ . , 2 412.720 2,830,648 41 . . . . . . > 10 Investment income (Pan VIII, column (A), lines 3, 4, and 7d) 81.934 156,735 41 ,,, . ' ' Cl:: 11 Other revenue (Part VIII, column (A), lines 5, 6d, Be, 9c, 10c, and 11e) - 180.464 -162.419 column IA\, lin~ 12\ ,,, , , ;
12 Total revenue - add lines 8 thrcuClh 11 (must eaual Part VIII .. 3,733.922 7,144,126 . . 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) 0 " 14 Benefits paid lo or for members (Part IX, column (A), line 4) , .. __ _, __ 0 gJ 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) 2 . 109,766 2, 402,, 050 Ul C: 16a Professtonal fund raising fees (Pan IX. column (A), line 11 e) , 4.313 QI b Total fundraising expenses (Part IX, column (D), line 25) ,4-09 61·9·' C. ~ ' .... .. , '_,
17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e) 1.662.953 2. 074 ,491 ,, .. 18 Total expenses. Add lines 13- 17 (must equal Pan IX, column ,(A), line 25) 3,772,719 4.480.854 19 Revenue less exoenses. Subtract line 18 from lfne 12 .. ·-··· .. -38,797 2,663,272 ;t i,ealnnina of Current Year End of Year
20 Total assets (Part X, line 16) 3,345,801 6,439,265 ~ •-· j -g 21 Total liabnlties (Part X, line 26) _ 1,226,880 1,541,533 if 22 Net assets or fund balances. Subtract line 21 from line 20 - -- .. 2.118.921 4.897.732 Part II Signature Block
Under pena!Ues of perjury. I declare that I have examined this return, Including accompanying schedules and statements .. and to the best of my r.nov.1edge and beUef. it is true. correct, and complete. Declaration of prep;irer (other than officer) Is based ori all fnformaUon of vlhTCll preparer has any knowledge_ Sign Sfgriature of otf.::er
Here 1 MARC TAYER
Type o, pnnt name and lille
Prin1/Type prepmers name I Prop;,rers signalure
Paid Alicia M. Owens Alicia M. Owens
Preparer FJtn1's r\llllle A.M. Owens. CPA, Al?C
Use Only 10340 Paseo Park Drive
Firm's address Lakeside, CA 92040
May the IRS discuss tflis return with the preparer shown above? See instructions For Paperwork Reduction Act Notlce, see the separate Instructions.

OM
I
Onie
President
I Dale il Chad< LJ if PTIN
04/22/25 self-<Jmployed P01212923
Frm's EIN _ .. - - Phone r.o. 619-698-2401
- --- - - --- - . - . . ~ -- .. - . -- IXI Yes I [No
Form 990 (2023)
Internal Revenue Service
Date: July 21, 2004
Department of the Treasury
P. 0. Box 2508
Cincinnati1 OH 45201
North Coast Repertory ThEATRE A Non Profit
Corporation
Person to Contact:

Sylvia A. Williams 31-07817
Customer Service Representative
Toll Free Telephone Number:
987 Lomas Santa Fe. Dr. D
Solana Beach, CA 92075-2125
Dear Sir or Madam:
8:00 a.m. to 6:30 p.m. EST
877-829-5500
Fax Number:
513-263-3756
Federal Identification Number:

This is in response to your request of July21) 2004, regarding your organization's tax-exempt status.

In November 1983 we issued a determination letter that recognized your organization as exempt from federal income tax. Our records indicate that your organization is currently exempt under section 501(c)(3) of the Internal Revenue Code.

Our records indicate that your organization is also classified as a public charity under sections 509(a)(1) and 170(b)(1 )(A)(vi) of the Internal Revenue Code.

Our records indicate that contributions to your organization are deductible under section 170 of the Code, and that you are qualified tp receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Internal Revenue Code.

If you have any questions, please call us at the telephone number shown in the heading o'f this letter.

Sincerely,
~'KJ&;w
Janna K. Skufca, Director, TE/GE
Customer Account Services
form W-9 Request for Taxpayer
(Rev, March 2024) Identification Number and Certification Depanmenl of the freaswy lnlem!ll Revenue SeMce Go to wivw.lrs;gov/ForrnW9 for Instructions and the tatest informat.ion.

Before you begin. For guidance related to the purpose of Form W-9, see Purpose. of Form, below.

Give form to the
request.er. Do not
send to the IRS.
1 Name of entityfllldiV<dLial. An en!JY Is requlred. (For a sole proprietor or dlS<egarc!iw entity, enter the owner's name on line , , and roter the buslness/dlsregarde<I entity's name on line 2.) •
North Coast Repertory Theatre
2 Business. name/disregllfded enlity name, H dllferen\ from above.

M
Q) 3a Cheek the-appropriate box lo1 federal tax classijlcatlon of the entity/individual v,hose name Is entered on tine I. Check -4 EJtemp!ions (codas apply only to Ol• "' only one of the folk>wfng seven boxes. certain entitle$, not Individuals; a. 0 lndivlduallsole p1oprielor ~ C corporallon 0 S corporaticm D Parlnershlp 0 Trost/estate see Instructions on page 3):
§
. ~ 0 LLC. Enter the tax classification ,(C = C corpo,allon. S" S corporallon, P : Partnersr1lp) Exempt payee cO(le {If any) ~ c:: Nole: Che<:k tho 'LLC" box above and, Jn the entry space, enler the epp<opria\e code (C, S, or PJ for the tax ___ g~ classltlcatlon of the LLC, unless It Is a disregarded entity. A disregarded enUty should IAsteed cl:ieck theapproiu!ate Exemption from Foreign Account Tax 2j box for lhe laJ< classification of hs owner: Complionce Aot (FATCA) reporllng. -~s D Olher (see instructions) code. pr any)
a. u
I:; 3b II on fine 3a you checked "Partne1shlp" or "TrusVestele," or checked "ll.C" and entered •p• as Its tax classifk:allon, ·2 and you we providing this form to a partnership, trust, or eslate In which you have an ownership Interest, check (Applies to 11ccoonta malnreined ~ this box if you have any foreign partners, owners. or beneficiaries. See fnslructfons □ outside the Un/led Sia/es,) .. <I)
QI 5 Address (number, street, and apl. or SLJtte no.J. See lnstruclions. Requester's name and address (opUona~ r:n 987 Lomas Santa Fe Drive, Suite D 6 C~y. slate, and ZIP code
Solana Beach, CA 92075
7 List account nurn.bet(s) here (optlonaQ
■:..., •• Taxpayer Identification Number {TIN)
I Social socurity number Enter I yovr TIN In the appropriate box. The TIN provided must match the name glven on line 1' to avoid backup wlthho!dlng, For indMduals, this rs generally your soolal security number (SSN). However, for a resident alien, sole. proprle1or, or disregarded entity, sea the Instructions for Part I, ·later. For other entities, i~ Is your employer 1denUfl,;;allon rJUmber (EIN). If you do no"! have a number, see How to gei a TIN, later.

DJJ-DJ-1 I I I I
or
j Employer lden!Jncellon numb or
Note: If the account Is In more than one name, see the Jns\ructrons for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter.

Certification
Under penalties of perjury, I certify that:

1. The number shown on this form Is my correct taxpayer identification number {or I am v,alting for a number to be Issued to rne); and

2. I am not subject to oaokup withhold Ing because (a) I am exempt from backup wlthholdlng, or (b), I have not been notified by the Internal Revenue Service (IRS) that ! wn subject to backup withholding as a result of a failure to report all Interest or dividends, or (o) the IRS has notified me that I am no longer subject lo backup withholding: and

3. I am a lJ.S. cil1'z.en or other U.S. person (defined below); and

4. The FATCA code(s) entered on this farm Qf any) indicating that I am. exempt from FATCA reporting is correct.

Cortificotion instructions. You must cross out item 2 above rr you l1ave been notified by the IRS that you are curren11y subject to backup withhold Ing because you have failed to report :311 lnteresl and dividends on your tax return, For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellallon of deb1, con1ribu!ioos to an individual retlremenl arrangement PAA), and, generally, payments other than Interest and dividends, you ani not qulred lo sign the certification, but you must provide your correct TIN, See the 1nstn,ctlons for Par1 II, laler.

Sign Sl9natt,re of O t. / Z ti 12,. n5 Here U,S. person Date J o u 1,, General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.

F-Uture developments. For the latest information about developments related to Form W-9 and Its lnstruc\lons, such as leglslallon enacted after they were published, go to 1'1\vw.lrs.gov/FormW9.

What's New
Line 3a has been rnoditied to clarify how a disregarded entity completes this line. An LLC that Is a disregruded entity should check the appropriate box for the tax classl1icatlon of 'its owner. Otherwise, II should check the "LLC" box and enter Its appropriate tax classmcatlon.

Ca(. No. 10231X
New line 3b has been added lo this form. A flow-through entity Is required lo complete this line to Indicate that It has direct of indirect foreign partners, owners, or beneficiaries when It provides the Form W-9 to another flow-through enllty In which It has an ownership interest. This change Is Intended to provide a flow-through entity with inforroatlon regarding the status of its Indirect foreign partners, owners, or beneficfaries, so that II can satisfy any applicable reporting requlrf3ments. For example, a partnership that has any lndlrect foreign partners may be required to comple1e Schedules K-2 and K-3. See 1Me Partnership Instructions tar Schedules K-2 and K-3 (Form 1065).

Purpose of Form
An lndlvldual or ent1ty (form W•9 requester) who Is required to life an information return. with the IRS Is giving you this form because they Form W-9 (Rev. 3·2024)
Order of
Malta Clinic
of San Diego
The City of Solana Beach Community Grant Program 2025 Request for Financial Assistance application MUST BE SUBMITTED by 5:00 PM Thursday, May 29, 2025.

Please submit completed applications via email to [email protected] and copied to [email protected].

If email submission is not possible for an applicant, hard copies may be dropped off at City Hall 635 South Highway 101 , Solana Beach, CA. 92075, Attn: Community Grants Program.

All requests will be determined by the following criteria:

Name of Organization: Order of Malta Clinic of San Diego Contact Person: _K_ir_st_en_L_im_m_er ___________ Email address: [email protected] Daytime Phone: ....:.6_19=---72....;3_;-5;_1_10'---------- Evening Phone: ____________ _ Mailing Address: _9_36_G_en_e_vi_ev_e_S_t _________________________ _ City: Solana Beach State: ....;;C;.;...A'-------- Zip: 92075

1. All the documents below are attached to this application:
□ W-9
0 Summary of Organization's Budget
□ Proposed Program Budget
D Financial and Tax Statements (see Application Guidelines) D Copy of the California Franchise Tax Board Entity Status Letter, showing exemption under Section 23701 d or Internal Revenue Code section 501 (c)(3)

2. Has your organization received financial assistance from the City before? 0 Yes D No If yes, please state the fiscal year it was received and for the proposed program was:
2019; under the name St Leo's Medical Clinic

3. Title of FY 2025/26 Proposed Program/Service: Order of Malta Clinic San Diego

4. What is the total amount requested for the FY 2025/26 Proposed Total Program? Includes all estimated costs to conduct proposed activity/program.

Requesting maximum award of $6000
Page I 1

5. Grant funds must be used for services or materials directly associated with the proposed activity.

Please describe how grant funds will be used:

The Order of Malta San Diego Clinic (formerly St. Leo's Medical Clinic) has been providing healthcare for underserved and uninsured residents of our community for decades. To continue fulfilling our vital mission of delivering compassionate medical care to those most in need, ongoing funding is essential.

6. Anticipated Program Objectives or Accomplishments:

Our clinic is committed to bridging the healthcare gap for uninsured and underserved individuals in our community.

Through this program, we anticipate achieving the following objectives and accomplishments:

1. Improve Access to Free, Quality Healthcare: Provide comprehensive medical services-including preventive care, chronic disease management, and health screenings-to uninsured or underinsured individuals.

2. Enhance Health Outcomes: Reduce preventable emergency room visits and hospitalizations by addressing medical needs early and consistently, especially for patients with chronic conditions such as diabetes, hypertension, and asthma.

7. Program Dates/Location:

The medical clinic located in Solana Beach is currently open and operating

8. Estimated number of Solana Beach residents to be served by proposed program: please see page 3

9. How will the organization acknowledge the City's financial contribution to the community/ beneficiaries of the proposed activity?
We are deeply grateful for the City's support and are committed to acknowledging its contribution in meaningful and visible ways. The City's financial support will be recognized through prominent signage at our clinic, ensuring that patients and visitors are aware of its valued partnership. We are also open and receptive to any additional acknowledgment methods the City may recommend.

10. Will there be any matching funds or other grants that would be applied to this program or service? If awarded this grant, will that enable other funding sources? The Clinic solicits and receives grants from a variety of organizations. At this time we are unaware of any other funding source that requires this grant.

Page I 2

11. Will volunteers be used for the proposed program or service and, if so, will they reduce expenses? Yes, the clinfc fully operates with a volunteer staff of medical professionals and ancillary staff.

12. If the proposed program or service is only awarded partial funding, will it still move forward? Will the program/service be scaled back and/or is there a threshold at which it will not move forward? Yes, while the clinic will continue to run with only partial funding, we are deeply reliant on grants and fundraising to provide medical services for our underserved community.

Acknowledgment of Responsibility:

May 27, 2025
Authorized Signature of Organization Date

ALL INFORMATION REQUESTED ON THIS APPLICATION MUST BE COMPLETED AS A CONDITION FOR BEING CONSIDERED FOR PUBLIC FUNDS BY THE CITY COUNCIL OF SOLANA BEACH.

Question #8. The Clinic at St. Leo's Mission was formed in Eden Gardens over thirty years ago, specifically to provide free health care to local residents of Solana Beach. Today, we still provide the same service. There has never been any advertising or desire to grow into a larger regional health provider. Over the years, word of mouth has spread among family and friends, and now people also come from outside the area. We provide care to anyone who comes without regard to residence, immigration status or ability to pay. It's a free clinic, still serving Solana Beach. We see an average of twelve patients per week.

Page I 3
May 23, 2025
Michael T. Psomas CPA, PC
A Public Accountancy Professional Corporation
,{,660 La.Jolla Village Drive, Suite 100
S,m Diego, California 92 I 09
(858) 210-2525
City of Solana Beach Community Grant Program
Solana Beach City Hall
Attn: Dan King
63 5 South Highway 101
Solana Beach, California 92075
Re: Grant Application of Order of Malta Clinic of San Diego, Inc.

Dear Mr. King,
In reference to Item 1 of the aforementioned grant application, specifically the request for financial and tax statements, as well as the California Franchise Tax Board Entity Status Letter, please accept the following explanation.

The free medical clinic at St. Leo's Mission has been in existence for over thirty years, serving low-income residents of Solana Beach. On August 16, 2024, the Order of Malta, an ancient Catholic lay religious order which operates other free medical clinics in the western United States and around the world took over the clinic at St. Leo's with the specific intent of continuing to operate it as a free medical clinic, largely unchanged from the previous operation albeit with additional oversight and licensure. At that time, the Order of Malta formed a new 501 ( c )3 corporation as a holding company for the clinic.

As before, patients are not asked for payment or insurance information, immigration status or anything other than basic information to treat them.

As a result of the new entity being formed on August 16, 2024, all financial information begins at that date, despite the fact that the clinic has been operating for over thirty years. Additionally, the first tax return is not due until November 15, 2025, for the first fiscal year which will end June 30, 2025. There is no tax return to provide.

City of Solana Beach
May 23, 2025

Page 2 of 2 ends

Finally, the Order of Malta obtained a tax exempt determination letter from the IRS on August 30, 2024, and then timely filed Form 3500A on November 2, 2024 with the California Franchise Tax Board applying for California tax exempt status. However, the current waiting period for California to issue the California tax exempt entity status letter is nine months. So, that letter is expected sometime in August 2025. Once it's issued, the California tax exemption, just like the Federal income tax exemption, will be effective retroactively to the formation of the entity on August 16, 2024.

As evidenced by the IRS determination letter (provided herewith), and a copy of the original Articles of Incorporation filed with the Secretary of State of California (provided herewith), which states it is "nonprofit public benefit corporation," the Order of Malta Clinic of San Diego is tax exempt.

I invite you to contact me at any time to discuss this matter fm1her.

Sincerely,
Mfohael T. Psomas
President
ORDER OF MALTA CLINIC OF SAN DIEGO, INC.

BUDGET
Fiscal Year July 1, 2025 TO June 30, 2026
Unrestricted Restricted Total
Donations and Contribution
General donations $ 30,000 $ $ 30,000
Donations for new programs 20,000 20,000
Donations for capital purchases 75,000 75,000
Assets released from restriction 95,000 (95,000)
Total donations and contribution 125,000 125,000
Expenses
Ongoing medication and lab work 14,400 14,400
New program medication and lab work 21,000 21,000
Referral costs 10,000 10,000
Office and general 24,000 24,000
Total Expenses 69,400 69,400
Change in Net Assets $ 55,600 $ $ 55,600
Net Assets at Beginning of Period 129,958 129,958
Net Assets at End of Period $ 185,558 $ $ 185,558
Note: All doctors, other medical professionals and staff are volunteers. The clinic does not pay anyone for their service. The expenses above do not reflect the value of the donated service.

ORDER OF MALTA CLINIC OF SAN DIEGO, INC.

BALANCE SHEET
As of March 31, 2025
(Unaudited - Management Financials)
Current assets:

Cash
Total current assets
Total assets
Liabilities and net assets
Current liabilities
Accounts payable
Total current liabilities
Total liabilities
Connnitments and contingencies
Net assets
Unrestricted net assets
Total net assets
Total liabilities and net assets
$
$
$
$
134,822
134,822
134,822
4,865
4,865
4,865
129,958
129,958
134,822
ORDER OF MALTA CLINIC OF SAN DIEGO, INC.

STATEMENT OF OPERATIONS AND NET ASSETS
For the Period from Inception August 16, 2024 to March 31, 2025 (Unaudited - Management Financials)
Unrestricted Restricted
Donations and Contribution
Donations $ 19,743 $ $
Initial contribution from St. Leots parish 123,780
Total donations and contribution 143,523
Expenses
Medication and lab work 9,115
Office and general 4,450
Total Expenses I 3,565
Change in Net Assets $ 129,958 $ $
Net Assets at Beginning of Period
Net Assets at End of Period $ 129,958 $ $
Total
19,743
123,780
143,523
9,115
4,450
13,565
129,958
129,958
Note: All doctors, other medical professionals and staff are volunteers. The clinic does not pay anyone for their service. The expenses above do not reflect the value of the donated service. ~ Department of the Treasury lm Internal Revenue Service RS
Tax Exempt and Government Entities J . P.O. Box 2508
Cincinnati, OH 4520 I
Date:
08/30/2024
iiiiiiiiiier:

Person to contact:

ORDER OF MALTA CLINIC OF SAN DIEGO INC
1475 BERYL STREET
Name: Customer Service
ID number: 31954
Telephone: 877 -829-5500
Accounting .period ending:

June 30
SAN DIEGO, CA 92109
Dear Applicant:

Public charity status:
1 ?0(b )(1 )(A)(vi)
Form 990 / 990-EZ I 990-N required:

Yes
Effective date of exemptlon:

August 16, 2024
Contribution deductibility:

Yes
Addendum applies:

No
DLN:
26053641002474
We're pleased to tell you we determined you're exempt from federal income tax under Internal Revenue Code (IRC) Section 50 1(c)(3). Donors can deduct contributions they make to you under IRC Section 170. You're also qualified to receive tax deductible bequests, devises, transfers or gifts under Section 2055, 2106, or 2522. This letter could help resolve questions on your exempt status. Please keep it for your records.

Organizations exempt under JRC Section S0l(c)(3) are further classified as either public charities or private foundations. We determined you're a public charity under the IRC Section listed at the top of this letter.

If we indicated at the top of this letter tho' .. ou're required lo file Form 990/990-EZ/990-N, our records show you're required to file an annual inf ,1T11'1t1on return (Form 990 or Form 990-EZ) or electronic notice (Form 990-N, thee-Postcard). If you don't fi le a required return or notice for three consecutive years. your exempt status will be automatically revoked.
l f we indicated at the top of this letter that an addendum applies, the e11closed addendum is an integral part of this letter.

For important i1ifonnation about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities.

Enter "4221-PC" in the search bar to view Publication 4221-PC. Compliance Guide for 501 (c)(3) Public Charities, which describes your recordkeeping. repo11ing. and disclosure requirements.

Sincerely,
~a,.~,:~
Stephen A. Martin
Director. Exempt Organizations
Rulings and Agreements
Letter 947 (Rev. 2-2020)
Catalog Number 35152P
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ARTICLES OF INCORPORATION
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ORDER OF MAL TA CLINIC OF SAN DIEGO
ARTICLE I.

For Office Use Only
-FILEDFile No.: 6350497
Date Filed: 8/16/2024
The name of the corporation is Order of Malta Clinic of San Diego, Inc. (the "Corporation").

A. The Corporation is a nonprofit public benefit corporation and is not organized for the private gain of any person. It is organized under the California Nonprofit Corporation Law for charitable purposes.

8. The primary purpose of the Corporation is to own and operate medical clinic(s) for serving the poor in need of medical services, and conducting activities and providing goods incidental to those services.

C. The Corporation is organized and operated exclusively for charitable purposes within the meaning of Section 501(c)(3) of the Internal Revenue Code of 1986, as now in effect or as may hereafter be amended (the "Code").

D. In furtherance of its purposes, the Corporation shall have all the general powers enumerated in Sections 5140 through 5142 of the California Nonprofit Corporation Law. as now in effect or as may hereafter be amended, together with the power to so1icit grants and contributions for such purposes.

ARTICLE II.

The name and address in the State of California of the Corporation's initial agent for service of process are:

Michael Psomas
1475 Beryl Street
San Diego, CA 92109
ARTICLE Ill.

The initial street and mailing address of the Corporation is 14 75 Beryl Street, San Diego, CA 92109
ARTICLE IV.

The Corporation shall have no members.

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ARTICLE V.

A. No substantial part of the activities of the Corporation shall consist of carrying on propaganda, or otherwise attempting to influence legislation (except as otherwise permitted by Section 50l(h) of the Code and in any corresponding laws of the State of California), and the Corporation shall not participate in or intervene in any political campaign (including the publishing or distribution of statements) on behalf of, or in opposition to, any candidate for public office.

B. Notwithstanding any other provision of these Articles of Incorporation, the Corporation shall not directly or indirectly (i) carry on any activity which would prevent it from obtaining exemption from Federal income taxation as a corporation described in Section 50l(c)(3) of the Code, or cause it to lose such exempt status, or (ii) carry on any activity not permitted to be carried on by a corporation, contributions to which are deductible under Section l 70(c)(2) of the Code.

C. Notwithstanding any other provision of these Articles of Incorporation or any other governing instrument of the Corporation, during such period, or periods, of time, if any, as the Corporation is treated as a "private foundation" pursuant to Section 509 of the Code: (i) the directors must distribute the Corporation's income at such time and in such manner so as not to subject the Corporation to tax under Section 4942 of the Code and (ii) the Corporation is prohibited from (a) engaging in any act of self-dealing (as defined in Section 494l(d) of the Code), (b) retaining any excess business holdings (as defined in Section 4943(c) of the Code) which would subject the Corporation to tax under Section 4943 of the Code, (c) investing any amount in such a manner so as to subject the Corporation to tax under Section 4944 of the Code, (d) within the taxable period, not removing from jeopardy any investment upon which an initial tax is imposed under Section 4944 of the Code, and (e) making any taxable expenditures (as defined in Section 4945(d) of the Code).

ARTICLE VI.

A. The property of the Corporation is irrevocably dedicated to charitable purposes. No part of the net income or assets of the Corporation shall ever inure to the benefit of any director, officer, or member thereof or to the benefit of any private person, except that the Corporation is authorized and empowered to pay reasonable compensation for services rendered and to make payments and distributions in furtherance of the purposes set forth in Article I hereof.

Upon the dissolution or winding up of the Corporation, its assets remaining after payment, or provision for payment, of all debts and liabilities of the Corporation shall be distributed to a nonprofit fund, foundation or corporation which is organized and operated exclusively for charitable, educational and/or religious purposes and which has established its taxexempt status under Internal Revenue Code section 50l(c)3. This will be the Sovereign Military HospitallerOrderofSt. John of Jerusalem of Rhodes and of Malta, Western Association, U.S.A., a California nonprofit religious corporation ("Order ofMalta")ifit is in compliance with the above requirements, otherwise to another United States Association of the Order of Malta that is in compliance with those conditions. Ifno such association of the Order of Malta exists on the date of dissolution, then to a nonprofit fund, foundation, or corporation which is organized and operated 2 US-DOCS\107112564.4
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exclusively for charitable or religious purposes in the United States and designated by the Grand Master or Lieutenant of the Grand Master of the Sovereign Military Hospitaller Order of St. John of Jerusalem of Rhodes and of Malta, and which, in each case, has established its tax exempt status under Section 50l(c)(3) of the Code.

ARTICLE VII.

Any amendment to or repeal of these Articles of Incorporation must be approved by the Order of Malta prior to taking effect.

Dated: August 13, 2024
/l.d)7.

Michael T. Psomas
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Form W•9
(Rev. March 2024)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Go t o www.irs.gov/FormW9 tor instructions and the latest information.

Before you begin. For guidance related to the purpose of Form W-9. see Purpose of Form, below.

Give form to the
requester. Do not
send to the IRS.
1 Name of entity/1ndIvldual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1. and enter the business/disregarded entity's name on line 2.)
Order of Malta Clinic of San Dieoo, Inc.
2 Business name/disregarded entity name, if dltferent from above.

C')
Q) 3a Check the appropr,ate box for federal tax classificatlon of the entity/individual whose name is entered on line 1 Check 4 Exemptions (codes apply only to Cl only one of the following seven boxes. ro certain enlItIes. nol 1nd1v1duaIs:

0. □ 0 C corporation 0 S corporation 0 Partnership 0 Trust/estate see InstructIons on page 3): C lnd1v1dual/sole proprietor 0 Q)
•
I:

II) □ LLC. Enter the tax classif1cat1on (C = C corporation. S = S corporation. P = Partnership) Exempt payee code IIf any} 5 - -- i_g Note: Check the "LLC" box above and, in lhe entry space, enter the appropriate code (C. S, or P) for the tax u classification of Exemption from Foreign Account Tax the LLC, unless 1t is a disregarded entity. A dlsregorded entity should instead check the appropriate ... ::i box for the tax classif1cat1on of its owner. Compliance Act (FATCA) reporting 0 '- C t; □ Other (see instruct ions) code (1f any) 'C £ Cl. u ~ 3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P'' as its tax classification. (Applies fo accounts maintained l.l Ql and you are providing this form to a pa11 nership, trust, or estate In which you have an ownership Interest. check □ outside the United States.)
~ this box if you have any foreign partners. owners . or beneficiaries. See 1nstruct1ons al 5 Address !number, street, and apt, or suite no.). See instructions. Requester's name and address (optional) en 625 S Nardo Street
6 City, state, and ZIP code
Solana Beach, CA 92705
7 Lisi account number(s) here (optional)
:.F.T •• Taxpayer Identification Number (TIN)
I Social security number Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 I to avoid backup withholding. For individuals, this Is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entitles. it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later.

DJJ-ITJ- 111 I I
or
Note: If the account is in more than one name, see the instructions for llne 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter.

Certification
Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and

2. I am not subject to backup withholding because (a) I am exempt from backup withholdi ng, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup witl1holding as a result of a failure to report all interest or dividends, or (c) the IRS has noti fied me that I am no longer subject to backup withholding; and

3. I am a U.S. citizen or other U.S. person (defined below): and

4. The FATCA code(s) en tered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

Certification instructions. You must cross out item 2 above if you have bean notified by the IRS that you are currently sub1ect to backup w1tt1r1olding because you have fa iled to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisIt1on or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the Instructions for Part II, later.

Sign Signature of :?.

Here U.S. person "7 . {~ Date '2. I 2,.'5
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.

Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9.

What's New
Line 3a has been modified to clarify how a disregarded entity completes this line. An LLC that is a disregarded entity should check the appropriate box for the tax classification of its owner. Otherwise, it should check the "LLC" box and enter its appropriate tax classification.

Cat. No. 10231X
New line 3b has been added to tl1is form. A flow-through en tity is required to complete this line to indicate that it has direct or ,nd,rect foreign partners, owners, or beneficiaries when it provides the Form W-9 to another flow-through entity in which it has an ownership Interest. This change is intended to provide a flow-through entity with information regarding the status of its indirect foreign partners, owners, or beneficiaries, so that it can satisfy any applicable reporting requirements. For example. a partnership that l1as any indirect fore ign partners may be required to complete Schedules K-2 and K-3 See the Partnership Instructions for Schedules K-2 and K-3 (Form 1065).

Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an information return with the IRS is giving you this form because they Form W-9 !Rev 3-20241
Pathways to
Citizenship
City of Solana Beach Community Grant Application
The City of Solana Beach Community Grant Program 2025 Request for Financial Assistance application MUST BE SUBMITTED by 5:00 PM Thursday, May 29, 2025.

All requests will be determined by the following criteria:

Name of Organization: Pathways to Citizenship
Sonya Williams, ED
858-519-2882
Contact Person: Email: [email protected]
Daytime Phone: Evening Phone: 858-519-
2882
Mailing Address: 120 Stevens Ave
City: Solana Beach State: CA Zip: 92075

1. All the documents below are attached to this application:

W-9
Summary of Organization's Budget
Proposed Program Budget
Financial and Tax Statements (see Application Guidelines) Copy of the California Franchise Tax Board Entity Status Letter, showing exemption under Section 23701d or Internal Revenue Code section 501 (c)(3)

2. Has your organization received financial assistance from the City before? Yes If yes, please state the fiscal year it was received and the proposed program:
2024-25: Digital Pathways: Implement the# l rated legal immigration software to expand legal access for low-income immigrants
2023-24: Pro Bono Program Expansion: Immigration law training in Solana Beach for volunteer attorneys and interns
2022-23: Voices of Freedom: Solana Beach Hybrid Citizenship Preparation Program 2021-22: Supporting Solana Beach Dreamers: Outreach and Legal Assistance for DACA Applicants in Solana Beach
2020-21: NCICC Solana Beach Immigrant Family COVID-19 Recovery Project 2019-20: Legal Immigration Services Scholarships for Solana Beach residents 2018-19: Educational Program Coordinator

3. Title of FY 2025/26 Proposed Program/Service:

Expand Legal Representation and Education for Immigrant Families in Solana Beach:

Add a bilingual DOJ accredited representative to Solana Beach staff

4. What is the total amount requested for the FY 2025/26 Proposed Total Program? Includes all estimated costs to conduct proposed activity/program. $8,800 project budget; $6,000 requested from the City of Solana Beach (see project budget)

5. Grant funds must be used for services or materials directly associated with the proposed activity. Please describe how grant funds will be used:

Grant will fund 5 additional hours/week for Pathways' bilingual administrative assistant, Ashley Lopez (a former Casa de Amistad student), to take immigration law courses, shadow Pathways' legal representatives, and apply for and earn her DOJ Accreditation to practice immigration law, increasing legal representation for eligible low-income immigrants in Solana Beach, and increasing access to reliable legal information for all immigrant families in Solana Beach.

6. Anticipated Program Objectives or Accomplishments:

Since receiving Department of Justice (DOJ) Recognition to practice immigration law in 2016, Pathways has provided more than 7,000 legal consultations for low-income immigrants in San Diego County, filed more than 920 cases with USCIS for clients from more than 45 countries, represented 233 new U.S. citizens, and helped more than 1,200 immigrant and refugee adults obtain work authorizations, improve their English, and prepare for citizenship. To maximize the impact of our small staff, Pathways has engaged more than 200 volunteer tutors, attorneys and legal interns in this complex and life-changing work.

As federal funding cuts force most large San Diego nonprofits to lay off staff and reduce services, Pathways has stepped up to fill the gap. By engaging a record number of volunteer tutors, legal interns and pro bona attorneys, Pathways' small staff is providing essential legal immigration assistance and education in Solana Beach and throughout San Diego County, ensuring that immigrant families have somewhere to turn in this rapidlyevolving legal landscape.

Funding from the City of Solana Beach will enable Pathways to impact 25% more low income immigrant families in Solana Beach, providing them with reliable legal information, helping them keep their families together and safe, and helping eligible families achieve lawful permanent residency, U.S. citizenship, and/or work authorization.

This project will provide expanded hours (5 additional hrs/wk) and legal training (including the Comprehensive Overview of Immigration Law course) for Pathways' bilingual administrative assistant, Ashley Lopez, to achieve her own DOJ accreditation, so she can file cases with USCIS for eligible clients, expanding legal representation and access for low-income immigrants in Solana Beach.

Over the past months, Ashley has interpreted for Pathways' Know Your Rights presentations and confidential legal consultations for the Casa de Amistad, St. Leo's, SBPC Hispanic Congregation, Earl Warren and La Colonia communities. When she earns her DOJ accreditation and the corresponding authorization to give "legal advice," she will be able to lead legal clinics, workshops, presentations, and consultations for local residents looking for a way to adjust their legal immigration status and protect their families.

Pathways will track and measure the number of low-income Solana Beach immigrants impacted, the number of volunteers engaged, the number of legal and educational clinics and presentations offered in Solana Beach, and will track and report Ashley's Lopez's DOJ accreditation progress.

7. Program Dates/Location:

June 2025 - May 2026
Pathways to Citizenship Offices, 120 Stevens Ave., Solana Beach, CA

8. Estimated number of Solana Beach residents to be served by proposed program:
100+ immigrants in Solana Beach

9. How will the organization acknowledge the City's financial contribution to the community/beneficiaries of the proposed activity?
We will submit press releases to local newspapers, and inform beneficiaries of the financial contribution made by the City of Solana Beach, plus acknowledge the City of Solana Beach's support on our website, biogs, social media, presentations, news coverage, etc.

10. Will there be any matching funds or other grants that would be applied to this program or service? If awarded this grant, will that enable other funding sources? Pathways is applying for a San Diego County Community Enhancement grant which will complete and complement this project by providing legal training, and extending the hours of Pathways' new community engagement coordinator in order to engage and train more high-quality local volunteers of all ages and backgrounds in this timely and crucial work.

11. Will volunteers be used for the proposed program or service and, if so, will they reduce expenses?
Yes. By engaging volunteer attorneys and legal interns in immigrant education and pro bono representation, Pathways maximizes the impact of its small legal staff.

12. If the proposed program or service is only awarded partial funding, will it still move forward? Will the program/service be scaled back and/or is there a threshold at which it will not move forward?
With partial funding, this project will move forward, but may take additional time (for Ashley to achieve legal accreditation) and impact fewer immigrant families.

Acknowledgment of Responsibility:

Authorized Signature assumes all responsibility for developing and implementing proposed activities or events in this application, including public acknowledgment of the City's financial contribution. Authorized signatures will comply with all accounting and budget procedures outlined by the City. Authorized signature and accompanying group will hold harmless the City of Solana Beach from all losses, claims, accidents, and problems associated, directly or indirectly with the development and implementation of proposed activities or events.

S I 10°111/- .
- ~ VVI.U.lllHl4,"--------------
Authorized Signature of Organization
May 28. 2025
Date

ALL INFORMATION REQUESTED ON THIS APPLICATION MUST BE COMPLETED AS A CONDITION FOR BEING CONSIDERED FOR PUBLIC FUNDS BY THE CITY COUNCIL OF SOLANA BEACH.

Budget Overview_Budget_FY25_P&L_Report
Pathways to Citizenship
January-December, 2025
ACCOUNT JANUARY 2025 FEBRUARY 2025 MARCH2025 APRIL 2025 MAY 2025 JUNE 2025 JULY2025 AUGUST2025 SEPTEMBER 2025 OCTOBER 2025 NOVEMBER 2025 DECEMBER 2025 TOTAL Income
Client Donation 2,500.00 2,500.00 2,500.00 2,500.00 2,500,00 2,500.00 2,500.00 2,500.00 2,500.00 2,500.00 2,500.00 2,500.00 30,000.00 Donation 17,416.67 17,416.67 17,416.67 17,416.67 17,416.67 17,416.67 17,416.67 17,416.67 17.416.67 17,416.67 17,416.67 17,416.63 209,000.00 Grant 10,975.00 10,975.00 10,975.00 10,975.00 10,975.00 10,975.00 10,975.00 10,975.00 10,975.00 10,975.00 10,975.00 10,975,00 131,700.00 Interest Paid 420.00 420.00 420.00 420.00 420.00 420.00 420.00 420.00 420.00 420.00 420.00 420.00 5,040.00 Total for Income 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.63 $375,740.00 Cost of Goods Sold 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Gross Profit 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.67 31,311.63 $375,740.00 Expenses
Advertising & Marketing 200.00 200.00 200.00 200.00 200.00 200.00 200.00 200.00 200.00 200.00 200.00 200.00 2,400.00 Bank Charges & Fees 16.17 16.17 16.17 16.17 16.17 16.17 16.17 16.17 16.17 16.17 16.17 16.13 194.00 fundraiser expenses 1,336.83 1,336.83 1,336.83 1,336.83 1,336.83 1,336.83 1,336.83 1,336.83 1,336.83 1,336.83 1,336.83 1,336.87 16,042.00 Insurance 200.00 200.00 200.00 200.00 200.00 1,400.00 200.00 200.00 200.00 6,247.00 200.00 200.00 9,647.00 Office Supplies & Software 1,089.50 1,089.50 1,089.50 1,089.50 1,089,50 1,089.50 1,089.50 1,089.50 1,089.50 1,089.50 1,089.50 1,089.50 13,074.00 Payroll 19,750.00 19,750.00 19.750.00 19,750.00 19,750.00 19,750.00 19,750.00 19,750.00 19,750.00 19,750.00 19,750.00 19,750.00 237,000.00 Payroll Fees 163.17 163.17 163.17 163.17 163.17 163.17 163.17 163.17 163.17 163.17 163.17 163.13 1,958.00 Payroll taxes 6,320.00 6,320.00 6,320.00 6,320.00 6,320.00 6,320.00 6,320.00 6,320.00 6,320.00 6,320.00 6,320.00 6,320.00 75,840.00 Postage 276,67 276.67 276.67 276.67 276.67 276.67 276.67 276,67 276.67 276.67 276.67 276.63 3.320.00 Rent& Lease 0.00 0.00 0.00 1,609.00 0.00 0.00 0.00 0,00 0.00 0.00 2,145.00 0,00 3.754.00 Taxes & Licenses 0.00 1,500.00 0.00 1,500.00 0,00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 3,000.00 Training 1.570.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,570.00 Volunteer Appreciation 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100,00 100.00 1,200.00 Tota I for Ex pens es 31,022.34 30,952.34 29,452.34 32,561.34 29,452.34 30,652.34 29,452.34 29,452.34 29,452.34 35,499.34 31,597.34 29,452.26 $368,999.00 Net Operating Income 289,33 359,33 1,859.33 -1,249.67 1,859.33 659.33 1,859.33 1,859.33 1,B59.33 -4,187.67 -285.67 1,859.37 $6,741.00 Olher Income 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 Other Expenses 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0,00 0.00 Net Other Income 0.00 0.00 o.oo 0.00 0.00 0.00 0.00 0.00 0.00 o.oo 0.00 0.00 $0.00 Net Income 289,33 359.33 1,859.33 ·1,249.67 1,859.33 659.33 1,859.33 1,859.33 1,859.33 -4,187.67 -285.67 1,859.37 $6,741.00 ASSETS
Current Assets
Bank Accounts
AAA • 8053 • Investments • 2
DDA XXXXXXXX7572 • 1
Total Bank Accounts
Total Current Assets

TOTAL ASSETS

LIABILITIES AND EQUITY
Total Liabilities
Equity
Opening Balance Equity
Retained Earnings
Net Revenue
Total Equity

TOTAL LIABILITIES AND EQUITY
Pathways to Citizenship
Balance Sheet
As of December 31, 2024
TOTAL
116,360.20
182,222.66
$298,582.86
$298,582.86
$298,582.86
245,104.44
53,478.42
$298,582.86
$298,582.86

DISTRIBUTION ACCOUNT
Income
Client Donation
Donation
Grant
Interest Paid
Total for Income
Cost of Goods Sold
Gross Profit
Expenses
Advertising & Marketing
Bank Charges & Fees
fundraiser expenses
Insurance
Legal & Professional Services
Office SuppHes & Software
Payroll
Payroll Fees
Payroll taxes
Postage
Rent & Lease
Taxes & Licenses
Training
Travel
Volunteer Appreciation
Total for Expenses
Net Operating Income
Other Income
Other Expenses
Net Other Income
Net Income
Statement of Activity
Pathways to Citizenship
January 1-May 28, 2025
TOTAL
5,698.75
105,111.03
35,475.00

0.40 $146,285.18
$146,285.18
304.98

31.00 357.50
-407.57
3,233.33
4,465.02
64,174.70
730.08
23,048.88
1,190.45
1,609.00
100.00
6,433.15
688.74
321.80
$106,281.06
$40,004.12
0 $40,004.12

DISTRIBUTION ACCOUNT
Income
Client Donation
Donation
Grant
Interest Paid
Total for Income
Cost of Goods Sold
Gross Profit
Expenses
Advertising & Marketing
Bank Charges & Fees
fundraiser expenses
Insurance
Legal & Professional Services
Office Supplies & Software
Payroll
Payroll Fees
Payroll taxes
Postage
Rent & Lease
Taxes & Licenses
Training
Travel
Volunteer Appreciation
Total for Expenses
Net Operating Income
Other Income
Other Expenses
Net Other Income
Net Income
Statement of Activity
Pathways to Citizenship
January 1-May 28, 2025
TOTAL
5,698.75
105,111.03
35,475.00

0.40 $146,285.18
$146,285.18
304.98

31.00 357.50
-407.57
3,233.33
4,465.02
64,174.70
730.08
23,048.88
1,190.45
1,609.00
100.00
6,433.15
688.74
321.80
$106,281.06
$40,004.12
0 $40,004.12
Form 99
Department cf the Trca~ury
lr.1e,-nal R&v6nu,; Servtee
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Cocle (except private foundations) Do not enter social security number's on this form as It mciy be made public.

Go to www.irs.gov/Form990 for instructions and the latest information.

A For the 2024 calendar ear or tax ear be inn·n , and endin 0MB No. 1545-0047
2024
•. _:.0R1fo·.to P,ublle
t- • J11specticm
B Chee~. if applicable: C Name ol organizaHon PATHWAYS TO CITIZENSHIP D Em_ployor irlontificatJon number 0 Address change __ o_o_in.c..g_bu_s_in_e_ss_a_s ____ _______ _____ ..-_____ _ 0 Name change
D Initial return
Number and street (or P,O bo)( if moll is not delivered to stree1 ~ddrer.s) Room /suite 120 STEVENS AVENUE
City or town

SOLANA BEACH
suite
CA
ZIP code
92075
E Telephone number
858-51 9-2882 D Final relurnllerm!naled Foreign country name Foreign provrncelstate/counly F orelgn postal code 0 Amended return 424 856
0 Apploc:atron pending F Name and address ol prtnc,pal officer rnale.7 OvcslI] No SONYA WILLIAMS 120 STEVENS AVENUE. SOLANA BEACH, CA 920 OvosD No I Tax-exemplstalus 00 501(c)[3) D b01(o) ) (insert no) D 4947(a)(1)or D 527 J Website: WWW.PATHWAYSSD ORG
t< Form otorgantza~1on ' 00 Corporation O Trust D Associabon D Other M State of legal domicile CA ~ n:J
E
Cl)
i)
I!)
clJ
i
1 2
3 4
5 6
Summa
Briefly describe the organization's mission or most significant activities:
.1.:9. P.13.9:{~l?~.l,.~_qA~ _1MM!~.f3tTt9_~_tJ_i;~!:' .~!'!9 ............. ___ .. __ .... .. . . ........................... _. ______ _ ....... .. ::::-~:t .;~ -r~; ;,~h: ~~:;~,;;,i~~ o.;~;u~~;, • r,; ~~~;~i~~ .. ~d ~f-~~~~~ • ;h~~-2so/~ ~f-it~-~~-; ~~~-~i;:· • • • • • • • .. • ·-• Number of voting members of the governing body (Part VI, lineIS~osi . . 3 11 Number of independent voting members of the governing b ~ {q I, • e 1 b) . . . . . 4 11 Total number of individuals employed In calendar year 20 (Pa Ii 2a) . . 5 5 Total number of volunteers (estimate if necessary) . . , . . . . , 6 60 1 7a Total unrelated business revenue from Part VIII, column ne 12 . . 7a 0 b Net unrelated business taxable income from Form 990-T Pa lne 11 , 7b g
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CD
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in
8 9
10 11
12 13
14 15
16a
b
17 18
19 Curront Yoar
Grants and similar amounts paid (Par!al ,(A). tines 1-3) . . . 0 0 Benefits paid to or for members (Patt I • colu n (A), line 4) . . . . . . ,_ _______ o _ ________ 0 Salaries, other compensation, emplOY.~ Part IX. column (A), lines 5-10) . ______ 24_1~,6_6_1 ______ 2_8""'4.'--0_14 Professional fundraising fees {~o!umn {A). line 11e) . . O 0 Total fundraising expenses {Pa o n (D), line 25) 41 ,790 , .. ·, ·Y/· ,, ,, · --_ Other expenses ( Part IX, co~(. es 11 a-11 d, 11f~24e} . . . . . . :-=.-=.-=_-=_-=_-=_-=_-=_-=_-=_-=_-4_s-=_,-4_-3_ ... 1:_-~_-_-_-_-~_-_-_-_-_8-=_7-=_,3-=_s-:=3 Total expenses Add Jines 1 • 7 ( i!St equal Part IX, column (A), line 25) . ,__ _ ____ 2_8_7.,__0_92-+-_____ 3_7_1,,._3_77_ Revenue less ex enses ne 18 from line 12 . . . . . 139,629 53,479 20 Total assets (Pafl. ~~ . . .
21 Total iiabllities4f5a_~~26) . . . , . . . . .

Beginning of Current Year End o(Yeat
243,914 298,583
0 0
Net assets 0'1f~n~~ifa1a9ces. Subtract line 21 from line 20 243,914 298.583 Signat~~~------ -------- ---- ----- ---------------- under penalties of perjury, I declare 1h'.1i (Jiave examined this return, lnclud;ng accompanying ~chedules and statemenl, , and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of prep3rer (other tllan officer) Is based on all rnformation cf w11tch preparer has any ~nowledge.

Sign Signature or officer Here SONYA WILLIAMS
Type or print oame and Ulla
Prepare~s name Preparcr't signature
Paid
Preparer Roland W Munqer
Use Only Firm's name Munaer & Comoanv, CPAs
Firm·s ~ddress 1818 Avocado Road, Oceanside, CA 92054
May the IRS discuss this return with the preparer shown above? See fnstructions For Paperworl< Reduction Act Notice, see the separate instructions.

HTA
I
Date

EXECUTIVE DIRECTOR
Date
Check D ,r
PTIN
4/21/2025 sE!ll-en,ployed P01871456
J Flmi's EIN "~ _., I Phone no 760-730-8020
[K]ves ON"
Form 990 (2024)
256
l, OH t15:201
D t NOV 06 2-013
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MAY t 2 2013
O•i : ... ____ _......., __
~~
Certificate of Amendment of Articles of Incorporation
The undersigned certify that
,--.. ·.,···-··-· ·~ ·:

1. They are the president and the secretary, respectively, of NORTH COUNTY IMMIGRATION AND ClTIZENSHIP CENTER , a Califomla corporation. with California Entity Number C3567665

2. Article 1 of the Articles of Incorporation of this corporation is amended to read as follows: The name of the corporation is PATHWAYS TO CITiZENSHIP

3. The foregoing amendment of Articles of Incorporation has been duty approved by the board of directors

4. The foregoing amendment of Articles of lncorporatioo has been duly approved by the required vote of the members as stated in the By~Laws.
::taU. t.k~- PaulaNance
Secretary
Secretary of State
Certificate of Status
I, SHIRLEY N. WEBER, PH.D., California Secretary of State, hereby certify:

Entity Name:

Entity No.:

Registration Date:

Entity Type:

Formed In:

Status:

PATHWAYS TO CITIZENSHIP
3567665
04/29/2013
Nonprofit Corporation - CA - Public Benefit

CALIFORNIA
Active
The above referenced entity is active on the Secretary of State's records and is authorized to exercise all its powers, rights and privileges in California.

This certificate relates to the status of the entity on the Secretary of State's records as of the date of this certificate and does not reflect documents that are pending review or other events that may impact status.

No information is available from this office regarding the financial condition, status of licenses, if any, business activities or practices of the entity.

Certificate No.: 316639733
IN WITNESS WHEREOF, I execute this certificate and affix the Great Seal of the State of California this day of April 11, 2025.

SHIRLEY N. WEBER, PH.D.

Secretary of State
To verify the issuance of this Certificate, use the Certificate No. above with the Secretary of State Certification Verification Search available at bizfileOnline.sos.ca.gov.

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Why You Received This Letter
Date: 5/28/2025
ESLID: 6007001580
According to our records, the following entity information is true and accurate as of the date of this letter.

Entity ID: 3567665
Entity Name: PATHWAYS TO CITIZENSHIP

1. The entity is in good standing with the Franchise Tax Board.

2. The entity is not in good standing with the Franchise Tax Board. [Z]
□
[Z] 3. The entity is currently exempt from tax under Revenue and Taxation Code (R&TC) Section 23701 d. □
□

4. We do not have current information about the entity.

5. The entity was administratively dissolved/cancelled on Administrative Dissolution process.

Important Information
through the Franchise Tax Board
• This information does not necessarily reflect the entity's current legal or administrative status with any other agency of the state of California or other governmental agency or body. • If the entity's powers, rights, and privileges were suspended or forfeited at any time in the past, or if the entity did business in California at a time when it was not qualified or not registered to do business in California, this information does not reflect the status or voidability of contracts made by the entity in California during the period the entity was suspended or forfeited (R& TC Sections 23304.1, 23304.5, 23305a, 23305. 1 ).
• The entity certificate of revivor may have a time limitation or may limit the functions the revived entity can perform, or both (R&TC Section 23305b).

Connect With Us
Web:

Phone:

California
ftb.ca.gov
800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States
Relay Service: 711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019)

Sandpipers
Square
Dance Club
The City of Solana Beach Community Grant Program 2025 Request for Financial Assistance application MUST BE SUBMITTED by 5:00 PM Thursday, May 29, 2025.

Please submit completed applications via email to [email protected] and copied to [email protected].

If email submission is not possible for an applicant, hard copies may be dropped off at City Hall 635 South Highway 101, Solana Beach, CA. 92075, Attn: Community Grants Program.

All requests will be determined by the following criteria:

Sandpipers Square Dance Club Name of Organization: ___________________________ _ Bonnie Violi [email protected] Contact Person: _______________ Email address:=----------- 760-215-5471 Cell 760-215-5471
Daytime Phone: Evening Phone: ___________ _
2408 La Plancha Ln Mailing Address: _____________________________ _ Carlsbad CA 2, 92009 City: ______________ State: ________ 1p: ________ _

1. All the documents below are attached to this application:
[!] W-9
[!] Summary of Organization's Budget
~ Proposed Program Budget
l!l Financial and Tax Statements (see Application Guidelines) l!l Copy of the California Franchise Tax Board Entity Status Letter, showing exemption under Section 23701 d or Internal Revenue Code section 501 (c)(3)

2. Has your organization received financial assistance from the City before? II Yes □ No If yes, please state the fiscal year it was received and for the proposed program was:
2024-2025 Learn to Square Dance Class
Learn to Square Dance in 2025

3. Title of FY 2025/26 Proposed Program/Service: _________________ _

4. What is the total amount requested for the FY 2025/26 Proposed Total Program? Includes all estimated costs to conduct proposed activity/program.

Caller Fees: 40 weeks x $200
Hall Rental, Hospitality, Mktg
Total class Expenses for 40 wks
$8,000
3,500
$11,500
Less student fees/donations: -4,000
Net Class Shortfall: -$7,500

Page 11 ends

5. Grant funds must be used for services or materials directly associated with the proposed activity.

Please describe how grant funds will be used:

The Square Dance Caller/Teacher and Hall rental fees are paid weekly and are a flat pre-agreed amount. If the class is large, fees for the caller can be increased. Two beginner classes are planned for 2025/26: !st class from August-December and 2nd class from January-May. Since we are able to use the La Colonia Community Center this year, the rental fees are much reduced.

Hospitality and Marketing costs are mostly provided by club members. Only significant pre-authorized expenses are paid by the club funds.

6. Anticipated Program Objectives or Accomplishments:

With the isolation caused by covid, many people ( expecially seniors) need a fun way to socialize and get exercise. It takes a significant commitment of time and money to get new square dancers trained. The square dance community has shrunk over time and clubs no longer have the resources needed to sponsor new learners. This program/grant will enable the participants to complete a 20 week course preparing them for club level dancing. Square Dancing for 2 hours is like walking 5 miles. In confers multiple benefits for both physical and mental health. It is fun and social.

7. Program Dates/Location:

Class is held weekly for 20 weeks at La Colonia Community Center in Solana Beach. We anticipate 20-30 participants from the local area. Class is advertised and open to the public age 9 to seniors. 40-60 new Dancers

8. Estimated number of Solana Beach residents to be served by proposed program: ______ _

9. How will the organization acknowledge the City's financial contribution to the community/ beneficiaries of the proposed activity?
All publicity flyers and newspaper articles will include statements regarding the City's support. An appreciation flyer will be displayed and also announced at each class & club dance. Although a " Learn to Square Dance" class is continuous for 20 weeks, the monthly club dance has one hour of dancing provided for new/first time dancers to learn and participate. This opportunity is publicized in the commnunity and introduces many residents to the fun and friendliness of Square Dancing.

10. Will there be any matching funds or other grants that would be applied to this program or service? If awarded this grant, will that enable other funding sources? The Palomar Square Dance Association (umbrella organization covering multiple San Diego county square dance clubs) has a support progam to provide $800 reimbursement to the clubs holding beginner classes.

Students provide a small donation fee per class. This fee can be waved for economically challenged individuals. Club members make weekly personal contributions to help pay for the classes.

The 2024 Solana Beach Grant received was a first for the Sandpipers club and has allowed the club to sponsor two instead of only one beginner class series in the past year. The new class graduates grow the club membership which helps to support the club and future classes.

No other funding sources are known.

Page I 2

11. Will volunteers be used for the proposed program or service and, if so, will they reduce expenses? Club management in square dancing is a completely volunteer activity.

Classes need as many experienced dancers as new dancers to be successful. The club members volunteer their time to attend class and also contribute to help cover the class expenses. The Square Dance Caller/Teacher is a professional who is paid per class. Sandpipers has sponsored Square Dancing in Solana Beach for the past 52 years.

12. If the proposed program or service is only awarded partial funding, will it still move forward? Will the program/service be scaled back and/or is there a threshold at which it will not move forward? The club treasury is limited and cannot continue to sponsor classes without assistance. Attendance fees at classes and at monthly club dances is not high enough to cover basic costs. The Covid shutdowns have hit all Square Dance clubs hard. The number of San Diego clubs has shrunk due to fmances and the limited number of dancers. We are in a re-building phase to get square dancing back to a "break even" financial situation. More dancers mean more fun for all, and is also helpful to share the costs. We are a 501(c)(3) organization. When the treasury is dry, square dancing stops.

Square Dancing has been designated as the USA's national folk dance and is too important to lose.

Acknowledgment of Responsibility:

ALL INFORMATION REQUESTED ON THIS APPLICATION MUST BE COMPLETED AS A CONDITION FOR BEING CONSIDERED FOR PUBLIC FUNDS BY THE CITY COUNCIL OF SOLANA BEACH.

Page I 3
Sandpipers Square Dance Club
Grant Program Proposal:

Learn to Square Dance Class (minimum necessary to dance with any club) Weekly: Aug 7th to December 2025
Student fees/donation $
Caller fees: 20 wks x $200 $ 4,000
Hall rental: 20 wks x $40 ** 800
Hospitality supplies: 20 wks x $35 700
Class recruitment/marketing 250
Total cost estimate - Fall class $ 5,750
Net shortfall for one class $
Anticipate 20-30 New Dancers
Learn to Square Dance Class (minimum necessary to dance with any club) Weekly: January- May 2026
Student fees/donation $
Caller fees: 20 wl<s x $200 $ 4,000
Hall rental: 20 wks x$40 ** 800
Hospitality supplies: 20 wks x $35 700
Class recruitment/marketing 250
Total cost estimate - Spring class $ 5,750
Net shortfall for 2nd Class $
Anticipate 20-30 New Dancers
2 Class series planned for August 2025-May 2026 $
** Have confirmation on La Colonia Park Rental at charity organization rate 2,000
(3,750}
2,000
(3,750)
{7,500)
Sandpipers Square Dance Club
Budget for next 12 months: June 2025-May 2026
Based Upon number of Dancers Attending Club Dances
Plan anticipates one Club Dance per month
10 Guests &4 10Guests&6
squares squares
Revenue:

New Dancer Guests -10 dancers @$10 each $
4 vs. 6 squares of dancers each month@ $12 per person
Annual Membership Dues
Estimated revenue annualized $
Costs:

Caller @$300 monthly $
Cuer @$125 monthly
Hall Rental @$225 monthly
Hospitality @$100 monthly
Marketing/Misc @$100 monthly
Total estimated costs $
12 Month Shortfall $
Steps to break even:

Some Callers will accept less than $300 when attendance is low.

Some Hall rentals could be less.

Hospitality and Marketing is currently donated by club members. 1,200 $
4608
1200
7,008 $
3,600 $
1500
2700
1200
1200
10,200 $
(3,192) $
In previous years, the club has received bequeaths and gifts from club members.

PSDA is offering a $800 gift to assist with new dancer classes in 2025.

New Beginner class:
lf donations are received or a Grant from Solana Beach is awarded, a new beginner class can be sponsored.

Club members who attend the classes as "Angels" to support the new students also generously contribute to assist with class costs.

The new dancers donate $10 per person per class to assist with class costs. 1,200
6912
1200
9,312
3,600
1500
2700
1200
1200
10,200
(888)
Sandpipers hope to sponsor 2 sets of classes: Learn to Square Dance 20 week series:

Student fees for 20 week series: $ 2,000
Caller Fees: 20 wks @$200
Hall Rental: 20 wks@ $40
Hospitality supplies: 20 Wks@ $35
Class recruitment/marketing
Net Shortfall per class
2nd Class Series
Grant request for 2 sets of classes
$ 4,000
BOO
700
250
5,750
$
$
Higher attendance at the monthly club dance or at class, increases revenue and reduces the "shortfall". (3,750)
(3,750)
(7,500}
Cash in Bank
Cash on Hand
Total cash
Income:

Sandpipers Square Dance Club
Balance Sheet at 04/30/2025
Sandpipers Square Dance Club
Income Statement
May 2024-April 2025
Dance Fees/Donations
Membership Fees
City of Solana Beach Grant for Arts
Total Income
Expenses:

Hall Rentals
Square Dance Caller fees
Round Dance Cuer fees
Hospitality
Marketing & Misc
Insurance
501c3 Filing costs
Total Expenses
Net "Loss" in past 12 months
$
$
$
$
$
$
$
$
7,945.70
200.00
8,145.70
13,105
1080
2500
16,685
4,112
9343
1400
1225
293
174
500
17,047
(362)

INTERNAL REVENUE SERVICE
P. 0. BOX 2508
CINCINNATI, OH 45201
Date: FEB 03 2012

SANDPIPERS SQUARE DANCE CLUE

C/O LESLIE MARTIN
1004 SANTA GABRIELLA
SOLANA BEACH, CA 92075-1521
Dear Applicant:

DEPARTMENT OF TI-IE 'tREASORY
D
17053273353011
Contact Person1
JOHN .JENNEWEIN ID# 3l307
Contact Telephone Number:
(877) 829~5500
Accounting Period Ending:

December 31
Fo:i;m 990 Required:

Yes . Effective Date of Exemption:

December 10, 2011
contribution Deductibility:

No
Addendum Applies:

No
We are pleased to inform you that u,pon review ot your application "for taxexempt status we have determined that you are exempt from Federal income tax under section S0l(c) (4) of the Internal Revenue Code. Because this letter could help reso+ve any questions regarding your exempt status·, you should keep it in your permanent records.

Please see enclosed Publication 4221-NC, Compliance Guide for Tax-Exempt organizations (Other than 50l(c) (3) Public charities and Private Foundations), for some helpful information about your responsibilities as an exempt organization.

Contributions to you are not deductible by donors under section 170(c) (2) of the Code.

Lois G. Lerner
Director, Exempt organizations
Bn.closure: Publication 422:t.-NC
!Rs
NJTtd .. •)?+Ti. /0 - i o - "1..,o) O - ---.-- .... - -... -.---···--- ----~-•--·~- ---·-· Letter 948 (DO/CG)
------------------------------------- ---- -
INTERNAL REVENUE· SERVICE
P. 0. BOX 2508
CINCINNATI , 0~ 4-5201
Date:

UNITED SQUARE DANCERS

OF AMERICA INC
C/0 USDA
PO BOX 712918
SAN DIEGO, CA 92171-2918
Dear Applicant :

DEPARTMENT OF THE TREASURY
Em lo er Identification Number:

OLN:
17053035380009
Contact Person :

JAMIE N HE!TBRINK
Contact Telephone Number:
(877) 829-5500
Group Exemption Number:
6387
ID# 31644
Subordinate Contribution Deductibility:

Yes
Addendum Applies:

No
We recognize your subordinates as exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). Your group exemption number is listed above. Keep this letter for your records . It cou1d help resolve questions on the exempt status of your subordinates.

Donors can deduct contributions they make to your subordinates under IRC Section 170 , They're al so qualified to receive tax-deductible bequests, devises , transfers or gifts under Section 2055, 2106, or 2522.

Your group exemption is effect ive as of the post mark date of your request , December 31, 2018.

Annual filing requirements
Your subordi nates are required to fi'le Form 990-seri es i nformation returns unless they qua1 ify as churches or integrated auxiliaries of churches or otherwise meet the exceptions in Inocme Tax Regulations Section 1.6033-2(9) . You can file a group return on Form 990, Return of Organization Exempt from Income Tax, for two or more subordi nate organizati ons who authorize you in writing to include them i n the group return and who are on the same tax year as you.

You must get a separate employer identifi cation number t o use when you fi le a group return. Also , you can ' t fi l e a group return using Form 990-EZ , Short Form Return of Organization Exempt from Income Tax. If you're required to file a Form 990-series return for yourself, you must fi le it as a separate return . You can 't be i ncluded i n the group return. A subordinate organization can choose to file a separate annual information return i nstead of being included in the group return . They must f ile one of the Form 990-series returns based on their annual gross receipts.

A subordinate organization that doesn ' t file a For,m 990-series ret urn , or isn ' t letter 2419
UNITED SQUARE DANCERS OF AMERIC,f\
102,1- 2015 USDA OFFICERS
PRL-:smt~NT
Ellery & lfaren (iulhr.1ud
,!.~H 1 La1•<~ude1· Ln
Green Bay, \Vl ,;.i,:; t:J
(!11!0) +!M·-06/ilJ
Pn.::iij k~11t(m11,-.;da:\~I __g·

VICE PRESIDENT
EASTERN REGlON
CT, })E, [) ,!f'C, ;l!l-~ ,\fl), J/ .. •i, .\'ll,
.\'J, .Y 1: !-'../, Hf, IT ,//Id /'A
"\'acam Position··

VICE PRESIDENT

CENTRAL REGION
.1L, f,-r,, GA,/,\',!, r; .\ff, .HS, SC
Olf, SC, T,\' ,111d tn·
Scott & Sanely Ebrig;ht
7il l7 l\!('admv Cn·d, T1·ail
linoxvilk, TN. :l7lJ:l I
;:.;, n:n-s,w- 1+81: SY: su5-·t·G(;-,;;; H
((111I ral_. VP((LJ11~•alii.nl)r
VlCE PRESIDENT

PLAINS REGION
. .fl/, FL, [J /,'S, J .. ·!, MX, ,\!{), xr~.
,\'!), (}/,', SD, TS ,111d rn
!\lark & lforn Ii rchsh:ich
:1:;cn Nd,rn~ka Dr. ti!
Bismarck, ND r,s;;o:1
J\t: 70!-:l20-!l07D B: ,m-:J\!!Hil8\!
1-1 hi i 11;-.; VI J(UJJI :;d:_L~)_ry·

VICE PRESIDENT

WESTERN REGION
.• 11,·, . ./1/., C.-1, co, lll, /1), .HT, xr·,
,\",H, on, l n~ Ii'.!, ,ll!d rt T
Nina (;t•igsby
101! E. Adyt-mu Pl
\'ail, /1.Z H,'.,(M,J
\!·HJ-·Hl l-:):,80
\\\·~.ll'.t'_liVP(~11,..;1J:i.1H.:_g

SECRETARY
Mal'ilvn Schmit
:l7(i ;:.;'E Nc,~dh:1111 Stn·(~t
1 Dallas, OR !J7:i:n;
( ,,o:i )5 03-0,r,:rn
S_,•c-r~r~n·v«r 11~d a. op~·

TREASURER
.Jim & .I 111!y Tayl,w
I t, I l \V L;i k,· ( '1.
l.iH lv!o11. ('() ,,o I •!U

USDA PROGRAMS
Cc111,•1wir1I Au ,-,n/ -1.\' l!.':iD,f Neus
l•_:d1u·,1tftiu t'\· Puhlic:1riln1.~·
J l.1nrli<·ap;1hl<' JJ,-111.cci:••
111.">"tll~'UU'i'
/'1"( 1.'>('J'iptf.fnt c:,rd J>rn/,:1"/IIIJS
Sori.tl .,l-Jc•.t!i.·1
();'):,l l!.~'l).Ti 'li•:fft•lr•r P1·0;:r,u11
l'o11tl, Pro-gn1111 ,t· ,'-, ... ,·lwl,;n;./Jip-s
.fO l(r):J (r)·nup .-i dul/ui.-. r 1~-d ,u
\VEBSITE: W\I w.11sda.nn!;

SQUARE DANCE - AMERICAN FOLK DANCE
Squore D~ncel
May 5, 2025
Bonnie Violi - Treasurer
Sandpipers Square Dance Club
2408 La Plancha Lane
Carlsbad, California 92009
Employer Identification Number: 80-0649329
To Whom It May Concern:

The Sandpipers Square Dance Club, Employer Identification Number (EIN) 80- 0649329, is a member in good standing as a subordinate organization of the United Square Dancers of America, Inc. (USDA) and has qualified for the USDA IRS Federal Group Exemption Program and has been so qualified effective as of the date of this award letter - May 5, 2025. USDA's EIN is 95- 37 48067 and the USDA Group Exemption Number (GEN) is 6387.

We have enclosed a copy of the letter from the Internal Revenue Service dated December 23, 2019, which identifies USDA as a Central Organization affording the Sandpipers Square Dance Club, Employer Identification Number (EIN) 80- 0649329, a qualifying Associate Member of USDA, exempt status under section 501 (c)(3) of the Internal Revenue Code. When the Sandpipers Square Dance Club identifies itself as a 501(c)(3) Nonprofit Tax-Exempt Organization - please use the USDA Group Exemption Number (GEN) 6387.

To avoid having its federal income tax exemption automatically revoked, the Sandpipers Square Dance Club must continue to maintain its active membership in the United Square Dancers of America and submit Annual Reports to the USDA, as well as file the required Form 990 with the IRS each year using their Federal Employer Identification Number (EIN) 80-0649329, Sincerely,
~ /le~'"'
Jim Maczko - Co-Administrator - Applications
USDA Group Exemption Program
Post Office Box 712918
San Diego, California 92171-2918
619-295-2635
501 [email protected]
([email protected])
/-·\ ;,\ i .
/ __ } f.-, q, !, l Qv1..., :U\... '\ "'-'-.3-··'
Pat Inglis - Co-Administrator - Renewals
USDA Group Exemption Program
9133 Creekside Trail
Stone Mountain, GA 30087
678-684-3886
50 ·1 [email protected]
(ing [email protected]
Information Copy.

Do not send to ms.

Form990-N
Department of the Treasury lntemal Revenue Service
Electronic Notice (e-Postcard)
for Tax-Exempt Organization not Required to File Form 990 or 990-EZ 0MB No. 1545-2085
2024
A For the 2024 Calendar year, or tax year beginning 2024-01-01 and ending2024-12-3l B Check if available
; D Terminated for Business
~ Gross receipts are normally $50,000 or less
C Name of Organization: SANDPIPERS SQUARE DANCE CLUB
2408 La Plancha Lane, Carlsbad, CA, US, 92009
D Employee Identification Number
E Website:

Sandpipers Square Dance Club
FName of Principal Officer: Bonnie Violi
2408 La Plancha Lane, Carlsbad, CA, US, 92009
Privacy Act and Paperwork Reduction Act Notice: We ask for the information on this form to carry out the Internal Revenue laws of the United States. You are required to give us the information. We need it to ensure that you are complying with these laws.
., ... ,.,.~
~le of Callfornia ·•i•'' Srcanchise Tax Board
~. • .PO Box 1286 •
Rancho Cordova CA 957 41-1286

SANDPIPERS SQUARE DANCE CLUB
PO BOX 2317 45
ENCINITAS CA 92023
: Tax-Exempt Status
: Sandpipers Square Dance Club
Regarding
Organization's Name
CCN • •• • .. • : 805293·1
Purpose
R&TC §
Form of Organization
Accounting Period Ending
Tax-Exempt Status Effective
: Social welfare
: 23701f
: Unincorporated Association
: 12/31
: 01/01/2007
Exempt Determination Letter
-Date: 08.24.12
case: 26600478857552176
Case Unit: 266004 78857552180
In reply refer to: 760:KTT:F120
We have determined the organization is tax-exempt from California franchise or income tax as stated in the above Revenue and Taxation Code (R& TC) section (§).

To retain tax-exempt status, the organization must be organized and operating for nonprofit purpo~es within the provisions of the above R& TC section. An inactive organization is not entitled to tax-exempt status.

We have based our decision on the information submitted and the assumption that the organization's present operations will continue unchanged or conform to those proposed in the organization's application. In order for us to determine any affect on the tax-exempt status, the organization must immediately report to us any change in:
• Operation
• Character
• Purpose
• Name
• Address
Our determination may no longer be applicable, if these changes occur:
• Material facts or circumstances relating to the organization application. • Relevant statutory, administrative, or judicial case law. • Federal interpretation of federal law in cases where our decision was based on such lnterpretation.

FTB 9941 PASS (REV 05-2012) Exempt Application\Correspondence \ LTR 003- EDL

Page 2 of 2 ends

'1,~~ ta ~ fua-wl ,j ~
It is the organization's responsibility to be aware of these changes should they occur. This paragraph constitutes written advice, other than a chief counsel ruling, within the meaning of R&TC· §21012(a)(2). •
For filing requirements, get Pub. 1068, Exempt Organizations - Filing Re:qulrements and Filing Fees.

Go to ftb.ca.gov and search for 1068. :

This exemption is for state franchise or income tax purposes only. For information regarding sales tax exemption, contact the State Board of Equalization at 800.400.7115, or go to their website at boe.ca.gov.

Kent T. Tran
Telephone: 916.845.4171
Fax: 916.843.1038
cc: Jim or Catherine Bowen
FrB 9941 PASS (REV 05-20;2) Exempt Application\Correspondence \ LTR 003-EDL
Form W•9
(flev. March 2024)
0epartmeol of lhe Tro~ury
Internal Aovenue Servlco
Request for Taxpayer
Identification Number and Certification
Go to WW\V,irs.gov/FormW'9 for Instructions Md the latest information, Before you begin. For guidance related to 1he purpose of Form W-9 see Purpose of Form below. ' ' Give form to tho
requester. Oo not
send to the IRS.
1 Na!llo of entity/individual. A,1 entry is roquirud. (for .r sole proprietor or d~regarded onltly, e~tor the ow11er'G riamo on lin~ 1, and an\&r tho busi~oosldlsrog.,rdod onlity's namo on lino 2.)
Sandpipers Square Dance Club
2 Business namo/dlsregarded enmy name, II different from .ibove, «; 3n Check lhe appropriate box for fedoral lllX classillca11on of tho enmy/fndlvldu3I wI1oso namo Is onIored on lino 1. Cheol< 4 Exompllons (codH apply onry to GI O'I only ono of lh0 following seven box~s. Ctltlain Mlltlas, not llldi~iduals; 111 Q. see lnsI,ucHons on page~): C: 0 (ndivlduaVsole proprietor 0 C corpora1ion 0 5 corporalion 0 Parlnnr.ihi)l 0 Ttu:;Vos!ate 0 • 411 D LLC, Enloi the tax clossifocution {C = C corporation, S ~ S cOl'pOrallon, r = Partno:ship) E><ompl payoo todo pi ony} 1 a, <:

Note: Ch•tk the "l.1-C'' bole ~boVe ~nCI, In tho entry space, cn1cr \ho opproprl.nlo coda (C, S, or P) for lho tax--- ig Ex11mptlon from Forofgn Account Tax :dl classlfiealioo ol tho lLC, unless ft Is a disregarded ontily. A discog~rdcd onllty should insto~d chock lho appropriale box tor Iha bX clllssilicallon or Its ownor. Compll8J'lco Act (fATCA) roporirng C t; 0 Other (Geo Instructions} Tax Free Organization coda (if ~ny) ·c 1. - 0. Q Jb If on lino 3a you ohcokod "Par1nor:ah!p" or "Trus1/os1a10." or chockad "lLC" aniJ entered •p• as Its tax classiOcation, i (,Appl/or; lo accounts mllfnlalned Md you nro providing 1his form 10 a partnorshlp, lrusl, or oslato In which you hovo on ownership inlorotl. check □ outs/do !ho United Slllte,.) ~ this box If you h1.1ve any foro1gn p~r1ncrJ, owners, or bonoflcl11rlos. See Instructions ., 6 Address (OUtr1b1Jr. stroot, and apt. or suile no.). See ln:mucllons. RoouosI0,'s name and addraos (cptionaD ., Cl')
2408 La PJanca Lane
0 City, $\ale, and ZIP ctmo
Carlbad CA 92009
7 Lisi account numbor(s) he/6 (opllonal)
:F.T ■ Taxpayer ldentirica1ion Number{TIN)
I Social &ecurity numl>or Enter I your TIN In the appropriate box. The TIN provided must match the name given on line 1 lo avoid backup withholding. For individu11is, this is generally your ~octal security number (SSN). Hov1av11r, for a resident alien, solo proprietor, or disregardod entity, s110 lhe -instructions for Parl I, later. For other entities, It Is your ernployer iclentificalion numbor (EIN). If you do riol have a number, see How to 901 a TIN, later.
[[]]-DJ-I I I I I or
Note: 11 lhe account Is In more than one name, see the lnsvucttoris for line 1. See also What Name and Number To Give the Requester tor guidelines on whose number lo enter.

Ce11ification
Under penaltJes o! perjury, I certify \hal:

1. Thf. number shown on this form Is lliy correct taxpayer ldentlrieatlon number (or I am walUng for a number to be Issued to me); and

2. I am nol su!Jject to backup withholding because (a) I am exempt from bacJ<up wilhholdlng, or (b) I hove not boen no!lfled by the lntcm<Jf Revenue Sorvlco (IRS) that I am subject to backup wllhho!dlng as a result ot a lalluro to report all lnlerest or dlVldends, or (c) tho IRS has nolltlod me that I am no longer subject to backup withholding: .ind
3, I am a, U.S. citizen or other U,S. person (defined below); ano 4, The FATCA code(s) ente(ed on tl1ls form ~I eny) indicatl g that I am exempt trom FATCA reporting is correct.

Certification instructions. You must cross out item 2 above if you have been nollried by the IRS that you are currenHy subject to backUp withholding because you have foiled to report all interest and dlvidendS' on your tax relU(n, for real estate transac\1or'ls, Item 2 does not apply. For mof1gaga Interest paid, :icquioltion or abandonment of ~ecursd property, canci:illarion or debt, contributions to an ino'lvidual rellrement arrangement QRA), and, generally, paymenls other thon lnterost and dtvldonds, you are nol roi:iulrod lo sign the certification, but you musl provide your comicl TlN. Soe lha tnstrvclionsfor Par111, faler.

Sign Slgnoh.lru ol ' ~ Here U.S. pa.tson Dute D - ;;?,_ 3- ~ General Instructions
Section reforencos are to the Internal Revonue Code unloss othervvlso notod.

Fu!uro developments. For the latest information about developments related to Form W-9 and Its Instructions, such as legislation ennctec;! after they were published, go to www.frs.gov/Fom1W9.

What's New
Uno 3a has boon modlllod to clarify fuM a disregarded ootlly completes this line. M LLC that 1s a diGregorded entity should chock tho appropriate box for the tax classification ot Its owner. Otherwise, it should check the ·uc· box and enter its <iPProprlate lax classilicnlion.

Cnl. No. 10231X
New line 3b has been added \o this form, A 1Iow-lhrough onllty Is 1equired to compfele this line to lndtcate that It has dirocl or lnclin:ict forolgn partners, owners, or benefloiarios when it provides the Form W-9 lo another flow-through entity In which It has an ownorshlp lnterost, This chango is Intended to provide a flow-through cn1Ily with information regarding the status of !Is indlrecl foreign partners, owners, or beneficiaries, so thal it can salisfy any applicable reporting requirements. For example, a partnership that has ~my lndfreot foreign partners may bo required to complete Schodulas K-2 and K-3. See lhe Partnership I11structions lor Schodules K-2 and K-3 (Form 1065), Purpose of Form
An individual 0( eri\lty {F"orm W•9 requostor) who is required to file an information return with the IRS is giving you this 1orm because they Form W •9 (Rev, 3-2024)
Solana Beach
Backpacks
for Kids, Inc.
- CITY OF SOLANA BEACH -

COMMUNITY GRANT APPLICATION
The City of Solana Beach Community Grant Program 2025 Request for Financial Assistance application MUST BE SUBMITTED by 5:00 PM Thursday, May 29, 2025.

Please submit completed applications via email to [email protected] and copied to [email protected].

If email submission is not possible for an applicant, hard copies may be dropped off at City Hall 635 South Highway 101, Solana Beach, CA. 92075, Attn: Community Grants Program.

All requests will be detennined by the following criteria:

Name of Organization: So I a.no Be<Xb 00 CK pct cks for I< 1 d 5 Inc Contact Person: J eooo De.. llamGlnD Email address: je.nnadella.n1Mo@amGt 1 0 I . "J Com Daytime Phone: ~5&- 232- \ g\ 3 Evening Phone: __________ _ Mailing Address: 10b3 \/ io.. M; I
City: Sp) O.t1G\ Beach
CtAmbre.S
State: CA

1. All the documents below are attached to this application:
~W-9
1B Summary of Organization's Budget
0 Proposed Program Budget
G"Financial and Tax Statements (see Application Guidelines) Zip: ClZ075
Gr Copy of the California Franchise Tax Board Entity Status Letter, showing exemption under Section 23701d or Internal Revenue Code section 501(c)(3) + in.SUA"O.IA C.~ Cj.V-Of-c..

2. Has your organization received financial assistance from the City before? [!r Yes D No If yes, P.lease state the fiscal year it was received and for the proposed program was: 202.'t w~ fc'.c<:.ivccl a. r~+}, ~u<1.:ror for 56 Ff'Ge Fo.r.-nus Ma.,~+ . .2.02..'¾- we. rc.cG,vc, f.;. ce s.pa.(:.G ~+ l.4C 10"• <> poi1L- fur F,-~~F,urnc,s Ma.rK,::+. U>v+ Ne. rc:.u:11e CA.5c:. o+ hible.s /er F,ec;Fa,mc:.-'.s Ma.rile:.+

3. Title of FY 2025/26 Proposed Program/Service: \ (151A.r o.n ~ o.,nd 00-,Y o. ti on S

4. What is the total amount requested for the FY 2025/26 Proposed Total Program? Includes all estimated costs to conduct proposed activity/program. ,$ (. 1 o o O • ~

Page 11 ends

SOLANA BEACH BACKPACKS FOR KIDS, INC.

Annual Income to Cash Statement
All Financials on Cash Basis
2024 2023 2022 Notes

REVENUES
Contributions - Principals $862 Dellamano Family
Contributions - Private $1,000 $7,020 $9,300 Private donors Contributions - Government Grants
Other
Total Contributions $1,000 $7,020 $10,162
TOTAL REVENUE $1,000 $7,020 $10,162
COSTS
Food Supplies $1,924 $7,952 $1,502 Food and supplies for donations Other Supplies
Fuel/ Gas $1,399 $1,456 $488 Fuel to distribute food
Legal / Admin $128 Legal zoom, fees
Other
TOTAL COSTS $3,451 $9,407 $1,990
INCOME -$2,451 -$2,387 $8,172
CASH BALANCE (BEGIN) $5,784 $8,172 $0
Cash - Bank of America (0823) $5,784 $8,172 $0
Retained Earnings -$2,451 -$2,387 $8,172
Assets Purchased (CAPEX) $0 $0 $0
CASH BALANCE (END) $3,334 $5,784 $8,172
~<in\ IRS DEPARTMENT OF THE. TREASURY
>l&f/1 • INTERNAL REVENUE SERVICE
CINCINNA'rI OH 45999 - 0023

SOLANA BEACH BACRPACKS FOR KIDS IWC
1063 VIA MIL CUMBRES
SOLANA BEAC.4, CA 92075
Date of this notice: 10-19-2021
~fication Number:

Form: ss-4
Number of ·this notice: CP 575 E
For assistance you ·may call us at:
1-800-829·4933

IF YOU WRITE, ATTACH THE
STUB AT THE END OF THIS NOTICE.

WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER
for applying for an Employer Identification Number (EIN) . We assigned you This EIN will identify you, your business accounts, tax returns, and documents, even i.f you have no employees. Please keep this notice in your pennanent records.

When filing tax docwnent-s, payments, and related correspondence, it is very important that you use your EIN and complete name and address exactly as shown above.

Any var iation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the information is not correct as shown above , please make the correction using the attached tear-off stub and return it to us.

When you submitted your application for an EIN, you checked the box indicating you are a non-profit organization. Assigning an EIN does not grant tax-exempt status to non-profit organizations. Publication 557, Tax-Exempt Status for Your Organization, has details on the application process, as well as information on returns you may need to file. To apply for recognitio~ of true -exempt status W'.lder Internal Revenue Code Section 50l(c) (3), organizations must complete a Form 1023-series application for recognition. All other entities should file Form 1024 if they want to request recognition under Section SOl(a).

Nearly all organizations claimiDg tax-exempt status must file a Form 990-seri es annual information return (Form 990, 990-EZ, or 990-~F) or notice (Form 990-N) beginning with the year they legally form, even if they have not yet applied for or received recognition of tax-exempt status.

Unless a filing exception applies to you (search www.irs.gov for Annual Exempt Organization Return: Who Must File), you will lose your tax-exempt status if you fail to file a required return or notice for three consecutive years. We start calculating this three-year period from the tax year we assigned the EIN to you. !f that first tax year isn't a full twelve months, you ' re still responsible for submitting a return for that year. If you didn't legally form in the same tax year in which you obtained your EIN, contact us at the phone number or address listed at the top of this letter.

For the most current information on your fiJ.ing requirements and other import ant infonnation, visit www.irs.gov/charities.
(IRS USE ONLY) 575E 10·19-2021 SOLA O 9999999999 SS-4
IMPORTANT REMINDERS:
* Keep a copy of this notice in your permanent records. This notice is issued only one time and the IRS will not be able to generate a duplicate copy for you. You may give a copy of this document to anyone asking for proof of your EIN. * Use this EIN and your name exactly as they appear at the top of this notice on all your federal tax forms.
* Refer to this EIN on your tax-related correspondence and documents. * Provide future officers of your organization with a copy of this notice.

Your name control associated with this EIN is SOLA. You will need to provide this information, along with your EIN, if you file your returns electronically.

If you have questions about your EIN, you can contact us at the phone number or address listed at the top of this notice. If you write, please tear off the stub at the bottom of this notice and include it with your letter. Thank you for your cooperation.

Keep this part for your records. CP 575 E (Rev. 7-2007) Return this part with any correspondence
so we may identify your account. Please
correct any errors in your name or address.

CP 575 E
9999999999
Your Telephone Number Best Time to Call
{ )

INTERNAL REVENUE SERVICE
CINCINNATI OH 45999-0023

1.111I111111.1 .. 1.111l1I 11 II 111II1111111IIIII11.1 .. 1 DATE OF THIS NOTICE: 10-19-2021
EMPLOYER IDENTIFICATION NUMBER: 87-3159853
FORM: SS-4 NOBOD

SOLANA BEACH BACKPACKS FOR KIDS INC
1063 VIA MIL CUMBRES
SOLANA BEACH, CA 92075
~ 199N e-Postcard
Confirmation .Pr.i.Y.9.~Y .. P.9J.i.~y
Print this page for your records. The Confirmation
Number below is proof that you successfully filed your
199N e-Postcard.

We received your 199N e-Postcard on 3/24/2025
9:04:54 PM.

Confirmation Number: 00000479918108303
Entity ID:
4799181
Entity Name:

SOLANA BEACH

BACKPACKS FOR
KIDS, INC.

Account Period Information
Account Period
Beginning:
1/1/2024
Account Period
Ending:
12/31/2024
This is not your entity's first year in business.

Your entity has not terminated or gone out of
business.

Your entity has not changed the account period.

Gross Receipts: $2000
This is not an amended return.

An IRS Form 1023/1024 is not pending.

Entity Information
FEIN:

Doing Business
As:

Solana Beach
Backpacks For
Kid
Website
Address:
not.applicable
Entity's Mailing Address
1063 via mil
cumbres
111 S CEDROS
AVE
Solana Beach
CA92075
Principal Officer's Information
Anthony
Della ma no
1063 via mil
cumbres
111 S CEDROS
AVE
Solana Beach
CA 92075
Contact Information
Name:

Anthony
Dellamano
Phone:
619-838-0466
After we process your 199N e-Postcard, you may
receive a bi II if the three year gr.o.5..5. .. .r..~.~.e..i.P..t...f.!.Y..e. .. rnge. is greater than the amount allowed for filing a 199N ePostcard. '--P_r_in_t_ ~I I Log Out I
Copyright © 2025 State of California
Form W•9
(Rev. March 2024)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Go to www.Jrs.gov/FormW9 for Instructions and the latest information.

Before you begfn. For guidance related to 1he purpose of Form W-9, see Purpose of Form, below.

Give form to the
requester. Do not
send to the IRS.

Narne of entity/Individual. An entry is required. (For a sole p1oprietor or disregarded entity, enter \he owner's name on line 1, and enter the business/disregarded entity's name on line 2.)
2 Business name/disregarded entity name, if different from above.

U'M fi1 V /1// 7 T£ ~- • ., t!K'J /f/! /l /2 ~ ; · T ~ 3a Check the appropriate bo.x for federal lax classification of the entity/indMdual whose name Is entered on line 1. Check [ only one ol the following seven boxes.
c: 0 Individual/sole proprietor D C corporation D S corporation 0 Iii ~ 0 LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) 0 Partnership 0 TrusVesfate
4 Exemptions (codes apply only to
certain entitles, not individuals;
see instructions on page 3):

Exempt payee code (ll any)
c. .g Note: Check the ''LLC" box above and, in tile enzry space, enter the appropriate code (C. S, or P) for the tax __ _ ~ t clessi!ication of the LLC, uriless ii is a disregarded entity. A disregarded entity should instead check the appropriate Exemption from Foreign Account Tax o .5 box for the tax classification of its owner. Compliance Act (FA TOA} repontng € £ 1 __ 0=._0_1h_e_r.:....(se_e_io_s_tN_c_u_on_s.:.... ) ==l\(=O=IV==?=R=~!:O:::f=-1=7==(=-Q~-=~~-=i)=o=. =~=8='='=C=· ="'='========-l code (ii any) _____ _ _ 0. u Iii: ·2 ~
3b It on line 3a you checked "Partnersh1p" or "TrusVestate, ·• or checked "LLC" and entered "P" as its tax classlficaliOn, and you are prov]ding thfs form to a partnership, trus1, or estate in which you have an ownership Interest, check ihls box if you have -any foreign partners, owners, or beneficiaries. See instructions 0 (Applies 10 accounrs maintained
outside the United States.)
~ 1-S--A-dd_r_es_s_(_nu_m_b_e-,.-s-tr-e-et-, a_n_d_a_p-t.-o-r-su-it_e_ri_o_.).-S-e-e-in_s_tru_c_t_io-ns-.-----------.,...R- e_Q_u_e_st-er-'s_n_a_m_e~a~n-d-a-dd_r_e-ss_(_op_t_lo-n-al-) ----- r/l
/o(-3 Vt/.J /VJ ll £ f-j
6 City, state, and ZIP code

5.cL.AN,'9 bf /-k.' I-/ c 19 q .2o 75
7 List account number(s) here (optionaO
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided mus·t match the name given on line 1 to avoid backup withholding. For individuals, this Is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Instructions for Part I. later. For other entities, it is your employer identification number (EIN). If you do not have a number., sea How to get a TIN, later.

Social security number
ITD-ITJ-1 I I I I
or
Note: If the account Is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter.

Certification
Under penalties of perjury, I certify that

1. The number shown on this form Is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and

2. I am not subfect to bacl<up withholding because (a) I am exempt from backup wi,thholding, or (b) I' have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends. or (c) the IRS has notified me that I am no longer subject to backup withholding; and

3. I am a U.S. citizen or other U.S. person (defined below); and

4. The FATCA code(s) entered on th(s form (it any) indicating that I am exempt from fATCA reporting is correct.

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions lo an individual retirement arrangement (IFIA}, and. generally, payments other than Interest and divi ou ot required to sign the certification, but you must provlde your correct TIN. See the instructions for Part II. later.

Sign Signature • /4
Here u.s. person D.:ite .S-/ 2 3 c) ,..

General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.

Future developments. For the latest lnformation about developments related to Form W-9 an<;i its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9.

What's New
Line 3a has been modlf!ed to clarify how a disregarded entity completes this line. An LLC that is a disregarded entity should check the appropriate box for the tax classification of its owner. Otherw1se, it should check the "LLC" box and enter its appropriate tax classification.

Cat. No. rn2s1 x,
New line 3b has been .added to this form. A flow-through entity ls required to comple1e this line to indfcate that it has direct or Indirect foreign partners, owners, or beneficiaries when it provides the Form W-9 to another flow-through entity in which it has an ownership interest. Th,s change is intended to provide a flow-through entity with information regarding the status of its indirect foreign partners, owners. or beneficiaries, so that it can satisfy any applicable reporting requirements. For example, a partnership that has any indirect foreign partners may be required to complete Schedules K-2 and K-3. -See the Partnership Instructions for Schedules K-2 and K-3 (Form 1065).

Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an information return with tile )RS Is giving you this form because they Form W-9 (Rev. 3-2024)
Solana Beach
Civic
&
Historical
Society
The City of Solana Beach Community Grant Program 2025 Request for Financial Assistance application MUST BE SUBMITTED by 5:00 PM Thursday, May 29, 2025.

Please submit completed applications via email to [email protected] and copied to [email protected].

If email submission is not possible for an applicant, hard copies may be dropped off at City Hall 635 South Highway 101 , Solana Beach, CA. 92075, Attn: Community Grants Program.

All requests will be determined by the following criteria:

Name of Organization: Solana Beach Civic & Historical Society Contact Person: Kathleen Drummond Email address: drummond.kathleen@ga Daytime Phone: 619.838.5466 Evening Phone: _6_1_9_.8_3_8_.5_4_6_6 _____ _ Mailing Address: _P_.o_. B_ox_5_o4
_________________________ _
City: Solana Beach State: _C_A ______ Zip: 92075

1. All the documents below are attached to this application:
~ W-9
~ Summary of Organization's Budget
l!l Proposed Program Budget
l!l Financial and Tax Statements (see Application Guidelines) l!l Copy of the California Franchise Tax Board Entity Status Letter, showing exemption under Section 23701 d or Internal Revenue Code section 501 (c)(3)

2. Has your organization received financial assistance from the City before? Ill Yes D No If yes, please state the fiscal year it was received and for the proposed program was:
2024-25 and prior to digitize Solana Beach historical archives and optimize digital assets

3. Title of FY 2025/26 Proposed Program/Service: Expand digital assets, scan archival materials

4. What is the total amount requested for the FY 2025/26 Proposed Total Program? Includes all estimated costs to conduct proposed activity/program.
$6,000

Page 11 ends

5. Grant funds must be used for services or materials directly associated with the proposed activity.

Please describe how grant funds will be used:

As in prior years, grant funds will be used to digitize archival records, hire professional website design, videography and video editing services, as well as to cover the operating costs of our digital assets (website, YouTube channel, digital vault for archived materials), which now house more than 300 years of historical records relevant to the community and City of Solana Beach. We are currently searching for a new digitization vendor.

6. Anticipated Program Objectives or Accomplishments:

Digitize archival materials donated by the Solana Beach Lifeguards, which could help inform residents about the history of the Marine Safety Department. Digitize materials donated by La Colonia first families. Expand our Y ouTube video library to include interviews with Solana Beach residents who have served in the military, or their relatives. We'd also like to conduct more interviews with current and past Council members to capture more perspectives from our public servants.

7. Program Dates/Location:

Fiscal year 2025-26. Solana Beach.

8. Estimated number of Solana Beach residents to be served by proposed program: All interested

9. How will the organization acknowledge the City's financial contribution to the community/ beneficiaries of the proposed activity?
The City's contributions are acknowledged on our website as follows: "With grant-funding support from the City of Solana Beach, we also have digitized more than seven decades of archival materials about the Society and our community. These materials include interviews with long-time and notable Solana Beach citizens, as well as videographies available online through our Y ouTube channel." Any 2025 grant awarded will also be reported in our newsletter.

10. Will there be any matching funds or other grants that would be applied to this program or service? If awarded this grant, will that enable other funding sources? No to both questions.

Page I 2

11. Will volunteers be used for the proposed program or service and, if so, will they reduce expenses? Yes, volunteers will sort and organize archival materials for digitization; schedule, organize and conduct video interviews.

Acknowledgment of Responsibility:

May 27, 2025
Authorized Signature of Organization Date

ALL INFORMATION REQUESTED ON THIS APPLICATION MUST BE COMPLETED AS A CONDITION FOR BEING CONSIDERED FOR PUBLIC FUNDS BY THE CITY COUNCIL OF SOLANA BEACH.

Page I 3
Solana Beach Civic & Historical Society FY 2025-26 Budget* CoSB Communlty Grant for expanding digital assets; digitizing archival materials**
Dues income
Holiday Boutique sales
Community outreach/member events
Donations/other income
Scholarship awards (3 @ $3,000.00 + $1,000 to MAEGA)
Administration (insurance, webslte, promotional expenses) TOTALS
*Assuming our application for a 2025-26 Community Grant is approved Activity
Scan archival materials into dlgital files
Edit and publish video interviews with area military veterans and/or their families, long-time residents, public servants, notable citizens Digital asset operating costs
Total
1 $6,000.00
$3,500.00
$11,000.00
$4,000.00
$2,500.00
$27,000.00
$6,000.00
$8,000.00
$10,000.00
$3,000.00
$27,000.00
Anticipated expense
$2,350.00
$3,000.00
$650.00
$6,000.00
,,.
_ ,
·- " Internal Revenue Service
Date: August 3, 2002
Solana Beach Civic And Historical Society
PO 8ox504
Solana Beach, CA 92075-0504
Dear Sir or Madam:

Department of the Treasury
P. 0. Box 2508
Cincinnati, OH 45201
Person to Contact:

Ms. E. Eckert ID 31-07436
Customer Service Specialist
Toll Free Telephone Number:
8:00 a.m. to 6~30 p.m. EST
877-829-5500
Fax Number:
513-263-3756
Federal Identification Number:

This letter is in response to your amendment of your organizaUon's Articles of Incorporation filed with the state on January 2~ 1991. We have updated our records to reflect the name change~s shown above. . + 1 Our records indi7ate that a_ d~termination l~~er)ssu~d i'l.eprili 1®D:.:~grant~g yo~~ orga~fz~tl,QJi e~emp~ion from .federal income tax under section 501 (c)(3) of the Internal Revenue.Code-.-: That letter is still in effect. 'I,, • 1 1 , ''\J / Based on information subsequently submitted, we classified your organization as one that is not a private oundation within the meaning of section 509(a) of the Code because it is an organization described in section 509(a)(2). •
This classification was based on the assumption that your organization's operations would continue as stated in the application. If your organization's sources of support, or its character, method of operations, or purposes have changed, please let us know so we can consider the effect of the change on the exempt status and foundation status of your organization.

Your organization Is required to file Form 990, Return of Organization Exempt from Income Tax, only if its gross receipts each year are normally more than $25,000. If a return Is required, it must be filed by the 15th day of the fifth month after the end of the organization's annual accounting period. The law imposes a penalty of $20 a day. up to a maximum of $10,000, when a return is filed late, unless there is reasonable cause for the delay.

All exempt organizations (unless specifically excluded) are liable for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of $100 or more paid to each employee during a calendar year. Your organization is not liable for the tax Imposed under the Federal Unemployment Tax Act (FUTA). '
Organizations that are not private foundations are not subject to the excise f8}Ces under Chapter 42 of the Code. However, these organizations are not automatically exempt from other federal excise taxes.

Donors may deduct contributions to your organization as provided in section 170 of the Code. Bequests. legacies, devises, transfers, or gifts to your organization or for its use are deductible for federal estate and gift _ ~ ax purposes If they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. ,olana Beach Civic And Hustorical Society
15-1950979
....
rour organization is not required to file federal income tax returns unless it is subject to the tax on unrelated 1usiness income under section 511 of the Code. If your organization is subject to this tax, it must file an ,come tax return on the Form 990-T, Exempt Organization Business Income Tax Return. In this letter, we are 1ot determining whether any of your organization's present or proposed activities are unrelated trade or 1usiness as defined in section 513 of the Code.
'he law requires you to make your organization's annual return available for public inspection without charge Jr three years after the due date of the return. You are also required to make available for public inspection a opy of your organization's exemption application, any supporting docum~nts and the exe~pti9n letter to any .. 1dividual who requests such documents in person or in writing: You can charge only a reasonable fee for :production and actual postage costs for the copied materials. The law does not require you to provide opies of public inspection documents that are widely available, such as by posting them on tne Internet .

Norld Wide Web). 1"& may be liable for a penalty of $20 a day for eacl) daY.,Y.O.U ~O. nq~ f!J~~~ th~~e ... ,., ... acumen ts available for-public inspection (up to· a '.maximum ;of $1 0,00O'inthe case of an annual return):· ecause this letter could help resolve any questions about your organization"s exempt status ~f!d foundation :a~. you should _keep it-with the organization's permanent records. • • you have any questions, please call us at the telephone numbe~ ~hown in the ~eading of thi,_letter. 1is letter affirms your organization's exempt status.

Sincerely,
~g~
John E. Ricketts, Director. TE/GE
Customer Account Services
......
,.. -
i,
'
. '
Secretary of State
Certificate of Status
I, SHIRLEY N. WEBER, PH.D., California Secretary of State, hereby certify:

Entity Name:

Entity No.:

Registration Date:

Entity Type:

Formed In:

Status:

SOLANA BEACH CIVIC AND HISTORICAL SOCIETY
0445698
02/07/1963
Nonprofit Corporation ~ CA ~ Public Benefit

CALIFORNIA
Active
The above referenced entity is active on the Secretary of State's records and is authorized to exercise all its powers, rights and privileges in California.

No information is available from this office regarding the financial condition, status of licenses, if any, business activities or practices of the entity.

Certificate No.: 243184940
IN WITNESS WHEREOF, I execute this certificate and affix the Great Seal of the State of California this day of August 30, 2024.

SHIRLEY N. WEBER, PH.D.

Secretary of State
To verify the issuance of this Certificate, use the Certificate No. above with the Secretary of State Certification Verification Search available at bizfileOnline.sos.ca.gov.

Form W•9
(Rev. October 2018)
Department of the Treasury
Internal Reveriue Service
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS. ► Go to www.irs .. gov/FormW9 for instructions and the latest information. 1 Name (as shoWn on your Inc - -
. I CllAa...
2 Busfn9$S name/disregarded
~ 3 Checkapproprfate box for federal tax classification of the porson whoas name Is entered on line 1. Check only ona of the g> following seven boxes,
4 Exemptions (codes apply only to
certain entltles. not Individuals: soe
a. instructlons on page 3):
a D lndiViduat/sole proprietor or D C Corporation 0 S Corporatlon 0 Partner.ihip 0 TrusVetJtate ai ig -single-member LLC Exempt payee code (if any) ___ _ !; ~ 0 Limited liability company. Enter the tru< classification (C-=C corporation, ·s:::S corporation, P=Partnmrship) ► __ _ o 2 Note: Check tt,e approp,iato box in the line (lbo11e for the t(ll( classlficatlo11 of the single-member owner. Oo not clieck e 'Iii LLC if the LLC is claseified as a single-membor l.LC ti at is disregarded from the owner unless the owner of 1119 LLC is Exemption from FATCA reporting code Of any) •.:: .E another LLC that i~ not disregarded from the owner for U.S. federal IQ)( purposes. Otherwise, a single-member LLC that c. Ii? Is disregarded from tho ownor should check the appropriate box for the tax classification of its ownor. !E g !-=O=-_O_th_e_r.;.ce_e_e_1n_s_tru_c_ti_o_ns.;.)_► _______________________ ,--_____ _,__1_'Ap/:l_io1>_1_0•_=_""_ 1:r_m•_lll_om_· od_..,_"_Jda_r_h•_u_.SJ_ c8' 5 Address (number, ~treat, and apt. or suite no:) Sea lnstructions. Requester's name and addrees (optional) al p_ 0. D 5Dtf (/) ~-=------,.;,,,.,,..:;-~---<.:,:;.-__;;;_____, ____________ ...,... ____ ---l 6 City, state, and ZIP code
~[ tlt/U{_ • ULA. Cit
7 List account numb1>r(o) hara (optionaQ
IN)
Enter your TIN In the appropriate box. Toa TIN provided must match the name given on line 1 to avoid backup withholding. For Individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. for other entities, lt is-your employer Identification number (ElN). If you do not have a number, see How to get a TIN, later.

Social security numbor
ITIJ -[D -I I I I I
or
Note: If the account rs In more than one name, see the Instructions for line 1. Also see What Name and ~ Number To Give the Requester for guldellnes on whose number to enter.

Certification
Under penalties of perjury, I certify that:

1. n,e number shown on this form Is my correct taxpayer identification number (or I am waiting for a number to be issued to me}; and

2. I am not subject to bacKup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c.) the IRS has notified me that I am no longer subject to backup wlthholdlng; and

3. I am a U.S. citizen or other U.S. person (defined below); and

4. The FATCA code(s) entered on this form Qf any) indicating that I am exempt from FATCA reporting Is correct.

Certification lnsttuctlons. You must cross out Item 2 above If you have been notified by the IRS that you are currently subject to backup withholding because you have falled to report all interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an Individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the Instructions for Part II, later.

Sign
Here I Signature of
U.S. p•rson ►
General Instructions
Section references are to the Internal Revenue Coda unless otherwise noted.

Future developments. For the latest information about developments related to Form W-9 and its Instructions, such as legislation enacted after they were published, go to www.frs.gov/FormW9.

Purpose of Form
An lndiVldual or entity (Form W-9 requester) who ls required to file an Information return with the IRS must obtain your correct taxpayer Identification number (TIN) which may be your social security number _ (SSN), Individual taxpayer Identification number (ITIN}, adoption taxpayer Identification number (ATIN), or employer Identification nl,Jmber (EIN}, to report on an information return the amount pald to you, or other amount reportable on an information return. Examples of lnformatlon returns Include, but are not llmlted to, the following. • Form 1099-INT Onterest earned or paid)
Cat. No. 1023~X
Dat.o ►
• Form 1099-DIV (dMdends, Including those from stocKs or mutual funds)
• Form 1099-MISC (vt1rlous typoo of Income, prfzes, awards, or g ross proceeds)
• Form 1099-8 (stoclc or mutual fund sales and certain other transaciions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage Interest), 1098-E (student loan Interest), 1098-T (tuition)
• Form 1099-C (CS11celed debt)
• Form 1099-A (acquisition or abandonment of secured property} Use Form W-9 only if you are a U.S. person ~ncludfng a resident allen), lo provide your correct TIN.
ff you do not return Form W-9 to the requester with a TIN, you might be subject to backup wlthhOlding. See What is backup withholding, later.

Form W-9 (Rev. 10-2018)
Solana Beach
Community
Connections
Solana Beach Community Connections (SBCC)
2025 Community Grant Program Application
Solana Beach Community Connections (SBCC) is a
nonprofit 501 (c)(3) devoted to helping older citizens in Solana Beach lead fruitful lives as they age in place or live in community settings. Governed by a volunteer Board of Directors, it offers several services which might provide the basis for a future Senior Center. These services
include:
o To promote civic engagement and offset cognitive
challenges, a monthly lecture series on international,
national, and local topics;
o To help with personal safety, presentations on home
safety, health, theft and scams, legal issues;
o To develop socialization and community building, a
monthly Games Day is held at La Colonia Community
Center inviting citizens (including those with cognitive impairment) to play games such as Mah Jongg,
Scrabble, Mexican Train, Chess, Checkers, and learn
some of the newer board games;
1 o Collaborative projects and events held in conjunction with Elder's Angels which benefit seniors: Holiday
Baskets distributed gratis to isolated adults,
Valentine's Day party, chair yoga (to aid in physical
mobility), free book distributions and craft building;
2 o Web-based information page useful to citizens
concerning transportation, home services, and helpful
nonprofit entities
(www.SolanaBeachCC.org/CommunityResources);
o Workshops guided by a professional writer to
encourage telling one's story through vignettes and
reflections;
o A Book Club through which book are read individually
and discussed monthly in a group setting, providing
mental stimulation and social engagement;
o Periodic discussions with City of Solana Beach
officials and other individuals regarding issues of
concern to senior citizens.

As a nonprofit, SBCC provides these services without cost, meaning no fee-paying members or organizational backing like a church or foundation. It works with volunteers and receives some small donations from individuals. Our bank account consists of $2,000.

We are limited in our ability to broaden and strengthen our activities in part because of a lack of funds (as well as staff, which we also seek to develop) and more volunteers -- another goal. We seek funds from the City of Solana
Beach, as detailed below:

Request:

1. Lecture Series

2. Games Day

3. Specialized Group Projects

4. Walking Group

5. Insurance
$1,800.
$1,000.
$1,300.
$ 300.
$1,000.
__ 6. Book Club and Writing Workshops $ 600.

Total $6,000.
3 1. Funds to support Lecture Series: We are giving 11
presentations a year on both the public policy and agingin-place issues. These presentations have associated costs:

Publicity: We use email and announcements in local
newspapers, which are not costly, but we reach many
people through publicity that does cost money, including posters placed in strategic locations and flyers distributed to entities around Solana Beach. The cost for printing is a minimum of $150.

For the past three years, we have co-sponsored this
program with Friends of the Solana Beach Library (FOSBL).

We have shared costs with them. FOSBL paid honoraria.

SBCC shared publicity costs -- the largest cost has been large-format posters. SBCC shared the work of the
publicity, but we did much of the contact material for
newspapers. Each organization posted to our respective
mailing lists; we shared distribution. SBCC did not pay labor, which was achieved by the members of the various boards. The costs amounted to approximately $150 per
lecture.
4 The relationship with FOSBL has been productive and
harmonious. Both organizations have benefitted and
enjoyed the collaboration. At the same time, other
arrangements have evolved. To save money, both groups
decided not to pay honoraria. Then the two organizations decided to separate the number of shared programs. Now, each group will develop its own program preference and
share presentations on a lesser basis. SBCC has found La Colonia to be an excellent meeting space; it
accommodates more people and presentations are not
severely restricted by time limits. SBCC will continue to work with FOSBL to the extent both groups find it useful.

Costs: SBCC plans to run programs throughout the
summer, as it has done in previous years, since it is not governed by a school calendar. It will have 11 programs a year, with December being devoted to holiday activities and Holiday Basket distribution. Major costs for the
Lecture Series will be publicity; we budget $150 per
program, and we would add a small amount of money to
pay fees for someone who charges a speaker fee.

Budget request: $1,800.
5 2. Games Day Program: We have developed a monthly
Games Day program, aimed at providing activity to seniors who may be isolated, lonesome, or who generally seek
socialization and activity. They meet at La Colonia from 12 noon to 2:00 PM monthly. We provide a variety of games
(Scrabble, Mah Jongg, Mexican Train, Chess, various other board games, etc.), drinks and simple snacks. For the past year, we have had the assistance of Eric Schade of Let's Play A Game Foundation, an organization that provides
various new games to stimulate interest and increase
activity. Eric introduces different games each month and teaches those who are interested. La Colonia provides
another advantage -- the ability to store supplies for
games, refreshments, and other materials.

Costs: SBCC has been providing the games from our
homes. Same are old and worn. Others are highly prized
and are loaned to SBCC. Regardless, we cannot depend
on these materials forever. we would like to replenish, purchase newer materials and relieve the loan situation.

Additionally, Eric Schade has been supplying games from his own organization without cost.

Budget request: $1,000.
6 3. Specialized Group Projects: Elder's Angels is a small group of volunteers that reaches out to isolated seniors and plans social events or group activities. Examples are:

Holiday Parties, Book and Magazine Distributions, Flower Arranging, Holiday Baskets. SBCC partners with Elder's
Angels and helps plan events that are offered
approximately every six weeks throughout the calendar
year. These have been sponsored through small individual grants on a per-event basis. SBCC would like to regularize and continue to support this so it becomes a dependable series of events throughout the year.

Budget request: $1,300.

4. Walking Program: SBCC endeavors to organize a
program for Walkers. We have a volunteer who would lead this. However, we need insurance (as noted above). We
estimate the cost of insurance coupled with the costs of publicity about a new activity and printed maps for each route to be moderate.

Budget request: $v300.

5. Insurance City of Solana Beach recommends SBCC
provide insurance coverage for its Board of Directors if 7 SBCC extends its activities to include a Walking Group.

Presently insurance coverage extends only to the activities offered at the La Colonia Community Center. While this is very helpful, it limits the extent of SBCC's usefulness within the city but away from La Colonia Park. An
insurance broker estimates coverage would cost about
$1,000/year.

Budget request: $1,000.

6. Book Club and Writing Workshops: SBCC sponsors a
Book Club and three Writing Workshops. It has leaders for each of these activities. SBCC does not charge a fee, but it does ask for volunteer contributions, for the leaders
should receive some contribution for what amounts to a
considerable amount of work and time. Receiving some
funding would assist with these costs as well as the
publicity associated with each activity.

Budget request: $600.

7. Transportation: SBCC is endeavoring to develop ideas for a local transportation project. This will take
considerably more funding, well beyond this budget
8 category. Therefore, we are not submitting a formal
request at this time for this category ..
9 Solana Beach Community Connections
Application for 2025
Budget Request:

1. Lecture Series

2. Games Day

3. Specialized Group Projects

4. Walking Group

5. Insurance
$1,800.
$1,000.
$1,300.
$ 300.
$1,000.
__ 6. Book Club and Writing Workshops $ 600.

Total $6,000.

Short Form
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
OMS No, 1545•0047
Form 99O-EZ 2024
Deparl menl o! the Treasury Internal Revenue Service
Do not enter social security numbers on this form, as it may be made public, Go to www.lrs.gov/Form990EZ for instructions and the latest information.

A For the 2024 calendar year, or tax year beginning , 2024, and ending B Check ri applicable: C D Employer idantification number 8 Address change 16 Name change SOLANA BEACH COMMUNITY CONNECTIONS - - ~ D lnltial retorn 315 EL PEDREGAL DRIVE E Telephone number D F,nal relurn /lermonated SOLANA BEACH, CA 92075
D Amended rehlm F Group Exemption D Appt1cation pending Number G Accounting Method: [~J Cash O Accrual Other (specify): H Check ~ if the organization is not I Website: SOLANABEACHCC. ORG required to attach Schedule 8 J Tax-exempt status (chec k only one) - ~ 501 (C)(3) □ sm(c) c ) (i~sert no.) O 4947(a)(1) or 0527 (Form 990).

K Form of organization: ~ Corporation LJ Trust lJ Association LJ Other:

L Add lines 5b, 6c, and 7b to line 9 to determine gross receipts . If gross receipts are $200,000 or more, or if total assets (Part II, column (8)) are $500,000 or more, file Form 990 instead of Form 990-EZ .. . ... . . .. , .. . . . . . . . . . $ 6. 072 _ l:Paft, ~lk,I Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I) Check if the organization used Schedule O lo respond to any question in this Part I. • • • ~ I • • • • • - ._ • • • • • • • • • 1 • • • • , , • • • • • • ~ • , • , • • • • [xl 1 Contributions, gifts, grants, and similar amounts received . ... ... . . .. .. . . '' · · •·' ' .. . . .. ' .. ... -. ' .. ... ' 1 6.072 . 2 Program service revenue including government fees and contracts . . . ....... . ..... .... , , .. . . . .. . . ... .. 2 3 Membership dues and assessments . .... , .. . , .. , . . . ... . ... '. '' . ... . .. .... •• • ••• ' • • • •• ' ·••i• • ·· ···· · · ·· 3 4 Investment income . . . .. . , . . . . . .. . ... .. ... ... ....... . ... ... .. , . ... . . . . , . . .. .. .. _ . . .. , .. . . . .. . . . .. ... 4 Sa Gross amount from sale of assets other than ,inventory .. . . .. . . . . . .. . . . , . .. I Sal t-?~ b Less: cost or other basis and sales expenses . . , .. .. . . ... . .. . ... .. . .. . . . .. f Sbl •··\/i" C Gain or (loss) from sale of assets other than inventory (subtract line 5b from line 5a) . ... . , . ' .. . ' .... ... .. ' . , ... ' ... .... ' Sc 6 Gaming and fundraising events:
~
i"~ ·1""i'_ Q) Gross income from gaming (attach Schedule G if greater than $15,000) , ,,, I Ga l . ~ a
C:

Q) b Gross income from fundra1sing events (not including$ of contributions ,, •. ;!';t. > Cl) from ,fundraising events reported on line l ) (attach Schedule G if the sum 6b l ~,-~'",'.:;- _·•'; ~ a: ot such gross income and co11tributions exceeds $15,000) . . . ... . .. . . .... .. j ~i • - - C Less: direct expenses from gaming and fundraising events . , ... . , , , .. , , ... I Ge l -·1:;,_ii = • ';,:-·c ,,. d Net income or (loss) from gaming and fundraising events (add lfnes 6a and -·- 6b and subtract line 6c) ......... . . .. .. . . , .. ... . , . . .... , . .. , . . . . . . . .. .. . . .... , . .... .. . . . .. , ....... , . 6d 7a Gross sales of inventory, less returns and allowances .. ... . .. .. .. . .... .. .. I 1al ~
,:~,if b Less: cost of goods sold . . , . . .. ... . ... .. , . .. . . .. , . ... . , . . .. ...... . . . .. . , , I 7b l ;!:.

C Gross profit or (loss) from sales of inventory (subtract line 7b from line 7a) .. . . .. . , . ' 0 • J I • • • • ._ • ,.. • • • • • • 0 7c 8 Other revem1e (describe in Schedule 0) .. . .. .. .. . .. . ... . ...... . . . .. .. ... . .. . . . ...... , .... . .... . . . . . . 8 9 Total revenue. Add lines 1, 2, 3, 4, Sc, 6d, 7c, and 8 .. . .... , . . ... .. .. . .. ... . .... .. . .... , . .. . ...... .. . 9 6.072. 10 Grants and similar amoun1s paid (list in Sched'ule 0) . . ...... . .... ..... . . . . . .. . .... . . . ... , . . .. , . . .. ... 10 11 Benefits paid to or for members_ . . . . .. . , ....... , ... . .. .. ... . , .. , . . . . . . , . , , .. , . , . , _ .. . , .. .. _ , . .. .. ... 11 (/) 12 Salaries, other compensation , and employee benefits . .. .. .. ... ... . ...... . . .. .. ..... ... . .... ... . ..... 12 QI (/)
C 13 Professional fees and other payrnenls to independent contractors ... ... . , , .. . ... , . . ... , ... . , , .... .... . 13 QI
C. 14 Occupancy, rent, utilities, and maintenance . . . . . .. . ....... . ' •• J ' • • • • • •• • ••••••• ' • • •• • ' ..I. • ' • ' • ~ .. .. . ... . 14 >< w 15 Printing, publications, postage, and shipping .... . ....... . . ...... ..... . __ .,. . . ... . .. .. .. . ... ... , .. . . .. . 15 16 - • SEE SCHEDULE 0 Other 16 5.653 . expenses (describe in Schedule 0), . . . ... .. , . ... . , .. ... , .... _ . . _ , , . , , . ,. ,. .... ., .. . .. , .. . _ ... , 17 Total expenses. Add lines 10 through 16 .... . . .. . . . . . .. . . . .. ... . . ..... .. ... . . , . , ... , , , .. , ... ... .. .. , 17 5,653. 18 Excess or (deficit) for the year (s\,Jblract l•ine 17 from line 9) ... , .. .. . _ . .. .. ,,, . , . , ... . . , - - , , ~ r • • - - - • • ~ 18 419 . 1/) - - - - Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree wilh end-of-year Q) -.. ~ 1/) 19 U) <[ figure reported on prior year's return) .. . , , . ... . . . . . . . . . , .. . ..... .. . .. . .. . ... . . .. .' ... ............ .. .. 19 2,410. -
Q) 20 other changes in net assets or fund balances (explain 1n Schedule 0 ) . . .. . ' ... ... ..... ' ' ... .. ' ······-. 20 z 21 Net assets or fund balances at end of year. Combine lines 18 {hrough 20 .. , . . ' ' .. , ... . ' ' ... .. ~ .... .. . 21 2,829.

BAA For Papeiwork Reduction Act Notice, see the separate Instructions. Form 990.EZ (2024) TEEA0B1"2L 09124124
~~ Department of the Treasury
~dJ!IJI Internal Revenue Service
IRS Tax Exempt .and Government Entities
P.O. Box 2508
Cincinnati, OH 45201
Dnte:
03/30/2022
Employer ID number:

Person to contact:

SOLANA BEACH COMivfUNJTY CONNECTIONS

C/O JILL MACDONALD
Name: Customer Service
ID number: 31954
Telephone: 871-829-5500
Accounting period ending:

December 31
Public charity status; 315 EL PEDREGAL DRIVE
SOLANA BEACH, CA 92075
Dear Applicant:
170(b)(1 )(A)(vj)
form 900 / 990-EZ / 990-N required:

Yes
Effoctivo date of exemption:

December 20, 2021
Contribution doductlbili(y:

Yes,
Addendum applies:

No
DLN:
26053466001032
We're pleased to telJ you we determined you're exempt from federal income tax under Internal Revenue Code (IRC) Section 501 (c)(3). Donors can deduct contributi'ons they make to you under IRC Section 170. You're also qualified to receive tax deductible bequests, devises, transfers or gifts under Section 2055, 2106, or 2522. This letter could help resolve questions on your exempt status. Please keep it for your records.

Organizations exempt under IRC Section 501(c)(3) are further classified as either public charities or private foundations. We detennined you're a public charity under the IRC Section listed at the top of this letter.

Ifwe indicated at the top of this letter that you're required to file Form 990/990-EZ/990-N, our records show you're required to file an annual information return (Form 990 or Form 990-EZ) or e1ectronic notice (Form 990-N, the e~Postcard). If you don't file a required return or notice for three consecutive years, your exempt status will be automatically revoked.

Ifwe indicated at the top of this letter that an addendum applies, the enclosed addendum is an integral part of this letter.

For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities.

Enter "4221-PC'J in the search bar to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, which describes your recordkeeping, reporting, and disclosure requirements.

Sincerely,
~ a.,. pf~
Stephen A. Martin
Director, Exempt Organizations
Rulings and Agreements
Letter 947 (Rev. 2-2020)
Catalog Number 35152P
~~ Department of the Treasury ~E/IIJJ Internal Revenue Service IRS Tax Exempt and Government Entities
P.O. Box 2508
Cincinnati, OH 45201
Dato:
03/30/2022
erson to contact:

SOLANA BEACH COMMUNITY CONNECTIONS

C/O JILL MACDONALD
Name: Customer Service
ID number: 31954
Telephone; 877-829-5500
Accountfng period ending:

December 31
315 ELPEDREGAL DRIVE
SOLANA BEACH, CA 92075
Dear Applicant:

Public charity status:
170(b )(1 )(A)(vi)
Form 990 1990-EZ / 990-N requlrod:

Yes
Effoctlve date of oxompUon:

December 20, 2021
Contributloh doductlbilfty:

Yes
Addendum applies:

No
DLN:
26053466001032
We're pleased to tell you we determined you're exempt from federal income tax under Internal Revenue Code (IRC) Section 50l(c)(3). Donors can deduct contributions they make to you under IRC Section 170. You're also qualified to receive tax deductible bequests, devises, transfers or gifts under Section 2055, 2106, or 2522. This letter could help resolve questions on your exempt status. Please keep it for your records.

Organizations exempt under IRC Section 501 ( c)(3) are further classified as either public charities or private foundations. We detemlined you:'re a public charity under the IRC Section listed at the top of this letter.

If we indicated at the top of this letter that you're required to file Form 990/990-EZ/990-N, our records show you're required to file an annual information return (Form 990 or Form 990-EZ) or electronic notice (Form 990-N, thee-Postcard). If you don't file a required return or notice for three consecutive years, your exempt status will be automatically revoked.

If we indicated at the top of this letter that an addendum applies, the enclosed addendum is an integral part of this letter.

For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities.

Enter "4221 -PC" in the search bar to view Publication 4221-PC, Compliance Guide for 501 (c)(3) Public Charities, which describes your recordkeeping, reporting, and disclosure requirements.

Sincerely,
~4--~
Stephen A. Ma1tin
Director, Exempt Organizations
Rulings and Agreements
Letter 947 {Rev. 2-2020}
Catalog Number 35152P
Form W-9 Request for Taxpayer Oh,• Form to tho
(Aw. Ocfcbor 20181 ldentfflcatlon Number and Certification requeewr. Do not ~ °' 1h11 r.-.;- hlorrw~Str\40a ► Go to www..t,a.povtFom,W9 for ln-structlons and the ...._t tnfonne1ti:Jl'I. send to the IRS.

I 1 N-(.S llh~ on }'OU' tnoorno tax rotum). Ncmo Is raqulrod on lt>la lno; do not !eawi lfilll lhO blanl<.

SOLANA BEACH COMMUNITY CONtlECTIONS
2 BU!llnn'lrl nsioofdl:Pegarded onlllY nane, If dllh!ront Iron\ 11bow <? a Cmck ~11 ba>:' f{X fodcnu t?:x ew;s!flc:atja, cil u... p::r.ron who:o = ie Cf1Ul!'-ed ,m ll'10 f. C11od< only one of !hi! _. Exemp1.10ne !~ appiy orily b ~ l foUowng s= bOXO:$. CCftlln Dntlltn, not hdMdulalo; -
IZI C ColJ;>Otatlon
lnslnlctloro on pege 3):
a 0 lndlvldul!Jlsolo proprietor or 0 S ·Corporstlon 0 PilltnGf'dllp OTruw ta10 ... ~erlLC ExDmpt PIJ'f9'!! code Of any) 1
11 0 Umftoc:1 llsbttlty company. Entor Iha tax cI~nc.atton (C..-C COl'P0ratlon, ScS corporatlofl, P..P~lp) ► 2l Note: Chick Iha approp,11119 box In 1h11 fine a.bovo tor the tax <:111.Qlflcatlon of tho slngle-mombGr own«. Do not Chock 8<olrtptlon from FATCA. r~ UC It tho U.C ls cllli:tneo as " ,1ngro-membc< UC that la cfl:.rQgard d from !ho owmr unlooa tho o-of tho LLC Is <=s codo 0f eny) cnothet LLC that Is not cfi3rogardoo from !ho own=r for U.S. tecfGt'll l 111)( purpoS3S. OtherwlsG, o sfngla-m~ U.C that fu 1 I& d!srog!lldcd lrcm Iha owner should cllack lhQ approprlato box fer tho tnx ctl'l!lSlflcatlon of 1111 ownor. 0 Olner (5130 lmrtrvcilon!I) ►
~., ___ ,,_U-SJ
5 Addross (numb,;,', ~. and apl or " U/to no.) Seo lns!Juctlonll. Roquostl!f's name and nddrus!J (optlonlll) J 3 15 EL PEOREGAL DRIVE
6 City, stllto. and z jp coda
SOLANA BEACH CA 92075
7 List account numbe,ts) hvo {opt/~
!J:;J••· Taxpayer Identification Number (TIN}
Enfer you~ TIN I Soclal aecur1ty nunmer I In_ the app_ro~fi:ate box. The TIN proVided must match the name given on line 1 to avoid backup wtt/1hofding. For rndMduals, this Is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, seB the lnstniclions for Part I, later. For other entities, it is your employer identlficatkm number (EJN). Jt you do not have a number. see How to get a TIN. later.

ITO -[D -I I I l I
or
Nott: If the account Is In more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose ·number to enter.

Certification
Under penalties of petjwy, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or l am waiting for a number to be issued to me); 811d

2. I am not subject to backup withholding because: (a) I am exempt from backup withhOlding, or (b) I have not been notified by the lntemal Revenue Service QRSJ that I am subject to backup withhOlding as a result of a failure to report an interest or dividends, or (c) the IRS h.as notified me that I am no longer subject to backUp withholding; and

3. I am a U.S. citizen or other U.S. person (defined belOW); and

4. The FATCA code(s) entered on this form (rt any? fndlca1ing that I am exempt from FATCA reporting is correct.

Cettfflcatkm ln&tructlons. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because )IOU have faifed to report all interest and dividends on your tax retvrn. For real estate transactions, Item 2 does not apply. For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contrlbutlons to an Individual retirement arrangement QRA), and generally, payments other than rnterest and cfNidends, you are not required to sign the certification, but you must provide your cOIT8ct TIN. See the lnstructlons for Part II, later.

Sign
Here Signatunt at
U.S. per.wn ►
General Instructions
:,action references ara to the lntemaJ Revenue Code unless otherwise roted.
uture developments. For the latest information about dsvslopments 1/ated to Form W-9 and its 'Instructions, such as leglsJat!on enacted 'fer they were published, go to www.irs;govlFormW9.
•urpose of Form
, individual or entity (Form W-9 requ&Ste,) who is required to file an ,rmation return with the IRS must obtain your correct taxpayer ,ntitication number (TIN) which may be your social security number iN), individual taxpayer identification number QTIN), adoption oayer identfficatlon number (A TIN), or employer identification number ~. to report on an Information retum the amount paid to you, or other ,unt reportable on an information ratum. Examples of information ms include, but are not limitsd to, the following.
rm 1099-JNT Orrterast earned or paid)
C No. 10231X
• Form 1099-DIV (dividends, including t
funds) • /
from stocks or mutual
• Form 1099·MISC (various types of Income, prizes, awards, or gross proceeds)
• Form 1099-8 (s1ock or mutual fund sales and certain o1her transactions by brokers)
• Form 1099-S (proceeds from real eslate transactions)
• Form 1099-K (merchant card and third party nstwork transactlons) • Form 1098 (home mortgage Interest), 1008-E (stUdent loan Interest), 1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abe.ndonment of secured property) Use Form W-9 only if you are a U.S. person Qocludlng a resident alien), to provide your correct TIN.

If you do not ratum Form W-9 to th request.er wftfl a TIN, you might be subject to beckup withho.'dfng. See What in oockup Withholdng, later.

Form W-9
Solana Beach
Community
Theater
1 3

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~~
- . .,;;
• 1{•._rttif ' ~
JIQ • . MIN-kip~
8"ft • . IP 1ie,fll -
~,,, - ~
• ~-- .,,~J
•- ~ ~ '"4121,. Wkl ~ ~ ....
-
,.,w, ~,HP!... ----• •• ~ .
~

Taking
Inspired
Action
Solana
TIAS
The City of Solana Beach Community Grant Program 2025 Request for Financial Assistance application MUST BE SUBMITTED by 5:00 PM Thursday, May 29, 2025.

Please submit completed applications via email to [email protected] and copied to [email protected].

If email submission is not possible for an applicant, hard copies may be dropped off at City Hall 635 South Highway 101, Solana Beach, CA. 92075, Attn: Community Grants Program.

All requests will be determined by the following criteria:

N f O . t· TIAS (Taking Inspired Action Solana) ame o rganiza ion: ____________________________ _ C t t P Kristin Brinner E .
1 dd [email protected] on ac erson: _______________ maI a ress: _________ _ D t. Ph 858-876-8293 E . Ph ay Ime one: _____________ vening one: ____________ _ M .1. Add 246 Barbara Ave
a11ng ress: -------------------------------
c·t Solana Beach S CA z· 92075 , y: ______________ tate: ________ 1p: ________ _

1. All the documents below are attached to this application:
□ W-9
Ill Summary of Organization's Budget
Ill Proposed Program Budget
□ Financial and Tax Statements (see Application Guidelines) □ Copy of the California Franchise Tax Board Entity Status Letter, showing exemption under Section 23701 d or Internal Revenue Code section 501 (c)(3)

2. Has your organization received financial assistance from the City before? D Yes Ill No If yes, please state the fiscal year it was received and for the proposed program was:
3 T·tI f FY 2025;26 p d p /S . Neighbors helping neighbors . 1 e o ropose rogram erv,ce: __________________ _

4. What is the total amount requested for the FY 2025/26 Proposed Total Program? Includes all estimated costs to conduct proposed activity/program.
$1500

Page 11 ends

Solana Beach City CouncilJune 4, 2025

Solana Beach City Council
June 4, 2025