Temecula City Council
November 15, 2022

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13

PROJECT/PROGRAM BUDGET (do not fill in shaded areas)

LINE ITEMS FOR PROJECT/PROGRAM REVENUES

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount of money requested from this City of Temecula $ 17,000 Community Services Grant (Not to exceed $50,000)
Amount contributed to the Project/Program by the Applicant Organization
Other grants or funding already awarded for Project/Program, if any $16,400 f
i
$0
In -Kind match amount or volunteer credit hours estimated amount $1,600 TOTAL REVENUE $35,000

LIST OF EXPENSES FOR PROJECT/PROGRAM

EXPENSES
Tools/Equipment
$15,000
Facilities/Rent/Insurance
$5,400
Supplies
$200
Marketing
$0
Services
$0
Food
$0
Other
$0
Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; HOWEVER PLEASE INCLUDE.
$14,400

TOTAL EXPENSES
$35,000
TOTAL BUDGET $35� 000
$35 C),00
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13

I ACKNOWLEDGEMENT/SIGNATURE PAGE I
The applicant acknowledges and agrees to the following:
• Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements.
• Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval.

Please allow time for checks to be processed.
• The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot.
• The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete.

I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief.

ORGANIZATION NAME:-TMZwurL VO Vty �r'�`,Cf V(XJc r 0A 4hC_A(j5 MAILING ADDRESS: a?_N o NA-TOL130 rron 5t . PHONE: (91 ) 5-0 (o - n 1 EMAIL:

PRESIDENT / AUTHORIZED OFFICER: JuSC(Iti

PRINT NAME F
SIGNATURE: �,Uk)d"

IF DIFFERENT THAN ABOVE,
APPICATION PREPARED BY:
to -Jf IAr
q TITLE
DATE: 1 anaa

MON TH, DAY, YEAR

PRINT NAME TITLE
SUBMIT ORIGNAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO:

City of Temecula
Community Service Funding
Attn: City Manager's Office
41000 MA I N jTD `CT
TCRAcri 11 A rA 01COn
Oupstions: Starey.BrownaTemecuiaCA_oov (951) 694-641"
RofQ%1 I n%Airav rrivlTomwr11Inr..A nnv /QF11 RQ'�_3QFQ City of Temecula Community Service Funding Reinvestment in Temecula GRANT APPLICATION Page 13 of 13

INTERNAL REVENUE SERVICE
P. 0. BOX 2500
CINCINNATI, OH 45201
Date: C' �� 0112015

TEMECULA VALLEY CONSERVATORY OF THE
ARTS

C/O RAYMOND W JOHNSON
26785 CAMINO SEGO
TEMECULA, CA 92590-3518
Dear Applicant:

DEPARTMENT OF THE TREASURY
Employer Identification Number:
47-3595763
DLN:
17053155325005
Contact Person:

JOSEPH R KENNEDY ID# 31647
Contact Telephone Number:
(877) 829-5500
Accounting Period Ending:

December 31
Public Charity Status:
170 (b) (1) (A) (vi)
Form 990 Required:

Yes
Effective Date of Exemption:

January 28, 2015
Contribution Deductibi3ity:

Yes
Addendum Applies:

No
We are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 501(c)(3) of the Internal Revenue Code. Contributions to you are deductible under section 170 of the Code_ You are also qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in your permanent records.

Organizations exempt under section 501(c)(3) of the Code are further classified as either public charities or private foundations. We determined that you are a public charity under the Code section(s) listed in the heading of this letter.

For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities . Enter 114221-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.

Letter 947

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all
y sir
n� California Secretary of State
Electronic Filing Secretary of State
State of California
Corporation - Statement of Information
Entity Name: TEMECULA VALLEY CONSERVATORY OF

THE ARTS
Entity (File) Number:

File Date:

Entity Type
Jurisdiction
Document ID
Detailed Filing Information

1. Entity Name:

2. Business Addresses.
a. Street Address of Principal
Office in California:
b. Mailing Address

3. Officers:
a. Chief Executive Officer:

C3751189
01/16/2022
Corporation

CALIFORNIA
H116996

TEMECULA VALLEY CONSERVATORY

OF THE ARTS
28780 Old Town Front St, C1
Temecula, California 92590
United States of America
28780 Old Town Front St, C1
Temecula, California 92590
United States of America
Susan Ann Miyamoto
PO Box 2312
Temecula, California 92593
United States of America
b. Secretary: Mark Alton Masters
PO Box 5716
Pasadena, California 91117
United States of America
cD
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rid
Use bizfile. sos_ ca qov for online filings, searches. business records, and resources.

California Secretary of State
zK:

Electronic Filing
Officers (Cont'd):
c. Chief Financial Officer:

4. Agent for Service of Process:

Mimi Chang
31537 Rancho Pueblo Rd., STE 201
Temecula, California 92592
United States of America
Susan Ann Miyamoto
28780 Old Town Front St., C1
Temecula, California 92590
United States of America
By signing this document, I certify that the information is true and correct and that I am authorized by California law to sign.

Electronic Signature: Susan Ann Miyamoto
Use bizfile.sos.ca.gov for online filings, searches, business records, and resources. c�
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0 STAM OF CALIFORNiA

CT-TR- I
(Ong (WI2017)

MAIL TO
Registry of Chante die Trusts
P O Box 903447
Sacramento, CA 94203-4470

STREET ADDRESS
1300 1 Street
Sacramento, CA 95814
(916) 210-6400

VVEBSITE ADDRESS
-- Qa!j-u OQVI013filles,

ANNUAL TREASURER'S REPORT

ATTORNEY GENERAL OF CALIFORNIA
Section 12566, California Government Code
11 Cal. Code Regs„ Section 301
Temecula Valley Conservatory of the Arts
(FORM CT-TR-1)
OF.PAR I MLNI Or JUS7ICF
FAL 1 1� 4 ,S.ti
.a�
For Registry Use Onty
,t)i „ ry of Chwlt`ble Trusts
CT0267119
Name of Organization I State Charity Registration Number 128780 Old Town Front St., C1
Address (Number and Street)
Temecula, CA 92590
City or Town, State and 21P Code
ASSETS
Corporation or Organization No.

I Federal Employer I D, No.

For annual accounting period ( beginning 01 / 01 / 21

BALANCE SHEET
Cash
$ 4,766.49
Savings
$
Investment
$
LandlBuildings
$
Other Assets
$ 6,000
TOTAL ASSETS sic f `j �-(' `'i 1� 1

REVENUE
3751189
47-3595763
ending 12 1 31 / 21 )

LIABILITIES
Accounts Payable
$
0 Salary Payable
$
0 T
Other Liabilities
$
0 TOTAL LIABILITIES
$
0 FUND BALANCE
Total Assets less Total Liabilities $ p, 1 k (�, ,

REVENUE STATEMENT
Cash Contributions
$
! r O it - .1q
Noncash Contributions
$
5,633,00
Program Revenue
$
2,256.08
Investments
$
n
Special Events
$
O
Other Revenue
$
2,50
TOTAL REVENUE $ F

NET REVENUE
Total Revenue less Total Expenses $ _ 3 o q ,

EXPENSES
Compensation of Offioers0rectors $
Compensation of Staff $
Fundraising Expenses $
0 0
0 Rent
Utilities
$
$
0 0
SuppItes/Postage
$
0 Insurance
$
1,294
Other Expenses
$
7,918.25
TOTAL EXPENSES $ 9,
I hereby declare under penalty of perjury that I have examined this report, including accompanying documents, and, to the best of my knowledge and lot, the conga 6, correct atu mplety and I am authorized to sign.

Susan Miyamoto President 5/2/22
Signature of Authorized Agent Printed Name Title Date

STATE of CALIFOPNI ,
CT-1 R-1
long 09t2010

MAIL TO
Registry ofChantaiieTrusls

ANNUAL TREASURER'S REPORT
P O Box 903447
Sacramento, CA 94203-4470

ATTORNEY GENERAL OF CALIFORNIA
Section 12586, California Government Code

STREET ADDRESS
1300 1 Street
11 Cal. Code Regs., Section 301
Sacramento, CA 95814
(916)210-6400

VV'ESSITE ADDRESS
WATT OPCiGa g0vflhontirs
Temecula Valley Conservatory of the Arts
(FORM CT-TR-1)
Name or Organization
28780 Old Town Front St., C1
Address (Number and Street)
Temecula, CA 92590
City or Town, State and ZIP Code
For annual accounting period ( beginning 01 1 01 1 21

BALANCE SHEET
ASSETS
Cash $ 4,766-49
Savings $
Investment $
Land/Buildings $
Other Assets $ 6,000
(it t•ARTMF,Ni a, r f:i l u
For Registry Use Orlly)
j 1
LQ
( iSfF�f U{ Chinli f IR Trusts
CT0267119 I
'ate Charity Registration Number
3751189
;orporation or Organization No
47-3695763
ederal Employer I.D. No.
ending 12 / 31 / 21 )

LIABILITIES
Accounts Payable $ 0
Salary Payable $ 0
Other Liabilities $ 0
TOTAL LIABILITIES - $y

FUND BALANCE
TOTAL ASSETS $ In 7 I,-(' `4 Total Assets less Total Liabilities $

REVENUE STATEMENT

REVENUE
Cash Contributions
$
�' O 11 .a,?
Noncash Contributions
$
5,633.00
Program Revenue
$
2,256.08
Investments
$
n
Special Events
$
U
Other Revenue
$

2.50 TOTAL REVENUE $ S q u, � R
4 — -

EXPENSES
Compensation of Officers/Directors $
0 Compensation of Staff
$
0 Fundraising Expenses
Rent
$
$
0 0
Utilities
Supplies/Postage
Insurance
$
$
$
0 0
1,294
Other Expenses
$
7,918.25

NET REVENUE

TOTALEXPENSES
Total Revenue less Total Expenses $ O C� ,
I hereby declare under penalty of perjury that I have examined this report, including accompanying documents, and, to the best of my knowledge Anti 719f. the contsioll canvct all mptete and I am authorized to sign.

Susan Miyamoto President 5/2/22
SegnAturo of Atfthonza Agent Printed Name Title Dale

Attachment to Ct-TR-1
List of "Other Expenses"
Annual Treasurer's Report — 2021
Temecula Valley Conservatory of the Arts
State Charity Registration No. CT026719

1. Website costs

2. Chamber of Commerce fee

3. Program instructor

4. Supplies (strings, rosin, bow)
S. Piano donation
TOTAL
$ 112.34
$ 300.00
$ 2,400.00
$ 105.91
$ 5,000.00
$7,918.25

Attachment to CT-TR-1
Annual Treasures Report- 2021
Temecula Valley Conservatory of the Arts
State Charity Registration No. CT026719
ASSETS
Other Assets List — Musical Instruments

1. 21 violins - $2,120

2. 6 cellos — $2,400

3. 4 violas - $ 480
TOTAL = $ 6,000

OTHER REVENUE
Checking Account Interest $2.50

FY 2022/2023

COMMUNITY SERVICE FUNDING

REINVESTMENT IN TEMECULA
GRANT APPLICATION #
54 TEMECULA VALLEY HIGH SCHOOL

GOLDEN BEAR FOUNDATION

CITY OF TEMECULA
FISCAL YEAR 2022 - 2023 ' `��122p
fil COMMUNITY SERVICE FUNDING - REINVESTMENT INFCC CA

PROGRAM APPLICATION
(Please Print or Type)
DUE ON OR BEFORE: MONDAY, SEPTEMBER 12,201.

PROJECT/PROGRAM INFORMATION i
Amount Requested: . 10,000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: Amplify - le r tion. of'Blavk HistoryStart Date: 1/25/23 End Date: 1/26/2023 Physical Address of Project/Program 31555 Rancho vista Road. Tempeu)OLCa 92592 _

INCLUDE IF DIFFERENT THAN ORGANIZATION S MAILING ADDRESS If Grant is Awarded, Make Check Payable to:

Mailing Address: PO Box 822072, Temecula, Cla 22582-2072

ORGANIZATION AND GEOGRAPHIC AREA SERVED
Name of Applicant n-,-- `"
Organization:-i TEMECULA VALLEY HIGH SCHOOLIGOLDEN BEAR FOUNDATION -car rounded: 2022
Website:

Social Media: ,NA
Number of Paid Staff; I Number of Volunteers: all student,2 staff Geographic Area(s) the Organization Serves: Tgmgcula Valley High Scheel Geographic Area(s) the Pr4)igc_t/Prougni Serves: Temecula Valley NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE E.XCLUSIVElY USED TO SERVE TEMECULA.

Contact Name: a VomSteeg Title/Position: Drpadmj nuj lair Social Science Contact Person's Direct Telephone: 951-491-1326 Contact Person's Email: dyomst ..g@tyusd_us

NONPROFIT STATUS
Is this organization incorporated as a nonprofit? Yes ❑ Date of Incorporation as a Nonprofit: _2009 No. [2 IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Federal Identification Number: EIN-26-1917730 State Identification Number:

PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND S'lAfE (FTB) AS FOLLOWS:

1. ❑ Attach IRS Deductibility Status using this link: �:111 a �s.ir, rovl s/cns/

2. ❑ Attach State Entity Status Letter using this link:
]litps:U www.f'tlz.c_a.&nv/onl,ilic/sclf_serVS , e0tily 51alus ICtter/ildca,I� 3 • ❑ Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity S a R S a c T :cl.dcfj.c;I,gnulVeriIicRIion/W0 Soil rchausnx"ftuili[v Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13

APPLICATION AUTHORIZATION I
Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No.[3 Yes ❑ IF YES, BRIEFLY DESCRIBE:

Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No.[3 Yes ❑ IF YES, PROVIDE COUNCIL MEMBER S NAME AND TITLE WITHIN THE ORGANIZATION:

This A ca a b
Executive Committee
0 a a
Board of Directors ❑ Members -at -Large U

MISSION STATEMENT OF ORGANIZATION
BRIEFLY DESCRIBE THE ORGANIZATION S MISSION/GOALS AND OBJECTIVES.

Amplify is a school and community -wide event where guest lecturers, professional and student performances, poets, musicians and actors join their collective voices in a two-day celebrating the deep and rich heritage of the black community. Our goal is to bring students, families and community members to hear first, second and third person accounts of the struggles and successes of the black community during the Civil Rights movement to the present. Our hope is though authentic stories, shared through measured and compassionate tones, our community will understand and empathize with the black experience in our cities and neighborhoods.

FINANCIAL STATEMENTS

UPON REQUEST, COPIES OF THE ORGANIZATION S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT, DO NOT SUBMIT NOW.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13

FUNDING SOURCES
CITY OF TEMECULA SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No.® Yes ❑ IF YES, PROVIDE BELOW.

NAME OF PROGRAMrPROt1 EC T
MONTH +YEAR

NAME OF CIIY GRANC
FUNDIDBYTHECrrYGRANF0RSP0NSMH1P
AMOUNT

FUNDM RECEIVED

ORSPONSORSHIP
$
$
$
$
$
$
$
$
OTHER OUTSIDE SOURCES SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PRU.J[!'T//'RO(;RAM IN THIS APPLICATION,? No ❑ Yes® IF YFS, PROVIDE INFORMATION IN TABLE BELOW,
AMOUNT MONTH +YFAR
RECEIVED NAME OF ENr Y FUNDING RBZEIVM
$ 0 We are seeking funding from Temecula Valley USD to
match donations from City of Temecula. 1
Citv of Temecula Community Service Funding - Reinvestment in Temecula GRANTAPPLICATION Page 7 of 13

GRANT PROJECT/PROGRAM DESCRIPTION

IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT

FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.

This is our inaugural attempt at bringing students, families and community members to learn first person account stories from those who rode on the buses that we now refer to as the "The Freedom Riders." An organization from San Diego has artifacts, a life-size replica of the bus and will bring out the father -son team to speak about their experiences. The second night we will hear from Lee Sentell, Director of Alabama Tourism and author and expert on The Road to Birmingham. We will have speakers, music, poetry reading, dancing, re-enactments each eveninc program.

ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS

PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT, $10,000 to Gaidi Finni, Executive Director SDAAMFA for "The Buses are Coming" exhibit $2000. African Drum and Dancers from Los Angeles
$500 Honorarium for Lee Sentell
$500. Honorarium for Yolanda Franklin "A Poetic Tribute to the Freedom Riders" $3000. David Dennis Sr. and son David share experiences from Freedom Rider $1750 Flights, housing and food for all guest speakers
�§i
r 10.11 and 12th
TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.

We are going to encourage different clubs representing marginalized people groups from all TVUSD HS campuses to send dance, song, drama teams in addition to the paid speakers and performers for two nights at the Golden Bear Theater. Students will sell tickets to parents and community members that will go toward next year's Amplify event. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM:
3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM_ 12000+ students
800+ community
20 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13

PROJECT/PROGRAM DESCRIPTION

CONTINUED
4 SUMMARY STATEMENT SUMMARIZE ANSWERS 1 3 ABOVE IN 50 WORDS OR LESS. "What would you ride for?" When the Freedom Riders left their homes to challenge segregatio In the South they knowingly risked their lives. This two day exhibit will immerse community members in an augmented reality and hear authentic stories that will shed new light on the Black community experience.
5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC

AFFECTED THIS NONPROFIT ORGANIZATION S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS.

N/A
Ir AFFLYINU FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL:
(1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM.
1) This will be the first year TVHS has attempted to host a Black History Celebration that is intentionally serving our students and the community.
2) We aim to charge community members a minimal fee to access the evening programs so program can expand and aim toward self-sufficiency.
3) We aim to continue this program year-to-year and have students and community grow to value and respect the contributions and sacrifices of the black community.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13

PROtIFGTI MGRAM BUDGL i' (do not fill in shaded areas)
umnEmFORPROACUNDIGRAM— REVENUES
LIST REVENUESWONE FM PR[]MM440GRAM
Amount of money requested from this City of Temecula $. 10,000 1 Conununity Services Grant (Not to exceed $50,000) 1
Amount contributed to the Project/Program by the Applicant $ 0 Organization
Other grants or funding already awarded for Project/Program, if any I $. 0 In -Kind match amount or volunteer credit hours estimated amount $• 2000.00 MEAL REVENUE $12,000.00
LLST OF FMENSIES FOR PROJEiCI'AW)G RAM
Tools/Equipment
Facilities/Rent/Insurance
Supplies
Marketing
Services
Food
$ 500.00
$ 16,500.00
500.00
Other. (Housing, airfare) $.1,750.00
Staffing Expense THIS IS INELIGIBLETO BE FUNDED BYCITY S GRANT HOWEVER PLEASE INCLUDE. $
TOTAL EXPCNSES $19,750.00
— — — TOIAL BUDGET $ $
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13

► 1111 11 I Blob► e
The applicant acknowledges and agrees to the following:

Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements.

Every Community Service Funding application is considered individually and on its own merit.

Awards will be given to organizations and activities that directly benefit the residents of Temecula.

Funding is not immediately available to the recipient, and requires an award letter signature upon approval.

Please allow time for checks to be processed.

The awarding of Community Service Funding does not constitute an automatic annual allocation.

The recognition for Community Service Funding should accrue to the City of Temecula.

Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately.

Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot.

The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement.

If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts In be bmi ed on o befo e hi a lica ion d e da e o hi a lica ion may be rejected as incomplete.

I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief.

ORGAWATION NAME: TV GB Fo ndatian
MAR INGADDRESS: PO Box 892072 PHONE: (__)
Temecula Ca 93589 EMAIL: dyomsteeg @tvtisd.us
PRESIDENT /ALYI'IIORTLED OFFICER: Jennifer Nguyen President SIGNATURE:

DATE:

IF DIFI•ERENTT IANABOVE,
APPLICATION PREPARED BY: Doug VoniSteeg Social Science Department Co -Chair „I y:trll;
SUBMIT ORICINALAPPLICA110N 13Y MONDAY, SEffEMBER 12, 2022, TO:

City of Temecula
Community Service Funding
An Ci Manage Office
41000 MAIN STREET
TEMMJLA, CA 92590
Questions: [email protected] (951) 694-6413
[email protected] (951) 693-3959
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
FTB ' PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/11 /2022
ESL ID: 8925509795
Why You Received This Letter
According to our records, the following entity information is true and accurate as of the date of this letter Entity ID: 3058980
Entity Name: TEMECULA VALLEY HIGH SCHOOL/GOLDEN BEAR FOUNDATION

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. ❑X 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 through the Franchise Tax Board Administrative Dissolution process.

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

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Temecula Valley High School Golden Bear Foundation
EIN: 26-1917730 1 Temecula, CA, United States
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Publication 78 Data e
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On Publication 79 Data List: Yes
Deductibility Code: PC
Form 990-N (e-Postcard) e
Organizations who have filed a 990-N (e-Postcard) annual electronic notice. Most small organizations that receive less than $50,000 fall into this category. > Tax Year 2012 Form 990-N (e-Postcard)
> Tax Year 2011 Form 990-N (e-Postcard)
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efile GRAPHIC rint - DO NOT PROCESS As Filed Data - DLN: 93492067009161 �O �� Short Form OMB No. 1545-1150
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) 2020 Dcpnrunen[ of the
Treasury
internal Revenue Renrice
A For the 2020 calei
8 Check it applicable:
❑ Address change
❑ Nane change
❑ Initial return
❑ Final return/terminated
❑ Amended return
❑ Application pending
► Do not enter social security numbers on this form as it may be made public. ► Go to www._rrs.gov( , fornr990fZ for instructions and the latest information. r year, or tax near beginning 01-01-2020 r and ending 12-31-2020 C Name of orgamzanon
Temrcula Valiey H:gh SchoolGolden Bear Foundation
Number and street (or' P O. box, tf mail
PO Box 892072
City or town, state or province, country
Temecula, CA 925892072
is riot delivered to street address)
or foreign Postal code
u cmpfoyer wentmcatron number
E Telephone number
F Group Exemption
Number ►
G Accounting Method: RlCash ❑ Accrual Other (specify) ► H Check ► 21 if the organization is not
required to attach Schedule B
I 1Rfebslte: ►WwW.TVGBFAOM
(Form 990, 990-EZ, or 990-PF).

I Tax-exempt status (check only one) - 10 SQl{C]{3] © 501(c)( ) ■ (Insert no.) R 4947(a)(1) or ❑ 527 K Form of organization: 121 Corporation ❑ Trust ❑ Association ❑ Other L Add lines Sb, 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 (B) below) are $SOO,000 or more, file Form 990 instead of Form 990-EZ . . . . . . . . . . . . . ► $ 117,751 Revenuer Expenses, and Changes in Net Assets or Fund Balances (see the instructions Check if the organization used Schedule 0 to respond to any question in this Part I , for Part
1 I)
, ❑p
115,023
1 Contributions, gifts, grants, and similar amounts received . . . . . . . . . . . . . . . . 2 Program service revenue including government fees and contracts . . . . . . . . . . . . . . . . 2 3 Membership dues and assessments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Investment income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Sa Gross amount from sale of assets other than inventory . . . . . . . Sa b Less: cost or other basis and sales expenses . . . . . . . . . . . . Sh c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line Sa) . . . . . .

Sc
6 Gaming and fundraising events
a Gross income from gaming (attach Schedule G if greater than $15,000) 6a 2,728 b Gross income from fundraising events (not including $ of contributions from fundraising events reported on line 1) (attach Schedule G if the sum of such gross income and contributions exceeds $15,000) 6b c Less: direct expenses from gaming and fundraising events 6c 2,573 d Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c) 6d
1,155
7a Gross sales of inventory, less returns and allowances . . . . . . 7a b Less: cost of goods sold . . . . . . . . . . . . . 7b c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) . . . . . . . . . 7c
8 Other revenue (describe in Schedule O) . . . . . . . . . . . . . . . . . . . . 8 9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 . . . . . . . . ► 9 116,178
10 Grants and similar amounts paid (list in Schedule O) . . . . . . . . . . . . . . . . 10 6,750
11 Benefits paid to or for members . . . . . . . . . . . . . . . . . . . . . . 11 12 Salaries, other compensation, and employee benefits . . . . . , . . . . . . , . . . 12 13 Professional fees and other payments to independent contractors . . . . . . . . . . . . 13 U
m
14 Occupancy, rent, utilities, and maintenance . . . . . . . . . . . . . . . 14 w
publications, postage, and shipping .
15 Printing,. . . . . . . . . . .
15 173
16 Other expenses (describe in Schedule 0) . . . . . . . . . . . . . . . . . . . 16 134,454
17 Total expenses. Add lines SO through 16 . . . . . . ► 17 141,377
r
18 Excess or (deficit) for the year (Subtract line 17 from line 9) . . . . . . . . . . 19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with 18 -25,199
end -of -year figure reported on prior year's return) . . . . . . . . . . . . . . . . . 19 225,605
w
Z
20 Other changes in net assets or fund balances (explain in Schedule O) . . . . . . . . . . . 21 Net assets or fund balances at end of year. Combine lines 18 through 20 . . . . . . . . . . 20 1,940
21 202,346
For Paperwork Reduction Act Notice, see the separate instructions. Cat. No, 10642I Form 990-EZ (2020)

FY 2022/2023

COMMUNITY SERVICE FUNDING

REINVESTMENT IN TEMECULA
GRANT APPLICATION #
15!5

TEMECULA VALLEY

PLAYHOUSE

CITY OF TE ECUTA
FISCAL YEAR 2022.2023

COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA

PROGRAM APPLICATION
(Please Print or Type)
DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022

PROJECT/PROGRAM INFORMATION
Amount Requested: $ 47,000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: TEMECULA TALENT REVIVED! Start Date: 7/1/22 End Date: 6/30/24 Physical Address of Project/Program: 42051 Main Street Temecula CA 92590 OTTCT INCLUDE IF DIFFERENT THAN ORGANIZATION's MAILING ADDRESS If Grant is Awarded, Make Check Payable to: Temecula Valley P a ho Temecula Vglley Players Mailing Address:

ORGANIZATION AND GEOGRAPHIC AREA SERVED
Name of Applicant
Organization: Jemecula Valw PlayhoUse Year Founded: 6/10/1983 Website: temeculavalleyplayers.com Social Media: FaceBook, Instagram, YouTube Number of Paid Staff: 0 Number of Volunteers: 16 year round; 30 at ea. production Geographic Area(s) the Organization Serves: Temecula, Murrieta, Menifee, and surrounding areas.

Geographic Area(s) the Pra"ect/Pro ram Serves: All of Temecula, incorporated and unincor rated.

NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE LCL_USI JELY USED TO SERVE TEMECULA.

Contact Name: Lisa Wunderlich Title/Position: Board Mernber/Dire t r Contact Person's Direct Telephone. 951-704-570 _ Contact Person's Email: I.wt�nderlich1 —vverizon.net

NONPROFIT STATUS
Is this organization incorporated as a nonprofit? Yes ® Date of Incorporation as a Nonprofit: 7/23/91 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Federal Identification Number: 33-0008806 State Identification Number: C1144097 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS:

1. ® Attach IRS Deductibility Status using this link: htt ://a s.irs. ov/a /eos/ See attached.

2. ® Attach State Entity Status Letter using this link:
litt s:// www.Ftb.ca . ov online/self serve entity status letterlindex.asp See attached.

3. ® Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: htt ://rct.dli .ca. ❑v/Verification/Web/Search.as x?facilit =Y See attached.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13

APPLICATION AUTHORIZATION
Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No 0 Yes ❑ IF YES, BRIEFLY DESCRIBE:

Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No ® Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION:

N/A. - - —
This Application has been authorized by the organization's:

Executive Committee ® Board of Directors
Members -at -Large ❑

MISSION STATEMENT OF ORGANIZATION
BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES.

The Mission of the Temecula Valley Players is to entertain, enrich, and educate our community and surrounding communities, especially our youth, through exceptional theatrical performance, education and appreciation for and of the arts in theatre. ( https://temeculavalleyplayers.com/) Temecula Valley Players (TVP) includes youth and adults of all backgrounds, socio-economic statuses, and ethnicities, and provides them with the opportunity to be part of a Broadway -style show with high production values where they work with professional directors, voice teachers, choreographers, designers, and technical crews TVP is Diversity, Equity, and Inclusion committed. Educating and inspiring our youth is what we care about the most. Through live theater, we teach them core social values to help shape a brighter future. TVP recently implemented a new program for youth, the Guest Education Artist Program. Thus far, three youth have been a part of the program in order to learn more about an area of interest and gain hands-on experience. To see more about these youth, go to: https://temeculavaIleyplayers.com/tvp-youth/ . Our objective is to showcase the incredible talent that is here in the Temecula community. Temecula residents need travel no further than Main Street in their own city to see a live performance Broadway -style show.

FINANCIAL STATEMENTS

UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW.

FVP is able to provide Financial Statements upon request.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13

FUNDING SOURCES 1
CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑X Yes ❑ IF YES, PROVIDE BELOW.

NAME OF PROGRAM/PROJECT AMOUNT MONTH + YEAR NAME OF CITY GRANT

FUNDED BY THE CITY GRANTOR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP $
$
OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? NO ® Yes ❑
IF YES, PROVIDE INFORMATION IN TABLE BELOW.

AMOUNT

NAME OF ENITY
MONTH + YEAR

RECEIVED
_—
J
I �4

FUNDING RECEIVED
$ N/A.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13

GRANT PROJECT/PROGRAM DESCRIPTION

IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT

FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT. the Project, TEMECULA TALENT REVIVED! will Focus on three areas for five productions annually performed in th-e 71d Town Temecula Community Theatre (OTTCT) during FYs 22/23 and 23/24: 1) Recruiting additional talent from remecula to the OTTCT stage in the form of actors, directors, musical directors, choreographers, stage managers, ighting and sound designers, set builders, prop managers, musicians, and all other aspects of theatre for productions.

Ne will recruit talent from Temecula for all positions prior to selecting talent from outside; 2) Defraying all costs for tctors from Temecula cast in shows so that paying membership fees, libretto deposits, portions of costuming, etc, will iot preclude actors from any socio-economic background from performing; and 3) Offering discounts of 15% to all Femecula residents, and free tickets to Temecula Foster Youth and Group Home Youth. TVP has been enriching the Femecula Valley with live productions since 1983. We have been a resident theatre company at OTTCT since its )pening in 2006. Temecula is incredibly rich in talent. With this project, our goal is to increase the number of actors, :restive team members, other crew, and attending audience from Temecula by 20%, Our productions for this season nclude West Side Story, A Christmas Carol, Daddy's ❑ in Who's Got the Will, Godspell, and Oliver. A proximate)

2.000+ attendees see our productions annually; we want to expand our reach In Temecula with this project. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.

ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT.

VIECULA TALENT REVIVED} grant funding will be spent on: 1) Advertising and Community 0 trea& to Temecula !dents via social media. local newspapers, local radio, show Production Bills, at the box office, and in -person visits to iior and Group Home communities; 2) Subsidizing the loss of TVP ticket revenue for residents of Temecula, and for drenlyouth in Foster Care and Group Homes given discount rates and free tickets; 3) Paying all production costs for Temecula actor cast in productions; 4) Renting equipment and facilities for OTTCT performances from Temecula inesses whenever possible (this includes but is not limited to: using Temecula Penske truck rental for load-in/load-out, tal space at the OTTCT for rehearsals, rental of the OTTCT stage and their special equipment for performances, and Dr rental and equipment; 5) Purchasing set building items (lumber, paint, brushes, rollers, nails, screws, casters, etc.), decorating items, batteries (for microphones), props, costumes (TVP often uses thrift stores such as Salvation Army fabric from JoAnn's) from Temecula businesses whenever possible; and 6) Providing food and drinks (no alcohol) to cast after their last production performance at their cast party in a Temecula establishment; and 7) Renting rophones as needed for Temecula actors. Please see the List of Project Expense on page 10 for a breakdown. 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.

I emecula residents will benefit from the project as they will be recruited/selected first for the Creative Team, crew, and performers in our season productions. When TVP has two or more equally qualified persons for a position. a Temeculan will be selected when available. This will highlight talent in Temecula and encourage Temeculans to share their talent in their own community. Performers in TVP productions learn from professionals as our creative teams are active in the industry TVP actors, especially youth, learn professionalism in every aspect of theatre whether they want to build sets„ sew costumes, or manage a stage. Please note: many Temecula youth who called TVP their home have gone on to become industry professionals themselves. Again, there will be no costs for Temecula actors removing financial impediments to performing. Temecula residents will benefit as their ticket costs will be reduced or free; they need only show ID with a Temecula address at the box office. This also serves to acquire accurate numbers for residents who benefit from the. program for grant auditing/reporting purposes- We have designed a system to gather accurate information for auditing and reporting. Research has proven that theatre benefits the community by teaching empathy, creating strong communicators, encouraging creative thinking/problem solving, building collaboration and teamwork, relieving stress, and more. Temecula businesses will benefit as needs for shows will be purchased in Temecula.

Restaurants and -other businesses -close to ffTfE-T will -benefit -from theatre -goers. 12500 FROM THIS PROJECT/PROGRAM:# based on attendance for disc/free tickets, business, creati 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM:
# based on persons who volunteer during productions and does not include Board Members, Conn members, and Creative team who also volunteer during this time. team, actors, etc.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13

PROJECT/PROGRAM DESCRIPTION

CONTINUED
4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.

TEMECULA TALENT REVIVED! benefits the Temecula Community by recruiting local talent first, making ticket prices more affordable for local residents, and spending funding In the Temecula businesses community for production needs TVP is a non-profit organization and has been a presence in the Temecula Valley for four decades.
5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC

AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS.

F
TVP completely shut down 3/20 through 8/21 during the pandemic. Our ability to serve the community was nearly non- existent and remaining shows for the 19120 season were canceled. All five productions for our 20/21 season were canceled. Our revenue comes predominantly from ticket sales and the financial loss was devastating (see attached 990 from 2020). Revenue was reduced from a $190,000 annual average to $17,881. If requested, TVP will provide prior 990s to demonstrate pre -pandemic revenue To remain solvent, we closed our warehouse and rented local storage for items required in future productions. Warehouse inventory was donated, or stored at the private residences of Board Members. TVP has performed in the Temecula Valley since 1983 and hopes this longevity confirms our ability to manage finances well. We have a substantial volunteer base and all Board Members volunteer 10-15 hours per week year round; we have no salaried employees. Although tickets for TVP quality shows (see numerous ITL awards at:
inlandtheatreleague.orgl) are priced lower than any local theatre group, we have not recovered pre-COVID attendance numbers. An article in the NY Times addresses this lack of post-COVID theatre attendance on a national level (see:
nytimes.com/2022/08/21/arts/performing-arts-pandemic-attendance). After receiving small SBA and CAC grants, TVP successfully reopened and served the Temecula community again with a full (5 shows) 21/22 season, but with an 8% attendance decrease. We are kicking off our 22/23 season with West Side Story on 9/2. We feel that inflation is decreasing-dL%cr-P-tion any-i n come-for-theatre-attendance--Through-TE M EC U LA -TAL ENTREV.Iu1=Di-wr�hn❑a-tase.tm- 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL:
(1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM.

TVP is applying for more than $5,000 to create the project, TEMECULA TALENT REVIVED! The residents and businesses of Temecula will benefit as detailed in Sections 1 through 3. Temecula actors will learn from industry professionals (local whenever possiblel committed to cultivating quality theatre performers by offering an experienced level of training in a safe and supportive environment. Actors will receive intensive instruction in all areas of theatre:
direction, musical direction. and choreography. TVP will measure the positive impact of the activities proposed via quality assessments completed at regular intervals by the director, musical director, and choreographer of each production. By production end, actors will receive an evaluation detailing their individual growth in the three areas described above. As part of the evaluation, actors will receive feedback on their individual work, teamwork, and any independent reviews received from audience members, as appropriate. Audiences will be encouraged to provide feedback on all aspects of productions including- actor quality (acting, vocal, and dance capabilities), direction. musical direction, choreography, and technical features such as lighting, costumes, sound, and set. TVP receives audience feedback directly, or via email, FaceBook, and Instagram. TVP Board Members are present at each show and make themselves personally available for audience feedback. Audience feedback is used for continuous improvement fi5r�tar�mmtmitr�Tt/P�vi1f activsl�t�ltNate part��ers�trrtlrg-trtt5UrnMT-A"tlslrTVlJrrdralsln5 F,-and oirrer grant opportunities in order to sustain the project after grant funding has ended.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13

PROJECT/PROGRAM BUDGET (do not fill In shaded areas)

LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount of money requested from this City of Temecula I $ 47,000 Community Services Grant (Not to exceed $50,000) '
Amount contributed to the Project/Program by the $ 85,000 Applicant Organization: stipends to Creative Team ($40K per season), Stage Labor at OTTCT ($45K per season)
Other grants or funding already awarded for Project/Program, if any $ 0 In -Kind match amount or volunteer credit hours estimated amount _ i_ ..
5,700 hours
TOTAL REVENUE 1 $132,000

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment Microphone rental, other rental equipment for 5 shows from Temecula businesses whenever possible.
$12,800
At OTTCT: Rehearsal space rental, stage rental, FOH
Facilities/Rent/Insurance Fees, Ticket Office Fees, Stage Equipment Fees $55,800
Supplies Set building: lumber, paint, brushes, nails, screws, etc. Set decorating items, props, etc. to be purchased from Temecula businesses. $ 24,500
Ads in: local papers, local radio, show bills, at the box office, and Marketing visits to senior homes and centers,
$ 10,000
Subsidize TVP loss of revenue for discount/free tickets. Estimate 2,400 Services discount tickets at 15% x $25 = $9,000.00 and 50 free at $25 = $1,250.00 $ 10,250
Food For cast parties at show closure to be held at Temecula establishments.

Estimate $600/production.
$ 3000
Truck Rental (Temecula Penske), mic batteries, costuming, production fees, Other and misc. (Temecula actors only).
$ 15,650
Staffing Expense THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; HOWEVER PLEASE INCLUDE.
$ 0

TOTAL EXPENSES
$ 132,000

TOTAL BUDGET
$132,000
$
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13

PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT
IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE.

If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information.

If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper rack -up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent.

If the funds were not spent in accordance with the approvedlawarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022.

1. Fill out table below (make additional copies if needed to explain all expenditures.)

2. Attach copies of receipts/invoices (in the same order as listed in this table.)

3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office— CSF EXPENDITURE REPORT due on or before September 12, 2022
Organization: _Temecula VallPv Pl.a.vers Name of Project/Program: _NIA FY 2021-2022 Amount of $ 0
CSF Grant Fund Awarded: Month & Year CSF Grant Received from City:

Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not i have precise number):

E Date on _ Expenditure
Name of Company Receipt/Invoice 1i1I Description Purpose a .. on Receipt or Invoice MUST BE ON OR BETWEEN Amount DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE JULY 1. 2021 - JUNE 30. 2022
$
2 3
4 5
6 EXPENDITURE TOTAL EXPENDITURE TOTAL MUST BE EQUAL TO
(OR GREATER) THAN TOTAL AWARD AMOUNT_
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13

FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT
If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the C ity of Temecula, follow these instructions.

If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approvedlawarded application, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation Including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page,

1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures.

A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.)
B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To recr,ivu qi ant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (lout no less than $10.000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds.

2. Attach copies of receipts/invoices (in the same order listed in table below).

3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula" Organization:
1 TOTAL FY 2022-2023
Amount of Grant Fund Awarded:

EXPENDITURE REPORT DATED
Name of Project/Program;
Month & Year FIRST $5,000 check
was received from City:

1. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted).

2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City

3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ _ Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this ProgramlProject (approximate number of beneficiaries if you do not have precise number) E
E a Name of Company
E on Receipt or Invoice
aZ I
1 2 I--
3 Date on
Receipt/Invoice

MUST BE ON OR BETWEEN
March 20, 2020 - JUNE 30,
2024
Expenditure

MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER EXPENDITURE TOTAL $
Amount
Description I Purpose

EXPENDITURE TOTAL
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13

ACKNOWLEDGEMENT/SIGNATURE PAGE
The applicant acknowledges and agrees to the following:

Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements.
• Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval, Please allow time for checks to be processed.
• The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula.

Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot.
• The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete.

I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief.

ORGANIZATION NAME: —TemQgula Valle PI housedba Temecula Valley Players MAILING ADDRESS: po Box 1293
Temecula CA 92593
PRESIDENT / AUTHORIZED OFFICER: Lisa S Vsluh2erlich
SIGNA
IF DIFFERENTT�N ABOVE,
APPICATION PREPARED BY.

PHONE: ( 714 ) 932-2215
EMAIL: Imunderlich1(Mverizon.net
Board Member/Director
TE: 8 3A 22

MONTH, DAY, YEAR
PRINT NAME T'r' E
SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO:

City of Temecula
Community Service Funding
Attn: City Manager's Office
41000 MAIN STREET
TEMECULA, CA 92590
Questions: Stacey. [email protected] (951) 694-6413
Betsy. [email protected] (951) 693-3959
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
FTB PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 8/8/2022
ESL ID: 2128036581
Why You Received This Letter
According to our records, the following entity information is true and accurate as of the date of this letter.

Entity ID: 1144097
Entity Name: TEMECULA VALLEY PLAYHOUSE
❑X 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. ❑X 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 through the Franchise Tax Board Administrative Dissolution process.

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

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INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY

DISTRICT DIRECTOR
2 CUPANIA CIRCLE
MONTEREY PARK, CA ?1754
Employer Identification Number:
33-000ET06
Date: JUL. 23, 1991 Case Number:
951162039
3U77ERIELD STAGE PLAYER, Contact Person:

PO BOX 74 AHMFP AHMFP
7EM ECULA, CA 92390 Contact Telephone Number:
(213) 725-7876
Accou.ritina Period Endings
pccemher 31
Foundation Status Classification:

S09ia)(27
Advance Ru1inn Period Begins:

Der. 13, 1990
Advance Ruling Period Ends:

Dec. 31., t994
Addendum Applies:

Y fr s
Dear Applicant.:

Based on information supplied, and assuming your operations will be as e.tated i,ri ,your application for ron cnnition of e�xemotion, we hive determined You are exempt from Federal income tax under section 501(a) of the internal Rev,anik.e Cods as 111 r,rilanizati,n descrih(rd in r:�r.tion 501(c)(3).

Because you are a newly created organization, we are riot now making .a final ne+ermi.n� tion of your foundMion state_• r.indr:r ar ctiori `109(a) of the mode. however, use nave ceter.mined that you can reasonably be expected to be a nlshl.ir.l.y nrgaiiizat.ion deicri.hed in -',actinn 509(.1)(2.).

Accordingly, you wil: be treated as a publicly supported organisation, and not as a private fnLlnddtion, durinp. an advance rUlirin of'ricid. Thi advance ruling period begins and ends on the dates shown above. i,'ithin 90 days after the end _�f your advance ruling period, you must S-uhrii t to urn i nfortgat i or1 T1eOded to drtr-rmirir whether You have mei the rF..,C�, ' re- ments of the applicable support test during the advance ruling period. If you k• t.ahlish thak you have hp?n i nublir:ly suodort?d orn-3ni7ation, v,nu will be classified as a section 509(a)(1) or 509(a)(2) organization as long as you con- tinur• to meat the rFn_lirwment-- ;,f this aonl.irahle sunnort test. Tf you do not meet the public support requirements during the advance ruling period, you will h:a r_lagsified a•, a 'irivat>I found<tion for futures neriods. Al.o, if you ars classified as a private foundatior;; you will be treated as a private foundation from they date of your lnrpption f(If nuToosos, nf sections 507(d) and 4940.

Grantors and contributors may rely on the determination that you. are not a private foundati,i)n n.nfil. 94 day after the end of your idvanco ru.lil5q or:rlod. if you submit the required informetion within the 90 days, grantors and contri- butors moy continLre to Fely nn thc• advance dPterminat.icni until the' Service Letter 1045(CG)

_2-

BUTTERFIELD STAGE PLAYERS
vanes a final determination of your foundation status.

If rjotice that ,vou 41i1i no loriger CIE' treated as a publicly S,UPPC,rteO Dr- til�n).7.afir�n l�. nUh)7. hE'ri )n tllr Jrltrrrlal, F'�'vQilil�' Fullatin., cir.-ITitort. .1nd CU-z- tr:outors may not rely on this determination after the date of such publica- tiQll, In .iiiiii-ti.nn, '•.h yr)l.l ln,:? ,,our statU,•- aS •4 oublicly ',uogorfed orllaniZd- :1�n arld a grantor or contributor was responsible for, or w'ss aware of, the act or failure to act, the=t resulted in vnur lo_s of :.u.cfil st'(tWs th_I, r,e,rs,tln m.a:
rot rely on this determination from the daTe of the act or failure to act.

Ak;o, i.'i a 7rani'Or or I'nnti-i.butur le•irll:ali th•it the S,rv.rn harl nii5n v)Fice that you, vioul0 be removed from cIaa.sification as i pubIicIy supported orgarlila- tin'i1; thlrn that die-c-cln may ncnt. 'rr,lti' i,rl JhIjF. drtcrmi.il?ticrl a, of the date ':• lch Y._r1%oso ee ge Was a g1Ai red.

If yaur •sourceS of Support, or your purposes, character, or method of operati•nn chaTi(ie, n)e,;FP Iet us i:r•:-iu) so we can consider the. effect of the change on )four exempt status and foundation status. In the case of an amend- ment to yOl.lr nYgani.Zatinn,31• dorument or byl.riw,, ole.3s, `iOrld 11'5 a c'MV of t`!'-' amended docuf,ient or byl;)Ws. ;iIso, you should inforn us of all changes in your name: or addre iks-.

A:: of .ianuary 1, 1984, you are liable for taxes unaer the Federal Insu.r- 3nl;c? Contribul ions Act (,inr_i,jl• cr.cijrity t):«5) or, romliner.ation of $t00 fir mOT9 you- pay to eacn of your employees during a calendar year. You are not liable for the. tax innsa•'d under the' Fedr-rnl Untmoinyme'nt Tax Art (FUTA), Org:anizacion= that are not private foundations are not subject to the pri- vate 'faun atirn exri'.ir- t.j; tinnt• about vxriG.e, ennjoyment, or othl,r Federal taxF m, Ole +.. if you are ;.ot Letter 1095(CG)

-3-
8UTTERFIELD STAGE PLAYERS
required to file, simply attach the label provided, check the box in the head- ing to indicate }hat your 4nna,;1 :grog-; rFr_=iot; era normally $25.000 ni• less. and sign the return.

If a return is required, it must be filed by the i5th day of tii� Fifth month after the end of your iuniA-il •a,:count.inn period. A oerialty of `' W o day is charged when a return is filed late, unless there is reasonable cause for the delay. However, the, maximun nF,nelty rharaed cannot rxcved V5.000 or 5 per- cent of your gross receipts for the year, whichever is less. This penalty may al,n he: charged ).f a return is not comolet.e., ,so pl?a3A be lure your return is complete before you file it.

You are not required to file Federal income tax returns unless you are suh jert to the tax on unrelated income under sar_t,ir)n 51l of thr load?. if ycu are sunject to this tax, yOu mu=..t file an income tax return on Form 990-T, Exempt Organi7atiOn Ati•si.nf-s•r• Income Tax Return. Jn this IF-tter we are not oetermining whether any of your present or proposed activities are unre- lated trade or husin?•3S :as d?fined in sei:tion S13 of the Code.

You need an employer identification nur;jer even if you have no employees.

Tf an employer identification number wos noS entered on Your aoulic.ation, number will be assigned to you ano you will be advised of it. Please use that number on all returns ynu fi•l.i .and in all corro;nonrirnce with th•? intprnal ,rvenue Service.
,+;e iro:iceted in ;:o:- h.=adinq of this letter that an addendum An g 1.i_e? _. Fhe iddendijm ''nr 1.05.;r1 '. i in i nt iaril oa rt of thin, IF.'ttnr.

Secause t:hi 'Letter could help resolve any questions about your exempt 1:A,itus-, ;rid fcovi6?t)nn �Jt itus, you '•hOLLlii 41-PO it In Your Dermaiient rF•cDrd. we �d'v'N Sent a copy of thi=. letter to your representative as indicated in ynlir power of attornriv.

If you nave ariY OU.e!Sti0n5-, plE'a•ae contact ine person whose name and tolep)one nurrlbr-r re, ?�hown in the hpadinr of thi- letter.

Enclosure(s):

Addendum
-orm 872-C
Sincerely yours, .,r,
Michael J. Quinn
District Director
Letter 1045(CG)

-4-
i;UiTER'rIELD STAGE PLAYERS
Due to the notification requirements of section 508(a) of the Code, the effiactive date of thi,-a 10,ker t.> D�?r.. 13. 19^0. thu d.ato coon which vjE- received your appiication. Contributions to you are deductible only if made on or aftE?r that date. Yo!t havp nrevinur-]y eorced to that r'ffective, date.

Letter 1045(CG)

Short Form I ome,:.1__.::::>:

Form 990-EZ Return of Organization Exempt From Income Tax 2020 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. Open to Public Department of the Treasury 0-Go to wwwJrs.gov1Form990EZfor instructions and the latest information. Inspection A For the 2020 calendar year, or tax year beginning 0 9-01 2020, and endin 08-31 12023.

B Check If applicable: C Name or organization D Employer identification number ❑ Address change T]i CULA VALLEY PLAYHOUSE 33-0008806
❑ Name change Number and street (or P.O, box if mail is not delivered to street address) Room/suite E Telephone number ❑ Initial return
❑Finalretum/terminated PO BOX 129A 00rI►ce0_a"o
V Amended return
11AppllcallonpondlN
y or town, state or province, country, and ZIP or foreign postal code bemecula,CA 92593
F Group Exemption
1 Number ►
G
Accounting Method: N Cash Accrual Other (specify) ► H Check ► 0 if the organization is not
1 Website: ► WWw, TEMECULAVALLEYPLAYERS . CON required to attach Schedule B
J
Tax-exempt status (chock only one) • W501(�gsL sflt ■ nsettna. ❑ ,+s,s�s1 or 527 (Farm 990, Form of organization: ® Corporation ❑ Trust Association Other 990-EZ, or 990-PF).

K
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
Part
II, column B are $500,000 or more, file Form 990 instead of Form 990-EZ I Revenue, Expenses, and Changes in Net Assets or fund Balances(see the instructions Check if the or anization used Schedule O to res oonnd to anyquestion in this Part I ................ 1 Contributions, gifts, grants, and similar amounts received . .. ............ .......... . ► $ 17,881
for Part 1)
, . .
1 5 911
2 Program service revenue including government fees and contracts ....... . ... . . . . . ...... 2 3 Membership dues and assessments .. .. . ... .......... . .... I .... ...... 3 830
4 4 Investment income .. ...... .... .. ....... . . . .. •' . .. . ... . . 5a Gross amount from sale of assets other than inventory .... .. . ....

CD
CC
_5a
b Less: cost or other basis and sales expenses . ....... , ...... .. 5b c Gain or (loss) from sale of assets other than inventory (subtract li A 5b from Ifne 5a) ...... ... 6 Gaming and fundraising events:
a Gross income from gaming (attach Schedule G if greater than ff $15,000) .. .. ... . .. . ... ...... 6a 1
b Gross income from fundraising events (not including $ of contributions An,
from fundraising events reported on line 1) (attach Schedfslo G 4 the fir080
sum of such gross income and contributions exceeds $15,000) ......... H6c c Less: direct expenses from gaming and fundr�ising events • ...... .... 12,479 d Net income or (loss) from gaming and fundrr5ising events (add lines 6a and 6b and subtract Sc
line 6c)............. ... .................... ' • . ......... sd
----(6,,399)
7a Gross sales of inventory, less relurnsand allowances ....... , ...... 7a b Less: cost of goods sold . .. r. . I .. - ........ .. .... 7b c Gross profit or (loss) from sales of inventory (subtract line 7b from line 7a) • . ................ 7c
8 Other revenue (describe 1n Scfseduie o') ... .......... . . . . . . . ...... . . . .... . 8 5,000
9 Total revenue, Add lines f, 2, 3, 4, 5c, Ed, 7c, and 8 . .... . ► 10 Grants and similar.amounts pajd (list in;Schedule O) .. . . . . . . ..... ....... ...... 9 5,402
10 11 Benefits paid to or for members .. . . . . . . . . . . . . . . . . . . . ... . . ... . . . ... .. . 11 7,000
H
v,
C
w
12 Salaries, other compensatton and employee benefits . . . . . . . . . .. . .. . .. .. . . . ...... 13 Professional fees and other payments to independent contractors ...... ................ 14 Occupancy, rent, utilities, and maintenance ............. ... ............... 15 Printing, publications, postage, and shipping . ............................... 12 13
14 _500
_
is 109.,
15 3,721
16 Other 9xpenses (describe in Schedule O)................................ 17 Total expenses. Add lines 10 through 16. . . ►
16 3 325
17 is
32555
27 253)
N!
a
Z20
18 Excess or (deficit) for the year (subtract line 17 from line 9) ......................... 19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with end -of -year figure reported on prior year's return) . ...... ..... . ..... . . . .........

Other changes in net assets or fund balances (explain in Schedule O) ... . . . . .. . . ... . . . . . . 21 Net assets or fund balances at end of year. Combine lines 18 thr h 20 .. IN. 19 27 018)
20 21
(54,271)
For Paperwork Reduction Act Notice, see the separate instructions. Form 990-EZ (2020) EEA

r
2949226800916
Short Form OMB No 1545-0047
Form 990-EZ Return of Organization Exempt From Income Tax �01 - Under section 501(c), 527, or 4947ta)(1) of the Internal Revenue Code (except private foundations) Oepartmonl of the Treasury
Inferno! novenue sarime
A For the 2019 calendar
S Check ifapplicable [
❑ Aedress change T,
❑ Name change !;
❑ Initial return
❑ Final retundterrnmated �Pc
❑ Amended return
► Do not enter social security numbers on this form, as rt may be made publics `� IN, Go to www.irs.gov/Form99OEZ for instructions and the latest information, /1c 4 , or tax year beginning September 01 , 2019, and ending August 31 .20 20 no of organize Iion I D Employer identification number
da Vall2y Pla house, dba Temecula Valley Players
end Street (or P O box if mall is not delivered to street addressl I Roorru'sulle I E Teiephone " nar 6�tl►[IL
or town, state or province, country, and ZIP or foreign postal rode F Group Exemption eculu, CA 02593.1293 1 Number ►
G Accounting Method: ❑• Cash ❑ Accrual Other (specify) W H Check ► n If the organization Is not I Webslte: No. www.temeculavalle pla ers.com required to attach Schedule B J 'fax -exempt status {check only one) — E 501ie2C3 ❑ 501 c) }0 [4ttsert no ) ❑ 494 Ta 1 or ❑527 1 (Form 990, 990-EZ, or 990-PF) K Form of organization Z corporation Ef Trust ❑ Association ❑ 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 11, column (B)) are $500,000 or more, file Form 990 instead of Form 990-EZ ► $ 169 581 Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part 1) Check if the organization used Schedule O to respond to any question in this Part I . ❑ 1 Contributions, gifts, grants, and similar amounts received 1 2, Program service revenue including government fees and contracts 2 3 Membership dues and assessments . 3 1.622
14 Investment income . . . 4
5a Gross amount from sale of assets other than inventory 5a_ b Less: cost or other basis and sales expenses . . . , . . , . :it) _ c Gain or (loss) from sale of assets other than inventory (subtract line 5b from line 5a) 5c -- 6 Gaming and fundraising events: COVED
a Gross income from gaming (attach Schedule G If greater than U' $15,000) . I sa _ FEB O 1 2021 °
b Gross income from fundraising events (not Including $ of contributions Q from fundraising events reported on line 1) (attach Schedule G If the �-_- sum of such gross Income and contributions exceeds $15,000) 1 6b 16,,gsg OGUEN, UT c Less- direct expenses from gaming and fundraising events' . Lee I145,056 d Net income or (loss) from gaming and fundralsing events (add lines 6a and 6b and subtract line 6c) . . . . . . . . . , . , . 6d 2Z.90i
7a Gross sales of inventory, less returns and allowances . . . 7a b Less: cost of goods sold . . . , . , 7b _
c Gross profit or (loss) from sales of inventory (subtract line 7b from line 7a) 7c 8 Other revenue (describe in Schedule O) . , . . . . . . . . 8 9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 ► 9 24.525 10 Grants and similar amounts paid (list in Schedule O) 10 11 Benefits paid to or for members . . . . , . . . 11
cm 12 Salaries, other compensation, and employee benefits . . . . 12 71400 N c 13 Professional fees and other payments to Independent contractors 13 1,073 tt9 L 14 Occupancy, rent, utilities, and maintenance 14 27,025 r-a 15 Printing, publications, postage, and shipping 15 258 lm 16 Other expenses (describe In Schedule O) S E 4 Start: _W►�rl�, 16 6,132 l- 17 Total expenses. Add lines 10 through 16 ► 17 41,880 18 Excess or (deficit) for the year (subtract line 17 from line 9) . . . . . . , 18 .17,363 ®l to 19 Net assets or fund balances at beginning of year (from fine 27, column (A)) (must agree with _ a end -of -year figure reported on prior year's return) . . . 19 .9.655 R. m 20 Other changes in net assets or fund balances (explain in Schedule O) . 20 `� Z 21 Net assets or fund balances at end of year Combine lines 18 through 20 ► 21 •27 018 C 7�
(J) For paperwork Reduction Act Notice, see the separate instructions. Cat No 106421 Form 990-iEZ (2019)

FY 2022/2023

COMMUNITY SERVICE FUNDING

REINVESTMENT IN TEMECULA
GRANT APPLICATION #
56 TEMECULA VALLEY

ROSE SOCIETY

Gi
CITY OF TEMI7CU11 A
FISCAL YEAR 2022.2023 5F� ll�
COMMUNITY SERVICE FUNDING - REINVESTMENT IN � E
PROGRAM APPLICATION a
(Please Print or Type)
DUE ON OR BEFORE: MONDAY, SEPTEMBER 1 2, 2022

PROJECT/PROGRAM INFORMATION
Amount Requested: $ 50,000
Project/Program Title:

MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION
Start Date: 2022 End Date: 3/2023
Physical Address of Project/Program: 30592 Jedediah Smith Rd., Temecula, CA

INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to:

Temecula Valley Rose Society
Mailing Address: PO BOX 890367
Temecula, CA

ORGANIZATION AND GEOGRAPHIC AREA SERVED
Name of Applicant Temecula Valley Rose
Organization: Society _ Year Founded: 1990
Website: temeculavalleyrosesociety.org Social Media: Facebook Number of Paid Staff. -0-
Number of Volunteers: 25
Geographic Area(s) the Organization Serves: Temecula
Geographic Area(s) the Project/Program Serves: Temecula NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA.

Contact Name: Virginia Boos Title/Position: President
Contact Person's Direct Telephone: 951-695-1689 Contact Person's Email: a rginiaboos@rocketem

NONPROFIT STATUS
Is this organization incorporated as a nonprofit? Yes E Date of Incorporation as a Nonprofit: 10-1990 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Federal Identification Number: 330428167
State Identification Number: 1570446
PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS:

1. p Attach IRS Deductibility Status using this link: httDJ/a17Ds.irs.aoylaapleosl

2. ® Attach State Entity Status Letter using this link:
httos:// www.ftb.ca.gov/onlinelself serve entity Status letter/indeX.ast]

3. I■D Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: htp;//rot.doi.ca.govNerification/Web/5earch.aspx?faciijty=Y r..ifv of TamPrtda Communitv Service Fundina - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13

APPLICATION AUTHORIZATION
Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No (i ] Yes ❑ IF YES, BRIEFLY DESCRIBE:

Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No " Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION:

This Application has been authorized by the organization's:

Executive Committee ❑ Board of Directors I!I Members -at -Large ❑

MISSION STATEMENT OF ORGANIZATION
BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES.

The Temecula Valley Rose Society was originally founded to encourage local citizens to enjoy roses, planting a rose garden on borrowed land. We now own the 3.4 acre property which is so much more than a rose garden, with many events and activities benefitting Temecula residents. Composting and soil building is taught, the Tree of Life garden offers children and adults lessons in gardening and nutrition, Eagle Scout projects thrive, pollinator and native plant areas are planned, the garden is a designated wildlife area. The beauty and spectacular view are enjoyed by Temecula visitors. Life events are photographed both personally and professionally. Our Board and volunteers will preserve this garden for many years to come.

FINANCIAL STATEMENTS

UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA's AUDIT, MAY BE NEEDED f UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. 1 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13

FUNDING SOURCES
CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ■ Yes ❑ IF YES, PROVIDE BELOW.

NAME OF PROGRAM/PROJECT MONTH + YEAR NAME OF CITY GRANT

FUNDED BY THE CITY GRANT OR SPONSORSHIP AMOUNT FUNDING RECEIVED OR SPONSORSHIP OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECT/PROGRAM IN THIS APPLICATION? NO ❑ Yes IF YES, PROVIDE INFORMATION IN TABLE BELOW.

AMOUNT MONTH + YEAR

NAME OF ENITY

RECEIVED FUNDING RECEIVED
$ -0- Roripaugh Family Foundation
$
I�
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13

GRANT PROJECT/PROGRAM DESCRIPTION

IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT

FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECTIPROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.

Program 1 - Peace and Friendship garden area, 6 peace poles with the message " May Peace Prevail on Earth", an effort begun in 1955 by a Japanese philosopher, after the destruction of WW2. The message is on each pole, in 42 languages, plus a Braille plaque.

Program 2 - Replacement of the garden gazebo, deteriorated after 25 years. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.

ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT.

Programl-Rose bushes, mulch, construction of pathways with maintenance, irrigation system and equipment with maintenance, 6 peace poles and shipping, addition of the message in 42 languages plus a Braille plaque, a display case to recognize donors.

Program 2-Gazebo unit, shipping, labor to install.
3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.

All citizens of Temecula, at whatever age, benefit from the Rose Haven Heritage Garden. From a simple family picnic, educational classes to learn about nutrition, gardening and composting, Eagle Scout projects, all the way to graduation celebrations and weddings, photography of life events, it's all here at this special place. Care and maintenance are done by local volunteers who enjoy the exercise and accomplishments. Our website encourages visits, tempting with many photos. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT 11500 FROM THIS PROJECT/PROGRAM:
3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 125 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13

PROJECT/PROGRAM DESCRIPTION

CONTINUED
4 SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS.

Program 1 - We join the world-wide Peace and Friendship movement, "May Peace Prevail on Earth", begun in 1955 by a Japanese philosopher, as a response to the WW2 destruction in Japan.

Program 2 - Replacement of the gazebo unit, due to deterioration of this 25-year-old structure, used for rental income, as well as visitors' enjoyment. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC !COMMUNITY.

FFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS.

Covid involvement changed everything. Meetings and activities for both adults and children were shut down. Outdoor meetings were attempted with little participation. Annual dues were not collected for 2021 resulting in a loss of revenue and membership interest.

I6
IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL:
(1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM.

Program 1 - Our Peace and Friendship garden area was initiated in 2020. It will need constant maintenance by our volunteers. A REDI presentation was well received by City officials in March 2022.

Program 2 - Our original decorative garden gazebo was installed about 25 years ago. It now needs to be replaced due to deterioration, as simple repair is not possible. This unit is important to us for income, as it is rented for family events, weddings, proposals. It is one of the main attractions for visitors, high on a hill for a spectacular view.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13

PROJECT/PROGRAM BUDGET (do not fill in shaded areas)

LINE ITEMS FOR PROJECT/PROGRAM REVENUES

EXPENSES

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount of money requested from this City of Temecula
$ 50,000
Community Services Grant (Not to exceed $50,000)
Amount contributed to the Project/Program by the Applicant $ 12,657
Organization
Other grants or funding already awarded for Project/Program, if any $ -0-
In -Kind match amount or volunteer credit hours estimated amount $ 43,816
TOTAL REVENUE $ 106,473

LIST OF EXPENSES FOR PROJECT/PROGRAM
Irrigation system, 6 peace poles, language
Tools/Equipment plaques $
Facilities/Rent/Insurance $
Roses, mulch
Supplies $
Marketing $
Services
$
Food
$
Other Pathways, donor recognition display case
$
Staffing Expense

THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT,
$_0_
HOWEVER PLEASE INCLUDE.
_ / d 4'3 G u S a TOTAL EXPENSES
$28,015
$107,729
$

TOTAL BUDGET
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13

PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT
IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21122 (LAST YEAR), THEN SKIP THIS PAGE.

If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information.

If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022, In audition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit andlor require additional back-up information to substantiate how funds received from the City were spent.

If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Yoar 2021-2029 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022. 1 _ Fill out table below (make additional copies if needed to explain all expenditures.)

2. Attach copies of receiptsJinvoices (in the same order as listed in this table.)

3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022
Temecula Valley Rose
Organization: Society
FY 2021-2022 Amount of $
CSF Grant Fund Awarded:

Name of Project/Program: _
Month & Year CSF Grant Received from City:

Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number):
c
Date on _ _ Expenditure
E Name of Company Receipt/lnvoice
on Receipt or Invoice MUST BE ON OR BETWEEN Amount I Description E ` JULY 1, 2021 - JUNE 30, 2022 ,ill, DESCRIBE THE EXPENDITURE 6 EXPENDITURE TOTAL
Purpose

PURPOSE OF EXPENDITURE

EXPENDITURE TOTAL MUST BE EQUAL TO
(OR GREATER) THAN TOTAL AWARD AMOUNT
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13

FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT
If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions.

If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page,

1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures.

A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.)
B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds.

2. Attach copies of receipts/invoices (in the same order listed in table below).

3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula"

EXPENDITURE REPORT DATED
Temecula Valley Rose
Organization: Name of Project/Program:Society
.

TOTAL FY 2022-2023 Month S Year FIRST $5,000 check
Amount of Grant Fund Awarded: $ was received from City:

1. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes, or No (already submitted).

2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City

3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) Date on
E Name of Company Receipt/Invoice

0.0 on Receipt or Invoice ! MUST BE ON OR BETWEEN
E March 20, 2020 - JUNE 30.

Q Z 2024
2 3
i

EXPENDITURE TOTAL
Expenditure
MUST SUPPORT PROJECT/PROGRAM IN APPLICATION $ AWARD LETTER 1 Description

EXPENDITURE TOTAL
Purpose
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13

ACKNOWLEDGEMENT/SIGNATURE PAGE
The applicant acknowledges and agrees to the following:
• Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements.
• Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval.

Please allow time for checks to be processed.
• The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot.
• The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete.

I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief.

ORGANIZATION NAME: Temecula Valley Rose Society
MAILING ADDRESS: PO Box 890367
Temecula, CA
PRESIDENT/AUTHORIZED OFFICER: Virginia Boos

PRINT NAME
PHONE: (951 695-1689
EMAIL: [email protected]
SIGNATURE: .t.t DATE:

IF DIFFERENT THAN ABOVE,
APPICATION PREPARED BY:

TITLE
9/12/2022
MONTH. DAY. YEAR

PRINT NAME TITLE
SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO:

City of Temecula
Community Service Funding
Attn: City Manager's Office
41000 MAIN STREET
TEMECULA, CA 92590
Questions: [email protected] (951) 694-6413
[email protected] (951) 693-3959
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
F T B PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/20/2022
ESL ID: 7848128431
Why You Received This Letter
According to our records, the following entity information is true and accurate as of the date of this letter.

Entity ID: 1570446
Entity Name: TEMECULA VALLEY ROSE SOCIETY
❑X 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,

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 through the Franchise Tax Board Administrative Dissolution process.

Important Information
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: ftb.ca.gov
Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States

ova a CrS / d o03
Department of The Treasury
American Rose Society
P.D. Box 30000
Shreveport, LA 71130
Dear Sir or Hadam,'
Internal Revenue Service
ED Croup 7401
Suite 11091 Stop 520
101 West Peachtree St.

Atlantae CA 30365
Person To Contact:

Kim Artis
Telephone Numberl
" W 331-1909
Refer Reply To: MAY 15 1992
E0 ! 7194: Ail
EIN: 31-1397710
Date: MAY 111992
Re have received and reviewed the amended or3anizing documents that you submitted on behalf of your organization, in which the organizing documents were approved and/or adopted an 3/20/92 and 3/26/92. This inforr*ation has been made a part of Your file,
Your organization shall continue to be recognized as exempt under Section 501(C)(03) of the Internal Revenue Coder effec- tive as of 06/83, You may continue to rely on this exemption until it is modifiedr terninated or revoked by the Internal Revenue Service,
Please continue to let us know of any changes in the purpose, character, method of operations name or address of your organization, This is a requirement for retaining your exempt status,
A copy of this letter should remain in your permanent records, as it may help resolve any question about Your exempt status, Thank you for your cooperation.
'Dine rely,
Ai
Y g nixations
Coordinator
. , ....v _. Li
REC-D
Le
■

In emal Revenue Service Deportment of the Treasury Aa -a- -, - 0 • f ' - /3 -jr- -( �--f
District
Director

AMERICAN RASE SOCIETY
Tls"'lEULA VALLEY RUSE sWCsTV
P.O. Bilk 34U 017
TMIMU9 A. CIL 4259"367
Dear Tor ---payer
3tIO M_ Las Angers Street. MS 7043
Los Angeles. CA 90012
Peisoe to Coda&
J6 aaxRAL:as
e epbone N tuber.
.Refer RePW to:

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ogle:

PERRUAPLY 74, 1993
EI : 33- 41428167
T!'_-7 ietter iS 1ii ias;xorse t:.: our cep uesr ivr g�- ewm-'_ =catt:s =7-g--z-d-ing the orb:: ra _^_a -cam
G C -6
ORS F�a
records ind_eare th-a r this orgy __zaz_,n~ wasrecog=:iZ('d GJ �T x:UGC f rcm c e -ra i ] 3:wC:a� under Gt �K.^_al Revenue 501(C' t o3 - Group exemptio-a numbe'_r 7044 has
The
been as-; ;Igned so zhe nrganizatic:: and ars sabot&_hates - I 4I�t� .atioi3 ZZtter �-�s�ed i -itm 1.9a1 , conk imi- s Cn be --ct effect.
a=- you need fu!:t:`r_er assi-sLarce, please cap_taa:t our offac az the above addr. ear. or teierhane wimber _
SIncereiy,
risciostrre A-Lai9ta-Itt

Confirmation
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 415/20219:40:31 AM.

Confirmation Number: 15TO44609509
Entity ID:

Entity Name:
1570446

TEMECULA VALLEY ROSE SOCIETY
Account Period Information
Account Period Beginning: 1/1/2020
Account Period Ending: 12/31/2020
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:$78761
This is not an amended return.

An IRS Form 1023/1024 is not pending.

Entity Information
FEIN:

Doing Business As:

Website Address:

Entity's Mailing Address
PO Box 890367
Florence Rafulowitz
Temecula CA 92589
Principal Officer's Information
Rebecca Weersing
PO Box 890367
Florence Rafulowitz
Temecula CA 92589
Contact Information
Name:

Phone:
330428167
Temecula Valley Rose Society
temeculavalley rosesociety.org
Florence Rafulowitz
9738733488
After we process your 199N e-Postcard, you may receive a bill if the three year gross receipt average is greater than the amount allowed for filing a 199N e-Postcard.
^Print j Log Out
- Q1
ILrA _1 , f /w✓ �J

-01 RS
Confirmation
Your Form 990-N(e-Postcard) has been submitted to the IRS • Organization Name: AMERICAN ROSE SOCIETY
• EIN:330428167
• Tax Year. 2020
• Tax Year Start Date: 01-01-2020
• Tax Year End Date: 12-31-2020
• Submission ID: 10065520210954481754
• Filing Status Date: 04-05-2021
• Filing Status: Pending
f `(60 6 3 0
,�o ----x-_ Or/ --aS 10663f
Note: FdW a copy of this filing for your records. Once you leave this page, you will not be able to do so.

MANAGE FORM 990-N SUBMISSIONS

a�aa-_o t-o5`loos/G
Form 9WN Electronic Notice (a -Postcard) OMB No. 1545-2085 Deoartroent of the Rmesury
internal Revondkf Servloo
fbr TWExemM Organbadw not Required to File Form 990 or M-EZ 2020 A For Ole 2020 Calendar year, or fax year bagtnnknq =Q&1:0 and ending 2020- M B Owdt If available
Q Termkwpd for Bwkwn
Q Qum rMwPfs wa nwarty tiSO,m orIas
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POBaxWM Temenuiit.
",U. 92M
F Name of Principal Ohioan. ItT+�[gs;gg
90-6y�INM. v
TEME -lu & r•_s uc. 92589
Open to Public Inspecticin
D Employee fdenti "Uon
Number 34428167
Pr(vacyAct and Paperwork Red"'J m Act Nedca; We osk Ivr the inrormahan on (his forth to carry out the Internal Revenue laws of the United States.

You era required to give)us the infarmafion. We need it to ensure that you We complying with these laws.

The organlzatlon Fa not required to provide inromlailon Mquesied on a form that is subject to the PaPerwolk Reduction Act unless OW reran dlspiays a valid OMB cenvot number. desks Or records Waling to a farm or its instructions must be reta[nod as tong as their Contents may become material in uw adminisvatlon of any Intnmal Revenue law. Tha nrles govemIng the confidentiality of the Form OWN is Covered in node section 6104.

The limo ndfoded to complete and file this form and related schedules wiN vary depending on the individual circumstances. The estimated average times Is 15 mmutos.

Note: This Image is provided rear your rocord■ only. Do Not mall this pays to the IRS. The IRS will not accept this filing via paper. you must file Your Form 99" (u-p*%tcard) alactmnIcWIY.

WIRS
Contact Information
�'© as-4 F"-G5-- / 06 33Y
fiQ= I,«t� ,merle I >QMI
e-Postcard Profile Select EIN Organisation Details Contact Infomaation Confirmation Electronic Notice -Form 990-N (e-Postcard)
Organization Address and Principal Officer Information
Organlzahon's legal name- l AMERICAN ROSE SOCIETY
If your organization conducts busyness using another name (DBA), enter other name:
= required field
Organization:

D9A Name
Temecula Valley Rose Society
DBA Name - continued
ENTER ADDrmNAL DBA NAMES
country
US - United States
v
Number and street (or Po eox).

PO Box 890367
City Orr~
Temecula
State'
CA - California
v
ZIP Code*
92589
oWntration'swebahawdreaa if.ppiicat,46
tem0u1avaIIayrris�,, ;81y

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AMERICAN ROSE S
P.O. Box 30,000 - Shreveport, Louisiana 71130-0030
8877 Jefferson Paige Road - Shreveport, Louisiana 71119-8817 Phone: 318-938-5402 - Fax: 318-938-5405 - www.ars.org
Date: March 1, 2019
From: American Rose Society
Chapter/Society Membership Services
Re: Federal Employer Identification Number (EIN)
The following information is for an affiliate of the American Rose Society, as assigned by the Internal Revenue Service.

Chapter/Society Name: Temecula Valley Rose Society
President: Virginia Boos, President
(951)-695-1689; [email protected].

Treasurer: Bonnie Bell
El Number: 33-0428167
CA FTB Number: 1570446
The Temecula Valley Rose Society is a subordinate of the American Rose Society and is in good standing with this organization.

The Temecula Valley Rose Society is exempt from federal income tax under the Group Exemption Number (GEN) of 7044.

The American Rose Society is recognized as a 501(c)3 organization by the IRS as are all of our subordinates in good standing.

r
TVRS
202Z oungE r.

Jan - Dec 22
Jan - Dec 22
irdinary Income T
Ordinary Expense
Income
Expense
4100 Interest -Savings

2.00 5100 Executive Committee
,4200 Member Donations
1 15103 Affiliate Insurance ARS
490.00
14230 Member Donations
400.00
$122 Insurance Directors & OfII
580.00
Total 4200 Member Donations
400.00
5123 P. O. Box rental
190.00
4300 Membership
5128 Supplies

70.00 1.4310 Membership Dues
1,500.00
5129 Telephone, Telecomm
300.00
4320 Nametags
240,00
.5135 Taxes and Fees

45.00 Total 4300 Membership

1.740.00
,5138 Square Processing Fee

52.00 4500 Program Income
Total 5100 Executive Committee
1,727.00
4515 Member Mtg Raffle
Total 4500 Program Income
550.00
,5200 Programs Committee
550.00
1 .5233 Member Meeting Room Rent
375.00
4600 Rose Haven Donations
;5234 Mbr Meeting Speaker Fees
200.00
4611 Photography/Photo Shoot

1.600.00
5235 ARS Programs Fee
125.00
4612 Reservation Donations
500.00
Total 5200 Programs Committee
700.00
4615 General Donations

1.250.00
5300 Membership Committee
4642 Landscape Maintenance Dona
15,350.00
21 Awards

60.00 4670 Visitor Donations
1,000.00
1!1�5330
22 Nametags
240.00
Total 4600 Rose Haven Donations

19.700.00
ARS Affiliate Dues

70.00 4700 Society Operations Donatio
Total 5300 Membership Committee
370.00
4710 Board Pledges
1,500.00
5600 Finance Committee
Total 4700 Society Operations Donatio
1,500.00
5540 Taz Preparation
250.00
4800 Ways & Means
'Total 5500 Finance Committee
250.00
4820 Stater Brothers Script
140.00
5700 Communications Committee
4822 Amazon -Smile
140.00
15710 Newsletter Print & Postage
300.00
Total 4800 Ways & Means
280.00
15730 Website - main TVRS
170.00
4840 Rose Haven Events
5740 Chamber of Commerce
300.00
4860 Special Events Proceeds

2.000.00
Total 5700 Communications Committee
770.00
4861 Garage Sales Proceeds
200.00
5800 Rose Haven Committee
Total 4840 Rose Haven Events
2,200.00
5812 Benches, Tables
500.00
Total Ordinary Income
26,372.00
5831 Annual Backflow Testing

50.00 5832 Irrigation Repair
1,000.00
Other Income
5833 Minor Maintenance
750.00
6010 Tree of Life Project

1.000.00
15334
Miscellaneous Supplies
500.00
$ ffgFPZa,-e-and� a%i p�` j-­ --
-.
--27,500:06
"
5835 Soil Amendments/Fertilizer
500.00
28,500.00
5836 Weed Supplies
400.00
5841 Non Rose/Tree Care
2,000.00
f
Total Income
64,872.00
5847 Landscape Maintenance
7,200.00
5848 Pond Maintenance
3,930.00
5851 APGA Membership
150.00
5852 Garden Insurance

1.275.00
5853 Porta-a-Potty
980.00
160.00
15854 Property Taxes
5065 Utilitties Vactric

1.000.00
5856 Utilities Water
1,500.00
5858 Internet Provider
660.00
Total 5800 Rose Haven Committee

22.555.00
v
Tote Ordinary Expense
26,372.00
Other Expense
701 RH Tree of life Exp
1,000.00
* 7019aPaace:arXd.rlendshlp•Exp --
'27,500.00
77 Total Expenses
28,600.00
12/17IZDZ 1
Net income 1
54,872.09
Q
e

Temecula Valley Rose Society
Checks, Auto -Pay, to Ratify
May 2022
Date
Num I Name
L-
Account
Amount
-J
JJ
12 Checks Issued from Check # 2940 to 2951, total $8.501.33 .06/0312022
2940
'White House Sanitation
15853 Porte -a -Potty
101.04
318.82
10510312022
2941
(Nancy Fitness
5834 Miscellaneous Supplies
105/10/2022
2942
Whisenhunt Communication
5670 Society bochures
325.00
05119/2022
2943
City of Temecula
5233 Member Meeting Room Rent
_
170.00
05/19/2022
2944
Agnardo Landscape
5847 Landscape Maintenance
600.00
05/19/2022
.2946
Temecula Trophy
5322 Nametegs
05/19/2022
2946
'Waterscape Creations. Inc.
;5848 Pond Maintenance
05/19/2022
2947
(Rolling Hills Construction
0f' �azalia'Project �'
*490.0Q
05/19/2022
2948
�Agriscape05/20/2022
2949
White House Sanitation
Park West
5853 Porta-a-Potty
�,[17 :Paa a:atrd i:riends>1ip-> x� `�
05/24/2022
2950
.05/24/2022
2951
Forest Bees
5637 Bees and Other Pests Contr
360.00
8,501.33
Electronic
Payment
Omega Print
05/09/2022
.Pay
5670 Society bochures
222.94
222.94
AutoPays
for Utilities:
05/23/2022
Autopay
Frontier Communications
5858 Internet Provider

65.87 05/27/2022
Autopay
Rancho California Water
5856 Utilities Water
126.39
05/03/2022
AutoPay
Southern California Edison
1 1,5655
Utililtles Electric
103.26
295.52
TOTAL
9,019.79
9,019.79

Temecula Valley Rose Society
Checks, Auto -Pay, to Ratify
April 2022
Num
Name
Account
Amount
5122 Insurance Directors & Offi
11 Checks issued: from check # 2929 to 2939, total = $4,874.14 .2929
Chubb
600.00
2930
'White House Sanitation
5853 Porta-a-Potty
101.04
2931
City of Temecula Library, Gen Meeting 5/22
5233 Member Meeting Room Rent

34.00 _ .
2932
2933
City of Temecula Library, Gen Meeting 6122
5233 Member Meeting Room Rent

34.00 Temecula Valley Pipe & Supply
W
•5832 Irrigation Repair
623.82
2934
]
Agnardo Landscape
5847 Landscape Maintenance
600.00
i
Agnardo Landscape
5836 Weed Supplies
463.24
.2936
Waterscape Creations, Inc.
5848 Pond Maintenance
_ 320.00
2936
.Agnardo Landscape, Reimb Stolen Battery Charger
5132 Other
118.54
2937
West —far mulch
"
901_gP€aw9nd Rdendship•EV►
640:00
2938
The Hartford Insurance
5852 Garden Insurance
1,328.00
2939
American Rose Society for Tem CultureFest Ins Cart
5103 Affiliate Insurance ARS

11.50 .AutoPays for Utilities:
4,874.14
.AutoPay
Rancho California Water
5856 Utilities Water
112.11
AutoPay
Southern California Edison
.5855 Utilllties Electric

45.48 ,AutoPay
Frontier Communications
;5858 Internet Provider

65.87 223.46
AutoPurchas
Amish Country
7017 Gazebo Project
1,262.00
TOTAL DISBURSEMENTS:
1 ,349.60
Vol

-08130/22

9.0 9-a--a�—C)9, 04 SOS�l
Temecula Valley Rose Society
Income vs Expenses
January through December 2021

Temecula Valley Rose Society
Summary Income vs Expenses YTD
—� January 1st throtrgh,DecembiDr'31, 2019
Jan - Dec 19
Ordinary IncomelExpense
4100 Interest - Say Ings.

1.82 4110 Investments
,4200 Member Donations
1,508.69

52.25 4300 Membership
2,269.50
4500 Program Income
697.00
4600 Rose Haven Donations
12,430.37
4700 Society Operations Donatlo
2,000.00
4800 Ways & Means
713.63
Total Income
Expense
5100 Executive Committee 1,024.50
5200 Programs Committee 831.01
5300 Membership Committee 602.94
5500 Finance Committee 500.00
5600 Education&Outreach Comm 332.45
5700 Communications Committee 651.92
5800 Rose Haven Committee 0 9 r79,
Total
Exnense _.aadoh s ra
Net Ordinary Income
Other Income/Expense
Other Income
6000 Other Income
Total Other Income
Net Other Income
Net Income
2,438.

FY 2022/2023

COMMUNITY SERVICE FUNDING

REINVESTMENT IN TEMECULA
GRANT APPLICATION #
57 GFWC TEMECULA VALLEY

WOMEN'S CLUB

CM OF TEMECUI,rA
FISCAL YEAR 2022.2023

COMMUNITY SERVICE FUNDING M REINVESTMENT IN TEMECULA

PROGRAM APPLICATION
(Please Print or Type)
DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022

PROJECT/PROGRAM INFORMATION
Amount Requested: $ 50,000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Fundraiser Cancellation
Project/Program Title: ` Compensation Project Start Date 1/1/23 Date; 12/31/23 Physical Address of Project/
Program INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: GFWC -Temecula Valley Woman's Club Mailing Address: PO Box 1056 Temecula, CA 92593

ORGANIZATION AND GEOGRAPHIC AREA SERVED
Name of Applicant
Organization' GFWC -Temecula Valley Woman's Club Year Founded;-1980 Fs, Temecula Valley Woman's Club
Website; www.tvwc.com Social Media:rr�-at
Number of Paid Staff: 0 _ Number of Volunteers: 80
Geographic Area(s) the Organization Serves _ The_Temcklla Vale Geographic Area(s) the Project)Prograrm Temecula
NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE f� Serves; 7{C!_USIVELY USED TO SERVE TEMECULA.

Contact Name: Patti Castillo Title/Position: Communciation & PR Chair Contact Person's Direct Telephone: 951-85()-Q498 Contact Person's Email: __plhcastillo QD a]Lpom

NONPROFIT STATUS
Is this organization incorporated as a nonprofit? Yes ® Date of Incorporation as a Nonprofit: 7/81,1982 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Federal Identification Number: 95-3788376_ _ State Identification Number: 1119999 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS:

1. ❑x Attach IRS Deductibility Status using this link: http:NapPs.ils,govla lees/

2. ❑ Attach State Entity Status Letter using this link:

WA tisL/ www.ftbca.gov/oRli-ne/self serve entity status letter/index,asp

3. 21 Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: htlp Mr do x'iFacilily=Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13

APPLICATION AUTHORIZATION
Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No ® Yes ❑ IF YES, BRIEFLY DESCRIBE:

Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No ❑x Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION:

This Application has been authorized by the organization's:

Executive Committee ❑ Board of Directors M
Members -at -Large ❑
MISSION STATEMENT OF ORGANIZATION 1
BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES.

The Temecula Valley Woman's Club is part of an International organization dedicated to the improvement of the educational, ethical and cultural life of the community through volunteer service.

FINANCIAL STATEMENTS

UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT, DO NOT SUBMIT NOW.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13

FUNDING SOURCES C
CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ® Yes ❑ IF YES, PROVIDE BELOW.

NAME OF PROGRAM/PROJECT AMOUNT MONTH +YEAR I NAME OF CITY GRANT Ij

FUNDED BY THE CITY GRANTOR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? No 0 Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW.

FUNDING RECEIVED
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13

GRANT PROJECT/PROGRAM DESCRIPTION

IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERr 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.

For 35 years, the Temecula Valley Woman's Club (TVWC) hosted the Holiday Home Tour. The Home Tour is TVWC's largest fundraiser. A portion of Home Tour funds raised went toward local scholarships. TVWC dedicated an amount of the remaining funds to The President Project, local non- profits, and the remaining amount to TVWC's operational costs. TVWC's operational costs include the following: meeting and facility fees, public relations, advertisement, membership engagement events, training, and financing of the following year's fundraisers, the Holiday Home Tour & Mid -year Fundraiser.
2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED

ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT.

Grant funding would pay for TVWC's operational costs of monthly meetings, fundraising events, membership engagement, public relations, and local non-profit projects. List of goods and services to purchase for the Home Tour Fundraiser; such as homemade soup supplies, gourmet food supplies, bakery food supplies, wrapping & packaging suppies, decorator expenses, craft supplies, booties (for guests to visit the homes), waste management rentals, van rentals, traffic control rentals, print advertising, brochure printing, ticket & poster printing, catering, table & chair rentals, portable toilet facility rentals, venue rentals, Insurance fees, licenses, and permit costs.
3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.

For 42 years, TVWC has given back to the Temecula Valley by volunteering, supporting, and donating to local non -profits, schools, and public agencies. TVWC has donated over 3 million dollars to local non -profits and 1.5 million volunteer hours. From local public schools, food banks, public libraries, and park and building foundations to animal shelters, children at risk, helping the homeless, and women's breast cancer support, the Club has impacted tens of thousands of citizens in the community. This grant will allow TVWC to continue pursuing, engaging, and increasing membership, allowing us to volunteer, donate and support more non -profits, local schools and libraries, and organizations. It will also subsidize some of the income lost due to canceling fundraising events for the past two years. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM: 250,000
3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13

PROJECT/PROGRAM DESCRIPTION

CONTINLIEII
4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS. undraiser Cancellation Compensation Project will increase membership and fundraising apabilities. With additional volunteers and funds, TVWC can return to hosting larger fundraisers wising funds to a pre -pandemic level. Increased volunteering, contributing, and donating to the immunity will result in an improved quality of life in the Temecula Valley and its citizens. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC

AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS.

At the end of 2019. TVWC had 120 members. In 2022, our membership declined to 80 members. Our members are the lifeblood of the organization. The decrease in membership reduced the number of charities supported, the dollars donated, and the hours volunteered to the community. In December, TVWC plans to host the 36th Annual Holiday Home Tour. The reduced membership and lack of income from the last two years will result in a smaller event, with the number of homes on tour reduced to two and ticket prices reduced. Overall cost increases resulted in cutting back on the number and variety of homemade soups to be sold, totally deleting the gourmet jams & jellies sold in the past, and the number and type of bakery items and crafts offered for sale at the Home Tour. The pandemic has impacted TVWC in many ways. This grant would assist TVWC in increasing membership and paying for fundraising costs. Getting back to pre -pandemic membership numbers will increase TVWC's ability to give back to the community, positively impacting residents and making Temecula and the surrounding communities a better place to live. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL:
(1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM.

Grant funds would allow TVWC to CONTINUE and EXPAND our membership and fundraising abilities.

The pandemic caused a reduction in attracting and maintaining members and limited fundraising efforts. TVWC had to cancel fundraisers in 2020 and 2021 and radically downsize the 2022 Home Tour. With this award, TVWC would have funds to cover the costs of maintaining and attracting additional members and assist in paying the price of hosting our fundraiser to the quality and level before the pandemic. In doing so, we can return our contribution to the community to the higher level performed in all the years before the pandemic.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13

PROJECT/PROGRAM BUDGET (do not fill in shaded areas)

LINE ITEMS FOR PROJECT/PROGRAM I REVENUES I EXPENSES

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount of money requested from this City of Temecula $
Community Services Grant (Not to exceed $50,000) 1 50,000.00 Amount contributed to the Project/Program by the Applicant $ Organization 26,950.00
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13

ACKNOWLEDGEMENT/SIGNATURE PAGE
The applicant acknowledges and agrees to the following:
■ Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements.
• Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval.

Please allow time for checks to be processed.
• The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot.
• The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. ■ If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete.

I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief.

ORGANIZATION NAME: L-1F WCr` 11r1-V1eL'VJCt V4 ` lie YY G.V1 �U.�D MAILING ADDRESS: l OK oo VJ PHONE: [ ' yj
l eImelco ,0-6 1 j5i3 EMAIL: P1 kccos --fl one
,y
rn
PRESIDENT / AUTHORIZED OFFICER:
-PRINT NAME
SIGNATURE:

IF DIFFERENTTH 80VE,
APPICATION PREPARED BY:QT3

PRINT NAME
TITLE
DATE: 9 4&M2.

MONTH, DAY, YEAR
T-
TITLE
t
SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO:

City of Temecula
Community Service Funding
Attn: City Manager's Office
41000 MAIN STREET
TEMECULA, CA 92590
Questions: [email protected] (951) 694-6413
Betsy. [email protected] (951) 693-3959
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13

Details about Gfwc-temecula valley womans club https://apps.irs.gov/app/eos/detai] sPage?ein=953788376&name=Gfw...

CQ HELPO MENU
Home > Tax Exempt Organization Search > Gfwc-temecula Valley Womans Club c Back to Search Results
Gfwc-temecula Valley womans Club
EIN: 95-3788376 1 Temecula, CA, United States
Other Names
Publication 78 Data e
Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.

On Publication 78 Data List: Yes
Deductibility Code: PC
Copies of Returns (990,990-EZ, 990-PF, 990-T) e
Electronic copies (images) of Forms 990, 990-EZ, 990-PF or 990-T returns filed with the IRS by charities and non- profits.

Tax Year 2019 Form 990EZ
Tax Year 2018 Form 990EZ
Tax Year 2017 Form 990EZ
Tax Year 2016 Form 990EZ
I of 9/10/2022, 12:39PM

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 09/11/2022
ESL ID: 7356915853
Why You Received This Letter
According to our records, the following entity information is true and accurate as of the date of this letter.

Entity ID: 1119999
Entity Name: GFWC - TEMECULA VALLEY WOMAN'S CLUB
X1.

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

2. The entity is not in good standing with the Franchise Tax Board. ❑X

3. The entity is currently exempt from tax under Revenue and Taxation Code (R&TC) Section 23701 f. ❑

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

5. The entity was administratively dissolved/cancelled on through the Franchise Tax Board Administrative Dissolution process.

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

afite GRAPHIC]hint - I00 NOT PROCESS Aa Filed Data - DLN: 934921-96005040 Short Form OMB No. 1545-1150
FOrm990EZ Return of Organization Exempt From Income Tax IN
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 2019 Department of the
Treasury
Internal Revenue Service
A For the 2019 tales
B Check if applicable:
❑ Address change
❑ Name change
❑ Initial return
❑ Final return/terminated
❑ Amended return
❑ Application pending
► Do not enter social security numbers on this form as It may be made public. ► Go to w}vtyirs.aoy/Fornr9sOEZ for instructions and the latest information.

Y_a5Zor tax year beginning 01-01-2019, and
Name of organization
GFWC - Temecula Valley Womans Club
Number and street (or P 0. box, If mail is not dehvorod to street addro.

PO Box 1056
City or town, state or province, country, and ZIP or foreign postal coda romecula, CA 92593
G Accounting Method: ❑ Cash ® Accrual Other (specify) ► I Website: ► www.tvwc.com
Tax-exempt st4tus (check only one) - 0 501(c)(3] ❑ 501(c)( ) ■ (insert no.) ❑ 4947(a)(t) or C1 527 D Employer identification number
E Telephone number
(310)994-0155
F Group Exemption
Number ►
H Check ► ® If the organization is not
required to attach Schedule B
(Form 990, 990-EZ, or 990-PF).

K Form of organization: O Corporation ❑ Trust ❑ Assoclatlon ❑ 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 (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ . . . . . . . . . . . . . . . . . . . . . . . . . . . ► $ 195,554 Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions Cheek if the organization used Schedule 0 to respond to any question in this Part I , for Part
1 I)
. pl
102,006
1 Contributions, gifts, grants, and similar amounts received . . . . . . . . . . . . . . �.f . 2 Program service revenue including government fees and contracts . . . . . . . . . . . . . . . . 2 20,875
3 Membership dues and assessments . . . . . . . . . . . . . . . . . . . . . . . 3 4 Investment income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 5a Gross amount from sale of assets other than inventory . . . . . . . Sa b Less: cost or other basis and sales expenses
c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) . . . . . .

Sc
6 Gaming and fundralsing events
G
a Gross Income from gaming (attach Schedule G if greater than $15,000) 6a Ixu
b Gross income from fundraising events (not including $ 93,026 of contributions from fundraising events reported on line 1) (attach Schedule G if the sum of such gross income and contributions exceeds $15,000) 1) • - 6b 72,673 c Less: direct expenses from gaming and fundraising events . . . 6c 7r,673 _
d Net income or (loss) from gaming and fundralsing events (add lines 6a and 6b and subtract line 6c) 6d
7a Gross sales of Inventory, less returns and allowances . . . . . . 7a —
b Less: cost of goods sold . . . . . . . . . . . . 71r� 0 c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) . . . . . . . . . 7c
8 Other revenue (describe in Schedule O) . . . . . . . . . . . . . . . . . . . . a
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 . . . . . . . . . ► 9 122,881
10 Grants and slmllar amounts paid (list in Schedule O) 10 11 Benefits paid to or for members . . . . . . . . . . . . . . . , . . . . . 11 12 Salaries, other compensation, and employee benefits . . . . . . . . . . . . . 12 ^
r
13 Professional fees and other payments to independent contractors . . . . . . . 13 J
a
14 Occupancy, rent, utilities, and maintenance . . . . . . . . . . . . . . . . 14 t'r
15 Printing, publications, postage, and shipping . . . . . . . . . . . . . . is
16 Other expenses (describe in Schedule 0) . . . . . . . . . . . . . . . . . . . 16 17 Total expenses. Add lines 10 through 16 . ►
17 18 Excess or (deficit) for the year (Subtract line 17 from line 9) . . . . . . . . . . . . 18 n
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with a
end -of -year figure reported on prior year's return) . . . . . . . . . . . . . . . . . 19 u
Z
20 Other changes in net assets or fund balances (explain in Schedule 0) . . . . . . . . . . . 20 21 Net assets or fund balances at end of year. Combine lines 18 through 20 . . . . . . . . . 21 For Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 10642I 1,580
1,489
102,731
105,800
17,081
123,216
2 140,299
Form 990-EZ (2019)

Temecula VAIr wnman's C]iub
a w
Cc�iGtsiliu,l ,mm�niIII
un Z�uli[s tiiien,
Ms. Patti Castillo
Temecula Valley Woman's Club
(951)-850-5498
I castillo@,qmaii.com
September 12, 2022
Community Service Funding:

REINVESTMENT IN TEMECULA
Attn: City Manager's Office
City of Temecula
41000 Main Street
Temecula, Ca 92590

DEAR SIR/MADAM,
The Temecula Valley Woman's Club (TVWC) is part of an International Organization dedicated to the improvement of the education, ethical and cultural life of the community through volunteer service.

TVWC has been serving the Temecula Valley for the past 42 years. TVWC has given back to the Temecula Valley by volunteering, supporting, and donating to local non -profits, schools, public libraries, and museums. TVWC has donated over 3 million dollars to local non -profits and volunteered over 1.5 million hours.

For the past 35 years, TVWC has hosted our largest fundraiser, the Holiday Home Tour. A portion of the proceeds from the home tour go toward scholarships, and the remaining proceeds go toward funding our non-profit support projects and TVWC's operational costs.

Sadly, because of the Pandemic, TVWC canceled the 2020 and 2021 Home Tours and mid -year fundraiser, impacting our fundraising income and membership. At the end of 2019, TVWC has 120 members. In 2022, our membership declined to 80 members. This reduction in funds and members reduced the number of charities supported, the dollars donated, and the hours volunteered to the community.

This grant would assist TVWC in increasing and engaging membership and expand our fundraising abilities to pre -pandemic levels. Getting back to pre -pandemic membership and funding capabilities will increase TVWC's ability to give back to the community, positively impacting residents and making Temecula and the surrounding communities a better place to live.

Tax ID #95-3788376 • Find us at Temecula Valley Woman's Club o no P.O. Box 1056, Temecula, CA 92593-1056 • (951) 302-1370 • www.tvwc.com

TVWC would like to thank you for your consideration throughout this process and for providing organizations like ours with opportunities to give back more to the community, which will result in an improved quality of life for the Temecula Valley and its citizens.

Sincerely,
i
Patti Castillo
Temecula Valley Woman's Club
Communications and PR Chair

ENCLOSURE

FY 2022/2023

COMMUNITY SERVICE FUNDING

REINVESTMENT IN TEMECULA
GRANT APPLICATION #
58 THE EMPOWERMENT CENTER

CITY OF TEMECUTA
FISCAL YEAR 2022.2023

COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA

PROGRAM APPLICATION
(Please Print or Type)
DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022

I PROJECT/PROGRAM INFORMATION
Amount Requested: $ 50,000
MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION
Project/Program Title: Youth Mental Health Community Health Worker Program Physical Address of Project/Program:

Start Date: Jan 1, 2023 End Date: Dec3t, 2023

INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: The Empowerment Center Mailing Address: 27262 Via Industrial
Temecula, CA 92592

I ORGANIZATION AND GEOGRAPHIC AREA SERVED
Name of Applicant
Organization. The Empowerment Center
Year Founded: 2005
Website: www.theempowermentcenterintl.com Social Media: `ww,facebook.com/theempowermentcenter Number of Paid Staff: 4
Number of Volunteers: 8
Geographic Area(s) the Organization Serves: Riverside County Geographic Area(s) the Proiect/Program Serves: Temecula NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA, Contact Name: Teresse Lewis, L.C.S.W. Title/Position: Executive Director Contact Person's Direct Telephone: 951-514-2939 x107 Contact Person's Email:[email protected]

NONPROFIT STATUS
Is this organization incorporated as a nonprofit? Yes ■❑ Date of Incorporation as a Nonprofit: 2005 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Federal Identification Number: 56-2497243
State Identification Number: C2588343
PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS:

1. ■❑ Attach IRS Deductibility Status using this link: htto:/Iai)ps.irs.gov/aoa/eos/

2. N Attach State Entity Status Letter using this link:
httos:// www.ftb.ca.gov/online/self serve entity status letter/index.as

3. 9 Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: http://rct.doi.ca.00vNerificationMebtSearCh.aSOY?facility=Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13

APPLICATION AUTHORIZATION
Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No [J Yes ❑ IF YES, BRIEFLY DESCRIBE:

Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No Al Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION:

This Application has been authorized by the organizations:

Executive Committee IN Board of Directors [t] Members -at -Large ❑

MISSION STATEMENT OF ORGANIZATION

BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES The Empowerment Center's mission is to help youth and families develop the resilience necessary to overcome challenges, discover the best of themselves and create healthier, happier patterns of living.

FINANCIAL STATEMENTS

UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENTAND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13

FUNDING SOURCES
CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ❑ Yes EN] IF YES, PROVIDE BELOW,
NAME OF PROGRAM/PROJECT AMOUNT MONTH + YEAR NAME OF CITY GRANT

FUNDED BY THE CITY GRANT OR SPONSORSHIP FUNDING RECEIVED OR SPONSORSHIP Breakthrough Family Wellness Program $ 5000.00 1 January 2021 Community Services Grant 1$
—L$
I �
$
OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECT/PROGRAM IN THIS APPLICATION? No ❑ Yes Q IF YES, PROVIDE INFORMATION IN TABLE BELOW,
AMOUNT MONTH + YEAR

NAME OF ENITY

RECEIVED FUNDING RECEIVED
$ 650,000 California Workforce Development Board April 2023 $ 100,000 Morgan Stanley Foundation_ 1January 2023
$ 100,000 Temecula Valley Unified School District March 2023 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13

GRANT PROJECT/PROGRAM DESCRIPTION

IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT

FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 11 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT I The Empoworrneni Canter's Youth Mental Heallrt Worker PraW.1 is an niruwalive Grow -your -own approach to training up the youth in the cily of Temecula to address The manlsil heallh conoorns of romecula's youth population. The purpese of Ih4 prntecl is to create an ecosystem that trains and deploys a front-line army of youth mental heallh workers to gaar emmpetentia9 that craalevlahlrt career palhwnya upon high school graduation Youth participants ages 17-24 will receive comprehensive training provided and aupervised by licensed menial heallh professionals to pmparn them for the workforce. Curriculum will include Mental Health Assessment Skills, AtWorecy Skills, Corear Readiness Skulls, knowledge of M la! and bohaivloral hk4(h referral systems, and skills to become trusted messengers to connecl youth and families to mil heallh Supports In times of need The rota+sf ".19)nitt Prngavn ir+eludes components in training, menlorship, supportive services, and case management to Osial with youth paniripant3 wtlhtnb plarmmi 1. Tuts program has a special emphasis on youth at -risk for homelessness, foster youth, youth from rao181 minority POP01111tflnS.8rid youth idnnhly1riq as LGB'rp. upon rnrRpreGnrl of the program, participants will be able connected to employment opportunities within fatal educatremal Inalitullons, mepl0l t+aaklh aprxtcres, aedcvnimunity bawd organizations to address health equity gaps and improve youth population mental health oultomes Ihmnttghout Temecula and acrmt;a the tNan4 Empire. Gradualhr s of tlae program will receive a state -recognized certificate of completion, providing an ecaaleroted opfrarlunity In gain a lain; lahla indaslryroqugni,ted skill sal to meat youth mental health needs without the barrier of a 4-year degree traditionally needed to work in the Wd of mental health TiSH rnolw alrre pruGram also inCludu supportive services for participants in need, including flexible training opportunities (after school. nights, and woskende), tor.1 mololly assr;tWncu, short•lanrr financial suplialll. As an organization that embraces youth and young adult development, The Empowerment Cenler ts~ this orej�el to mir•.reasa the avAiiat lUly of ail lino anR oompassl"ate mental health supports of the youth populations. TEC is inviting the City of Tsmoruta to oarlirar with us in Ih c very qXrklkty and rnMvatkve programming fmr our youth 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED,

ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT.

Grant funds will be used to cover the costs of youth mental health training, curriculum materials, and program participation incentives including meal provision for evening and weekend trainings and gift cards.
3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.

This grant funding will specifically benefit Temecula residents through focused participant recruitment efforts to Temecula youth ages 17-24. The participants will receive career readiness skills, mental health job skill certification, and employment opportunities to serve other local youth residents in need of mental health and community supports. This will improve the overall mental wellbeing of Temecula youth and families, strengthen and equip the youth workforce within the city, and directly boost Temecula's economy by creating viable local career pathways for high school graduates within the school district and local community based organizations.

Tragically, it was recently reported that two Great Oak High School sludents died by suicide. The program's purpose is to increase hope and improve the life outcomes of teens and young adults here in our own backyard by raising up Youth Mental Health Workers by equipping them to not only recognize and address their awn needs but effectively and compassionately address the mental health needs of their peers as well.

In addition, through a partnership with the Temecula Valley Uniried School District, the district is on board to refer their students and former graduates to participate in the project, and in turn, program participants will provide local students and families in need with mental health supports and connection to community based resources. 3b ESTIMATED

M FROM TEMECULA EXPECTED TO BENEFIT

FROM THIS PROJECT
100

PROGRAM
3c , ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM. 15 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13

PROJECT/PROGRAM DESCRIPTION

CONTINUED
4 SUMMARY STATEMENT— SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.

The Empowerment Center's Youth Mental Health Worker Project is an innovative approach to providing peer -to -peer mental heath support for Temecula's youth population. Grant funds will be used to cover the costs of training, curriculum, and supportive services. Temecula residents will benefit by receiving effective mental health support and job opportunities. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC

AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS.

I The COVID-19 pandemic allowed The Empowerment Center to pivot their services to virtual platforms, removing the barriers to attendance. Although we had to shut our doors to in -person programming, the pandemic allowed us to reach the most youth and families through virtual programming that we have reached in the last 5 years. This pivot has allowed us to expand our services across the county, state, and country.
6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL:
(1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM.

These grant funds will create a new programming for The Empowerment Center. The Empowerment Center has been invited by the California Workforce Development Board to provide Mental Health Worker training and employment preparation services to the adult workforce. We recognize that youth are in just as much of a need of these same skills, supports, and experiences, and it is our goal provide youth with the same opportunites through this Youth Mental Health Worker Project. This grant will help us to create this opportunity for youth population and want to partner with the city of Temecula to deploy this new and innovative program for our residents.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13

{ PROJECT/PROGRAM BUDGET (do not fill in shaded areas)
LINE ITEMS FOR PROJECT/PROGRAM i REVENUES

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount of money requested from this City of Temecula $ 50,000 Community Services Grant (Not to exceed $50,000)
Amount contributed to the Project/Program by the Applicant $ 20,000 Organization
Other grants or funding already awarded for Project/Program, if any I $ 650,000 In -Kind match amount or volunteer credit hours estimated amount $ 55,000 TOTAL REVENUE $ 775,000

LIST OF EXPENSES FOR PROJECT/PROGRAM

EXPENSES
Tools/Equipment $25,575
Facilities/Rent/Insurance
Supplies
Marketing
Services
Food
Other
Staffing Expense
$ 54, 000
$142,500
$ 65, 500
$175,000
$ 25, 000
_ $25,000
THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT; $295 000 HOWEVER PLEASE INCLUDE. ,
TOTAL EXPENSES $807,575
TOTAL BUDGET $775,000 i $807,575
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13

PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT
IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21122 (LAST YEAR), THEN SKIP THIS PAGE.

If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021. and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit andlor require additional back-up information to substantiate how funds received from the City were spent.

If the funds were not spent in accordance with the approved/awarded application, the organization will be reel! II red to return the amount of funds to the City, To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022.

1. Fill out table below (make additional copies if needed to explain all expenditures.)

2. Attach copies of receipts/invoices (in the same order as listed in this table.)

3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13

FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT
If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions.

If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receiptslinvoices, must be submitted to the City as outlined on this page -
I. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures.

A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. (If you were awarded less than $5,000, submit Expenditure Report for that amount.)
B. If awarded grant funds exceeding $5,000. A) Follow #1,A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed forthe remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10.000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds.

2. Attach copies of receipts/invoices (in the same order listed in table below).

3. Send to:

Organization:

City of Temecula, 41000 Main St., Temecula, CA 92590,
Attn: City Manager's Dept. "CSF-Reinvestment in Temecula"

EXPENDITURE REPORT DATED
TOTAL FY 2022-2023
Amount of Grant Fund Awarded: $
Name of Project/Program:

Month & Year FIRST $5,000 check
was received from City: _

1. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted).

2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City

3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number)- E Name of Company
d
E on Receipt or Invoice
Q Y I
Date on
Receipt/Invoice

MUST BE ON OR BETWEEN
March 20, 2020 - JUNE 30.
2024 —
Expenditure

MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER $
Amount I Description
$
XPENDITURE TOTAL $ EXPENDITURE TOTAL
Purpose
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13

ACKNOWLEDGEMENT/SIGNATURE PAGE
The applicant acknowledges and agrees to the following:
• Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements.
• Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval.

Please allow time for checks to be processed.
• The awarding of Community Service Funding does not constitute an automatic annual allocation. ■ The recognition for Community Service Funding should accrue to the City of Temecula. ■ Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot.
• The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete.

I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief.

ORGANIZATION NAME: The Empowerment Center
MAILING ADDRESS: 27262 Via Industria
Temecula, CA 92592
PHONE: ( 951) 51 4-2939
EMAIL: [email protected]
PRESIDENT/AUTHORIZED OFFICER: TereSSe Lewis, LCSW Executive Director SIGNATURE:

IF DIFFERENT THAN ABOVE,
APPICATION PREPARED BY:

Iv�
•I - II I I i P,. Ir
DATE: September 9, 2022
SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO:

City of Temecula
Community Service Funding
Attn: City Manager's Office
41000 MAIN STREET
TEMECULA, CA 92590
Questions: [email protected] (951) 694-6413
Betsy. [email protected] (951) 693-3959
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13

Q HELPO MENU
Home > Tax Exempt Organization Search > The Empowerment Center < Beck to_SeaRch Rcsu t.

The Empowerment Center
EIN: 56-2497243 1 Temecula, CA, United States
Other Names
Publication 78 Data o
Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.

On Publication 78 Data List: Yes
Deductibility Code: PC
Form 990-N (e-Postcard) 8
Organizations who have filed a 990-N (e-Postcard) annual electronic notice. Most small organizations that receive less than $50,000 fall into this category.

Tax Year 2007 Form 990-N (e-Postcard)
Copies of Returns (990, 990-EZ, 990-PF, 990-T) o
Electronic copies (images) of Forms 990, 990-EZ, 990-PF or 990-T returns filed with the IRS by charities and non- profits.

Tax Year 2019 Form 990EZ
Tax Year 2018 Form 990EZ
y Tax Year 2017 Form 990EZ
Tax Year 2016 Form 990EZ
Page Last Reviewed or Updated: 20-November-2020 - r* Share 1 $ Print

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
FT'B PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/9/2022
ESL ID: 8908301590
Why You Received This Letter
According to our records, the following entity information is true and accurate as of the date of this letter.

Entity ID: 2588343
Entity Name: THE EMPOWERMENT CENTER
0 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. 0 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 through the Franchise Tax Board Administrative Dissolution process.

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

90 Return of Organization Exempt From Income Tax No, 1545-0047 Form
n0MB
Under section 50i(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 0 1 Department of the Treasury
► Do not enter social security numbers on this form as it may be made public. OPen Internal Revenue Service
► Go to www.irs.9ov1Form990 for instructions and the latest information. Inspection A For the 2021 calendar year, or tax year beginning January 01 , 2021, and ending December 31 2O 21 B Check if applicable:

C Name of 22EIzation THE EMPOWERMENT CENTER D Employer identification number ❑ Address change
Doing business as 56-2497243
❑ Name change
Number and street (or P.O. box if mail is not delivered to street address) Room/suite E Telephone number ❑ Initial return
27262 VIA INDUSTRIA 951414-2939
❑ Final return/terminated
City or town, state or province, country, and ZIP or foreign postal code ❑ Amended return
Temecula, CA 92590 0 Grossraceipts $ 3162,974
❑ Application pending
F Name and address of principal officer: LaKeshia McClanahan H(al Is this a group return for subordinates? 0 Yes ®No 27262 VIA fNDUSTRIA, Temecula, CA 92590 Hlb) Are all subordinates included?d Yes ❑ No I Tax-exempt status:
0 501(c)(3) SC ( )-4 (insert no.) 4947(a)(1) or 13527 It "No," attach a list. See instructions.

J Website: I. [email protected] H(a) Group exemption number ► K . Form of mg "ITIAVOMOCorparatlon []Trust Association EjOther►I L Year of formation: 2005 M State of legal domicile; CA d
Vl
e
W
`o
b
13 14
15 16a
b
17 1s
19 Briefly describe the organization's mission or most significani activities:
our mlegsa Is to halp yearn an Iemillaa ilevetep tha realllsnca nacascary to eye rc*me elsrtlanpoe, dfacnwr4iuiieef offFieinoeive"s, ana-crea(ehee(il"oi; _"""' happier _ ........ ama or
- - -- - Che......._❑ oga_.......o......................------......------...........------..._........_..__.......... ..._._.._inued its operations or disposed of more than 25% of its rlet assets.

Number of voting members of the governing body (Part VI, line 1 a) . . .

Number of independent voting members of the governing body (Part Vl, lin Total number of individuals employed in calendar year 2021 (Part V, line 2a Total number of volunteers (estimate if necessary) . . . . . . . .

Total unrelated business revenue from Part VIII, column (C), line 12 . .

Net unrelated business taxable income from Form 990-T, Part I, line 11 Contributions and grants (Part VIII, line 1h) . . . . . . , . , . .

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

Investment income (Part VIII, column (A), lines 3, 4, and 7d) Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 110) .

Total revenue -add lines 8 through 11 (must equal Part _Vill, column (A), line 1 Grants and similar amounts paid (Part IX, column (A), lines 1-3) . - Benefits paid to or for members (Part IX, column (A), line 4) . . . . , Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-1 Professional fundraising fees (Part IX, column (A), line 11 e) . . . . .

Total fundraising expenses (Part IX, column (D), line 25) ► 9,1E Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e) Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) Revenue less expenses. Subtract line 18 from line 12
p 20 Total assets (Part X, line 16)
21 Total liabilities (Part X, line 26) .
22 Net assets or fund balances. Subtract line 91
n line 20
a1b) . . . . 4
1 5
. . . . . at]
7b
Prior Year
I
a
2 O
Current Year
283,674
352,549
9,000
10,375
64 50
0 0
?L
29ZT38
362,974
10,132
2,000
0 0
�)
0 0
O
269,710
0 0
292,011
279,842
294,011
12,894
66,963
Beginning of Current Year
End of Year
94,161
1'J4.923
8,200
0 as." 1
164.923
Under penalties of herihry, I declare that I have examined this return, including accompanytng schedules and statements, and to the best of my knowledge and belief, it Is true, carWi, and 000pfete. Declaration of preparer (other than officer) Is based on all information of which preparer has any knowledge.

Sign
Here
Paid
Preparer
8lgtwltrro of officer
Dale
AlK9ghILMc_Cianshan. Treasurer -_
Type or print name and lido
Print/Type preparer's name Preparer's signature Date Check J if TIN self-employed
Use Only Firm's name ► FirnVe El ►
Firm's address ► Phone no.

May the IRS discuss this return with the preparer shown above? See instructions Yes No For Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 11282Y Form 990 (2021)

FY 2022/2023

COMMUNITY SERVICE FUNDING

REINVESTMENT IN TEMECULA
GRANT APPLICATION #
59a

THE SALVATION ARMY
(A: CHILD SPREE)

CITY OF'1`EMECULA.

FISCAL YEAR 2022.2023

COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA

PROGRAM APPLICATION
(Please Print or Type)
DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022

PROJECT/PROGRAM INFORMATION
Amount Requested: $13 500 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: Temecula Child Spree Start Date: May 2022 End Date: Aug 2023 Physical Address of Project/Program: Promenade Temecula I JC Penney• 40820 Winchester Rd, Temecula

INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: The Salvation Army Mailing Address: 40270 Los Alamos Rd
Murrieta, CA 92562

ORGANIZATION AND GEOGRAPHIC AREA SERVED
Name of Applicant
Organization: The Salvation Army, a California corporation Website: murrieta.salvationarmy.org
Year Founded: 1865 (England)
Social Media: facebook.com/SalArm Murr€eta
Number of Paid Staff: 3 Number of Volunteers: 15
Geographic Area(s) the Organization Serves: Southwest Riverside County Geographic Area(s) the Prolect/Prograrn Serves: Requested project funding will serve Temecula residents only NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA.

Contact Name: Major Jessyca Carr Title/Position: Corps Officer Contact Person's Direct Telephone: 562-480-2654 Contact Person's Email. [email protected]

NONPROFIT STATUS
Is this organization incorporated as a nonprofit? Yes Date of Incorporation as a Nonprofit: 1.0/19/1914 (CA core) No ❑ IF NO, THEN INELIGMLE TO RECEIVE CITY FUNDING
Federal Identification Number: 94-1156347 State Identification Number: 0078321 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTS) AS FOLLOWS:

1. El Attach IRS Deductibility Status using this link: htt ://a s.irs. ov/a /eos/

2. ® Attach State Entity Status Letter using this link:
https://www.fib.ca.gov/online/self serve entity status letter/index.as

3. ® Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: http://rct.do'.ca.gov/VerificationMeb/Search.aspx?facilitv=Y City of Temecula Community Service Funding - Reinvestment In Temecula GRANT APPLICATION Page 5 of 13

APPLICATION AUTHORIZATION
Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, Investments, or interests In real property with a Temecula City Council Member during the past 12 months? No ® Yes ❑ IF YES, BRIEFLY DESCRIBE:

Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No ® Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION:

This Application has been authorized by the organization's:

Executive Committee ® Board of Directors ❑ Members -at -Large ❑

MISSION STATEMENT OF ORGANIZATION
BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES.

Since the founding of The Salvation Army in 1865 In London, England, The Salvation Army has fulfilled its mission to "meet human needs without discrimination." The Salvation Army Is a Christian church and leading provider of programs and services for low-income, homeless, and at -risk individuals and families. Nationwide, The Salvation Army serves approximately 30 million individuals annually. The Southern California Division, which oversees activities in nine counties in the southern and central coast regions, currently operates 53 Corps Community and Service Centers offering a variety of programs based on community needs. These services include food pantries and hot meals; childcare centers, after -school programs, and summer camps for low-income children; homeless prevention services (including rental and utility assistance); emergency disaster relief, seasonal/holiday assistance; and services for military veterans. For persons experiencing homelessness, The Salvation Army provides food, hygiene, and other essential items; street outreach; emergency and interim housing; and permanent supportive housing, offered in conjunction with case -managed supportive services. Additionally, for individuals struggling with substance use, The Salvation Army's Adult Rehabilitation Centers offer a 180-day residential work -therapy program. The Salvation Army is also a major developer/operator of affordable housing (Sllvercrest Residences) for low-income elderly persons. In sum, The Salvation Army exists to meet human need wherever, whenever, and however it can. The proposed project - Child Spree - falls within The Salvation Army's Family Services programs targeting low -Income families with children in need of essential back -to -school Items.

FINANCIAL STATEMENTS

UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAYBE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW.

City of Temecula Community Service Funding - Reinvestment In Temecula GRANT APPLICATION Page 6 of 13

FUNDING SOURCES
CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ® Yes ❑ IF YES, PROVIDE BELOW.

NAM PROGRAM/PROJECT

FUNDED BY THE CITY GRANT OR SPONSORSHIP
AMOUNT
$
MONTH +YEAR

FUNDING RECEIVED

NAME OF CITY GRANT

OR SPONSORSHIP
$
$
$
$
OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTJPROGRAM IN THIS APPLICATION? NO ® Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW.

AMOUNT

NAME OF ENITY
MONTH +YEAR

RECEIVED

FUNDING RECEIVED
$ 2 year total
Pechanga Casino - Any childen
June 2021/2022
14,000
$ 1,500
Milguard Windows - Any Childen
June 2022
$ 2 year total
8,050
Murrieta Rotary Club - Murrleta Children only
July 2021/2022
$ 10,000
City of Lake Elsinore - Lake Elsinore Children
February 2021
$
$
$
City of Temecula Community Service Funding - Reinvestment In Temecula GRANT APPLICATION Page 7 of 13

GRANT PROJECT/PROGRAM DESCRIPTION

IMPORTANT-RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT

FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT Each year, typically in early August, The Salvation Army helps low-income children in Southwest Riverside County start the school year off with new clothes, shoes, and school supplies - a program called Child Spree. This support is critical to families whose children would otherwise be unprepared for the new school year. For many years, The Salvation Army has partnered with JC Penney at the Promenade Temecula, and will again In 2023- School aged children are given the opportunity to pick out $125 worth of new clothes and shoes and then pick out a back pack and school supplies. New books and breakfast are also given to the children.
2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.

ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAMIPROJECT.

The Salvation Army requests funding from the City of Temecula to assist with August 2022 expenses as well as next year's (August 2023) expenses related to its Child Spree back -to -school event, serving children residing in Temecula. Requested grant funds will be used for the purchases of school supplies (approximately $25 per child) as well as 90 $125 JC Penny gift cards for Temecula children. The gift cards are purchased and spent on the day of Child Spree. Volunteers and staff hand the gift cards to the cashiers and carefully monitor the event to ensure that only children's school clothes and shoes are purchased with the gift cards. Prior to the event, back packs and school supplies are purchased for distribution at Child Spree. Children are permitted to select their own backpack and school supplies, as the element of choice reduces waste and increases dignity for the families. Receipts for JC Penney and school supplies are retained by The Salvation Army for audit purposes. 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.

This grant will be used specifically for children of the city of Temecula. Targeted beneficiaries are low - Income families with school -age children who, without this assistance, may begin the school year unprepared, without the essential school supplies and and confidence that a new set of clothes and shoes brings to a child. The Salvation Army works with the school district liaison to identify the children who could benefit most from this event and live in Temecula. Additionally, this funding spent within the city will generate increased tax revenue, ultimately benefiting all residents of Temecula. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM:
90 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM:
60 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13

PROJECT/PROGRAM DESCRIPTION

CONTINUED
4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.

The Salvation Army requests City of Temecula funding to purchase school supplies, clothing, and shoes for Temecula children participating in the annual Child Spree back -to -school event. The program assists children in need with essential items for a positive start to the school year. 5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC

AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS.

Over the course of the COVID 9 pandemic, The Salvation Army was called upon to serve significantiy higher numbers of people with food, clothing and financial ass}stance more than any other time In its 25 years in Southwest Riverside County. While service needs - and as a result program expenses - Increased dramatically, private donations have begun to decrease. The Salvation Army was compelled to stretch every dollar to meet the needs that arose throughout the pandemic. Additionally, due to Inflation and the skyrocketing costs of items such as food and vehicle fuel (to transport food and other essential program Items), The Salvation Army has been challenged in operating its programs at a level that meets the high demand for services and financial assistance. The pandemic further affected the ability to utilize volunteers in carrying out the programs and services in Southwest Riverside County, including Child Spree. In years past Volunteers took the children shopping while parents waited outside. These last few years parents have shopped with their children. The reduction in volunteers also meant a reduction in donations.

With children having returned to in -person learning on school campuses, and the rising cost of basic essentials, requests for back -to -school assistance has increased greatly. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL:
(1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM.

2. The requested funding will allow The Salvation Army to expand the existing Child Spree program to serve a higher number of Temecula children in need of assistance. With the requested funding, the number of Temecula children served will increase by an annual average of 15 to 50 (and an over all a total of 200 to 250 children each year).

In addition 2023 will be the 25th year of Child Spree so we anticipate a big event with news coverage and more participation from Temecula children.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13

PROJECT/PROGRAM BUDGET (do not fill in shaded areas)

LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount of money requested from this City of Temecula
Community Services Grant (Not to exceed $50,000)
$ 13,500
Amount contributed to the Project/Program by the Applicant Organization
$ 22,350
Other grants or funding already awarded for Project/Program, if any $ 33,550
In -Kind match amount or volunteer credit hours estimated amount _ $ 6,300

TOTAL REVENUE
$ 75,700

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment
$ 0
Facilities/Rent/Insurance
$ 0
Supplies
$ 100
Marketing Banner awknowledging donors
Services Shopping spree, backpack & school supplies
$ 300
$ 67,000
Food In -kind donation from McDonald's and Starbucks
1,800
$ 4,500
Other Inkind volunteers & reading books
Staffing Expense
THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT;
HOWEVER PLEASE INCLUDE.
$ 2 OOO

TOTAL EXPENSES
$ 75,700

TOTAL BUDGET
$ 75,700
$ 75,700
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13

PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT
*IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21122 (LAST YEAR), THEN SKIP THIS PAGE.

If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information.

If your organization was awarded a Community Service Funding Grant In Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent.

If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receiptsAnvoices, must be submitted to the City on or before due date: September 12, 2022.

1. Fill out table below (make additional copies if needed to explain all expenditures.)

2. Attach copies of recelptslinvoices (in the same order as listed in this table.)

3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office —CSF EXPENDITURE REPORT due on or before September 12, 2022
Organization: Name of Project/Program:

FY 2021-2022 Amount of $
CSF Grant Fund Awarded: Month & Year CSF Grant Received from City:

Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries If you do not have precise number):

E
Date on
Ex anditure
EName
of Company
Receipt/invoice
Description
Purpose
a« i
on Receipt or Invoice

MUST BE ON OR BETWEEN
Amount

DESCRIBE THE EXPENDITURE

PURPOSE OF EXPENDITURE
JULY 1, 2021-JUNE30.2022
1 $
2 3
4 5
6 EXPENDITURE TOTAL Q EXPENDITURE TOTAL MUST BE EQUAL TO (OR GREATER) THAN TOTAL AWARD AMOUNT.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13

FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT
If your organization Is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these Instructions_ If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 fay the City of Temecula, all grant funds received must be expended anylirne on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent In accordance with the approved/awarded appllcat Ion, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page.

1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures.

A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. (If you were awarded less than $5,000, submit Expenditure Report for that amount.)
R. It awarded grant funds exceeding $5,000. A) Follow #1.A above first. 13) To receive grant funds exceeding $6,000 (between $5K••$50K), submit the following Expenditure Report to be reirnbursed for the remaining balance of award to demonstrate funds were spent In accordance will) the Application. This report can be submitted In $10,000 increments (but no less than $10.000 unless the remaining grant award funding amount Is less than $10K). This report must be submitted to the City no later than June 30. 2024 to receive remaining grunt funds.

2. Attach copies of receipts/Invoices (in the same order listed In table below).

3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula"

EXPENDITURE REPORT DATED
Organization: Name of Project/Program:

TOTAL FY 2022-2023 Month a Year FIRST $5,000 check
Amount of Grant Fund Awarded: $ was received from City:

1. Is thfe Expenditure Report Is to provlda documentation for first $5,000 awarded and recaived? You_ or No (already submitted).

2. My organization has already recolvod $ of the total FY 2022-23 Grunt Fund awarded by the City

3. Is this Expenditure Report Is submitted to request reimburaemunt of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living In 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise ntttnbery m
Date on
Expenditure
Name of Company
Receiptllnvoice

MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER E
on Receipt or Involce

MUST BE ON OR BETWEEN
March 20, 2020-JUNE 30.

Amount
Description
Purpose
2024
1 $
2 $
3 $
EXPENDITURE TOTAL $ EXPENDITURE TOTAL
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13

ACKNOWLEDGEMENT/SIGNATURE PAGE
The applicant acknowledges and agrees to the following:
• Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements.
• Every Community Service Funding application is considered individually and on Its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. 0 Funding is not immediately available to the recipient, and requires an award letter signature upon approval.

Please allow time for checks to be processed.
• The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. a Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately, • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot.
• The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete, I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief.

ORGANIZATION NAME: The Salvation Army
MAILING ADDRESS: 16941 Keegan Avenue
Carson, CA 90746
PRESIDENT / AUTHORIZED 0 • JZebel,
T NAME
SIGNATURE:

PHONE: (562) 264-3620
EMAIL:
cas.divisional,commander usw.salvationarm .or
- Divisional Secretary for Business
TITLE
DATE: opyv
?rL/
N10N 111, DAY, YEAR

IF DIFFERENT THAN ABOVE,
APPICATION PREPARED BY: Major Jessyca Carr, Corps Officer, The Salvation Army Murrieta Corps

PRINT NAME TITLE
SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO:

City of Temecula
Community Service Funding
Attn: City Manager's Office
41000 MAIN STREET
TEMECULA, CA 92590
Questions: [email protected] (951) 694-6413
Betsy. [email protected] (951) 693-3959
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13

Department of the Treasury
Internal Revenue Service
Tax Exempt and Government Entities
IRS PO Box 2508
Cincinnati, OH 45201

THE SALVATION ARMY

TERRITORIAL HEADQUARTERS
TERRY 0 HUGHES
30840 HAWTHORNE BLVD
RCH PALOS VRD, CA 90275
Dear Sir or Madam;
Date:

August 30, 2021
Employer ID number:
94-1166347
Form 990 required:
990, No
Person to contact:

Name: Mr. Flammer
ID number: 0203064
We're responding to your request dated November 17, 2020, about your tax-exempt status We issued you a determination letter in June 2011, recognizing you as tax-exempt under Internal Revenue Code (IRC) Section 501(c)(3).

We also show you're not a private foundation as defined under IRC Section 509(a) because you're described in IRC Sections 509(a)(i) and 170(b)(1)(A)(i).

Donors can deduct contributions they make to you as provided in IRC Section 170. You're also qualified to receive tax-deductible bequests, legacies, devises, transfers, or gifts under IRC Sections 2055, 2106, and 2522.

In the heading, we indicated whether you must file an annual information return. If you're required to file a return, you must file one of the following by the 15th day of the 5th month after the end of your annual accounting period.

Form 990, Return of Organization Exempt From Income Tax . Form 990-EZ, Short Form Return of Organization Exempt From Income Tax . Form 990-N, Electronic Notice (e-Postcard) for Tax -Exempt Organizations Not Required to File Form 990 or Form 990EZ
. Form 990-PF, Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation According to IRC Section 60330), if you don't file a required annual information return or notice for 3 consecutive years, we'll revoke your tax-exempt status on the due date of the 3rd required return or notice.

You can get IRS forms or publications you need from our website at www.irs.gov/fortns-pubs or by calling 800-TAX- FORM (800-829-3676).

If you have questions, call 877-829-5500 between 8 a.m. and 5 p.m., local time, Monday through Friday (Alaska and Hawaii follow Pacific time).

Thank you for your. cooperation.

Sincerely,
__+.4" a.. AozFC'
Stephen A. Martin
Director, Exempt Organizations Rulings and Agreements
Letter 4168 (Rev. 09.2020)
Catalog Number 6666BG

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
T g PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 7/8/2022
ESL ID: 3734826934
Why You Received This Letter
According to our records, the following entity information is true and accurate as of the date of this letter, Entity ID: 0078321
Entity Name: THE SALVATION ARMY
❑X 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.

X❑ 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 through the Franchise Tax Board Administrative Dissolution process.

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

8/26/22, 3:29 PM
Details
1-10ME ABOUT MEDIA CAREERS REGULATIONS RESOURCES PROGRAMS CONTACT Registrar{3t El.--�etails
Entity type: Corporate Class as registered with the Secretary of State or based on founding & registration documents.

Organization Name: THE SALVATION ARMY IRS FEIN: 941156347 Entity Type: Religious SOS/FTB Corporate/Organization Number: 0078321 Registry Status: Exempt - Religious Renewal Due/Exp. Date:

RCT Registration Number: EX565010 Issue Date: 12/31/1990 Record Type: Charity Registration Effective Date: 12/31/1990 Date of Last Renewal: DBA:

Mailing Address
Street: 30840 HAWTHORNE BLVD.

Street Line 2:

City, State Zip: RANCHO PALOS VERDES CA 90275
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Date Established:
5/30/2018
Association Date:
6/20/2018
Expiration Date:
12/3 l/2018
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

INNOV81VE DEVELOPMENT
Registration No:

E0035517
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
2/21/2019
Association Date:
3/9/2019
Expiration Date:
3/9/2019
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant;
LESTER CONSULTING GROUP, INC.
https:/Irct.doj.ce.govNerificafion/Web/Details.aspx?result=el 07b9bf-65944ab2-8b64-del8411723ef 2/4

8/26/22, 3:29 PM
Details
Registration No:

E0019177
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
1/23/2014
Association Date:
1/1/2014
Expiration Date:
11/30/2015
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC. DBA TRUESENSE MARKETING Registration No:

E0031101
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
8/31/2017
Association Date:
9/15/20t7
Expiration Date:
12/31/2017
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC. DBA TRUESENSE MARKETING Registration No:

E0031258
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
9/28/2017
Association Date:
10/1/20t7
Expiration Date:
9/30/2019
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH,
INC. DBA TRUESENSE MARKETING
Registration No:

E0031360
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
10/20/2017
Association Date:
11/l/2017
Expiration Date:
4/30/2018
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH,
INC. DBA TRUESENSE MARKETING
Registration No:

E0i�U
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
10/9/2018
Association Date:
10/15/2018
Expiration Date:
12/31/2019
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH,
INC. DBA TRUESENSE MARKETING
Registration No:

E0037233
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
9/6/2019
Association Date:
10/1/2019
Expiration Date:
9/30/2020
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH,
INC. DBA TRUESENSE MARKETING
Registration No:

E0037445
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
10/9/2019
Association Date:
10/1/2019
Expiration Date:
9/30/2020
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH,
INC. DBA TRUESENSE MARKETING
Registration No:

E0040453
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
8/4/2020
Association Date:
8/l/2020
Expiration Date:
9/30/2021
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC. DBA TRUESENSE MARKETING Registration No:

E0040828
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
9/11/2020
Association Date:
10/I/2020
Expiration Date:
9/30/2021
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC. DBA TRUESENSE, MARKETING Registration No:

E-0044914
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
9/15/2021
Association Date:
10/1/2021
Expiration Date:
9/30/2022
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC. DBA TRUESENSE MARKETING Registration No:

E0044015
Registration Type:

Fundraising Event
Registration Staters:

Complete
Date Established:
9/15/2021
Association Date:
10/1/2021
Expiration Date:
9/30/2022
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC.

DBA TRUESENSE MARKETING
Registration No:

E0044916
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
9/15/2021
Association Date:
10/1/2021
Expiration Date:
9/30/2022
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC.

DBA TRUESENSE MARKETING
Registration No:

IC0048164
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
8/24/2022
Association Date:
10/1/2022
Expiration Date:
9/30/2023
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC. DBA TRUESENSE MARKETING Registration No:

E0049205
Registration Typc:

Fundraising Event
Registration Status:

Complete
Date Established:
9/26/2022
Association Date:
10/l/2022
Expiration Date:
9/30/2023
Prereq Type:

Prerequisite
Relationship:
hftps:Hrct.doi.ca.govNerifrcation/Web/Details.espx?result=e l 07b9bf-6594-4ab2-8b64-del 8411723ef 3/4

8/26/22, 3:29 PM
Details
Charity
Registrant:

MIRIAM HOUGHTON DBA EXPRESSIONS
Registration No:

E0018684
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
10/29/2013
Association Date:
1/l/2013
Expiration Date:
12/31/2012
Prereq 'lope:

Prerequisite
Relationship:

Charity
Registrant:

MIRIAM HOUGHTON DBA EXPRESSIONS
Registration No:

E0018688
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
10/29/2013
Association Date:
3/2/2013
Expiration Date:
12/31/2012
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

TSM DONOR ENGAGEMENT TEAM, INC,
Registration No:

E0030538
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
5/10/2017
Association Date:
5/15/2017
Expiration Date:
7/31/2017
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

TSM DONOR
ENGAGEMENT TEAM, INC.

Registration No:

LQQ3 t 124
Registration Type:

Fundraising Event
Registration Staters:

Complete
Date Established:
9/5/2017
Association Date:
10/l/2017
Expiration Date:
9/30/2019
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

TSM DONOR
ENGAGEMENT TEAM, INC.

Registration No:

E0036403
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
5/9/2019
Association Date:
1/1/2018
Expiration Date:
12/31/2018
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

TSM DONOR

ENGAGEMENT TEAM, INC,
Registration No:

E0037371
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
9/27/2019
Association Date:
1/1/2019
Expiration Date:
9/30/2020
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

TSM DONOR
ENGAGEMENT TEAM, INC.

Registration No:

E0040826
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
9/11/2020
Association Date:
10/1/2020
Expiration Date:
9/30/2021
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

TSM DONOR
ENGAGEMENT TEAM, INC.

Registration No:

E 00 44910
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
9/15/2021
Association Date:
10/1/2021
Expiration Date:
9/30/2022
https://rct.doi.ca.govNerificationtWeblDetails.aspx?result=el07b9bf-6594-4ab2-8b64-del8411723ef 4/4

FY 2022/2023

COMMUNITY SERVICE FUNDING

REINVESTMENT IN TEMECULA
GRANT APPLICATION #
59b

THE SALVATION ARMY
(B: HOMELESS PREVENTION)

CITY OF TEMECUI[A
FISCAL YEAR 2022.2023
COMMUNITY SERVICE FUNDING • REINVESTMENT IN TEMECULA

PROGRAM APPLICATION
(Please Prim or Type)
DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022

PROJECT/PROGRAM INFORMATION
Amount Requested: $ 36,500 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: Temecula Homeless Prevention Start Date: 1/1/2023 End Date: 12/31/2023 Physical Address of Project/Program: Lmailing address

INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: The Salvation Army Mailing Address: 40270 Los Alamos Rd
Murrieta, CA 92562

ORGANIZATION AND GEOGRAPHIC AREA SERVED
Name of Applicant
Organization: The Salvation Army Year Founded: 1865 (England) Website: murrieta.salvationarmy.org
Number of Paid Staff: 3
Social Media: facebook.com/SalArm_yMurrieta
I
Number of Volunteers: 15
Geographic Area(s) the Organization Serves: Southwest Riverside County Geographic Area(s) the Project/Program Serves: Requested project funding will serve Temecula residents only NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA, Contact Name: Major Jess ca Carr Title/Position: Corps Officer Contact Person's Direct Telephone: 562-480-2654 Contact Person's Email: [email protected]

NONPROFIT STATUS
Is this organization incorporated as a nonprofit? Yes ® Date of Incorporation as a Nonprofit: 10/19/1914 (CA corp) NO ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Federal Identification Number: 94-1.156347 1 State Identification Number: 0078321 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS:
1, 91 Attach IRS Deductibility Status using this link: http://apl)s.Irs.gov/a[ )D/Qos/

2. ® Attach State Entity Status Letter using this link:
https://www.ftb.ca.gov/online/self serve entity status letter/index.as 3, ® Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: htt :llrc .doi.ca. ovNerification/Web/Search.as x?faciilt =Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13

APPLICATION AUTHORIZATION
Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, Investments, or interests in real property with a Temecula City Council Member during the past 12 months? No ® Yes ❑ IF YES, BRIEFLY DESCRIBE:

Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No ® Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION:

This Application has been authorized by the organizations:

Executive Committee ® Board of Directors ❑ Members -at -Large ❑

MISSION STATEMENT OF ORGANIZATION
BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES.

Since the founding of The Salvation Army in 1865 in London, England, The Salvation Army has fulfilled its mission to "meet human needs without discrimination." The Salvation Army is a Christian church and leading provider of programs and services for lowincome, homeless, and at -risk individuals and families. Nationwide, The Salvation Army serves approximately 30 million individuals annually. The Southern California Division, which oversees activities in nine counties in the southern and central coast regions, currently operates 53 Corps Community and Service Centers offering a variety of programs based on community needs. These services include food pantries and hot meals; childcare centers, after -school programs, and summer camps for low-income children; homeless prevention services (including rental and utility assistance); emergency disaster relief, seasonallholiday assistance; and services for military veterans. For persons experiencing homelessness, The Salvation Army provides food, hygiene, and other essential items; street outreach; emergency and interim housing; and permanent supportive housing, offered in conjunction with case -managed supportive services. Additionally, for individuals struggling with substance use, The Salvation Army's Adult Rehabilitation Centers offer a 180-day residential work -therapy program. The Salvation Army is also a major developer/operator of affordable housing (Siivercrest Residences) for low-income elderly persons. In sum, The Salvation Army exists to meet human need wherever, whenever, and however it can. The proposed project - Temecula Homeless Prevention - will be an expansion of The Salvation Army's Southwest Riverside County Family Services program, which currently provides rental assistance in the region and seeks to supplement this

FINANCIAL STATEMENTS

UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAYBE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW.

City of Temecula Community Service Funding - Reinvestment In Temecula GRANT APPLICATION Page 6 of 13

FUNDING SOURCES
CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ® Yes ❑ IF YES, PROVIDE BELOW.

NAME OF PROGRAM/PROJECT AMOUNT

FUNDED BYTHE CITY GRANT OR SPONSORSHIP
MONTH + YEAR NAME OF CITY GRANT

FUNDING RE I OR, SPONSORSHIP
OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTJPROGRAM IN THIS APPLICATION? NO ® Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW,
AMOUNT

RECEIVED

NAME OF ENITY
MONTH + YEAR

FUNDING RECEIVED
$ 24,000
FEMA-EFSP Emergency Food Shelter Program - Amount listed is what was used for Temecula Residents Only
11 /2021-11/2022
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13

GRANT PROJECT/PROGRAM DESCRIPTION

IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT

FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.

The Temecula Homeless Prevention program, a proposed expansion of existing services at The Salvation Army serving Southwest Riverside County, will provide up to two months of rental assistance to families and individuals in crisis and at risk of homelessness who reside in the city of Temecula. The program's purpose is to avoid eviction and prevent homelessness for these vulnerable households. As part of the screening process, the Case Manager will request verification of residence in the City of Temecula and proof of financial crisis. Rental assistance will be provided in conjunction with housing - focused case management, including the preparation of a housing stability plan for each household. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.

ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT.

City of Temecula grant funds will be used to deliver rental assistance payments directly to rental property owners and/or management companies on behalf of program participants with past -due rent. The Case Manager will utilize a landlord verification form (evidencing rent owed), current lease, and a late notice (or three day pay or quit notice). A maximum of two months of rent will paid per program participant, and the program will work with the participant to determine the amount of rent that the resident is able to pay. No payments will be given directly to program participants. The same assistance can be given for those with a past due mortgage, but only the principle and interest will be paid, not the escrow or other charges. The Salvation Army Case Manger will try to work with the loan servicer to assist the client. 3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.

The proposed program expansion in Temecula will enable The Salvation Army to significantly increase the capacity and effectiveness of its existing homeless prevention program currently offered by The Salvation Army in Southwest Riverside County. The program will target individuals, couples, and families who are at high risk of homelessness without this assistance. Program beneficiaries will maintain their housing stability. The need for rental subsidies, particularly due to the COVID-19 pandemic, has risen greatly as a result of job losses, reduction of work hours, illness, inflation, and other factors, all of which have led to significantly increased numbers of households at imminent risk of homelessness.

According to the County of Riverside Point -In -Time Count, 67 individuals were found to be homeless (sheltered and unsheltered). Through this program, The Salvation Army will prevent additional households from becoming homeless thus saving Temecula tax payers the burden of additional cost of 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM: 42
3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM: 2 City of Temecula Community Service Funding - Reinvestment In Temecula GRANT APPLICATION Page 8 of 13

PROJECT/PROGRAM DESCRIPTION

CONTINUED
4 SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.

Salvation Army requests a grant from the City of Temecula to provide up to two months of rental stance (paid directly to landlords) for Temecula residents experiencing financial crisis and are at of eviction, thus preventing homelessness,
5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC

AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS.

Over the course of the COVID-19 pandemic, The Salvation Army was called upon to serve significantly higher numbers of people with food, clothing and financial assistance more than any other time in its 25 years in Southwest Riverside County. While service needs - and as a result program expenses - increased dramatically, private donations have begun to decrease. The Salvation Army was compelled to stretch every dollar to meet the needs that arose throughout the pandemic. Additionally, due to inflation and the skyrocketing costs of everyday supplies and vehicie fuel The Salvation Army has been challenged in operating Its programs at a level that meets the high demand for services and financial assistance.

The reduction in private donations and the increase everyday operating costs, reduces the amount of funding available to keep Temecula's struggling people housed. 6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL:
(1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM.

2. Funding from the City of Temecula will allow the homeless prevention program to expand from serving approximately 18 Temecula Residents annually to 42 residents during the proposed program term.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13

PROJECT/PROGRAM BUDGET (do not fill in shaded areas)

LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount of money requested from this City of Temecula
$
Community Services Grant (Not to exceed $50,000)
36,500
Amount contributed to the Project/Program by the Applicant $
I
Organization
12,300
Other grants or funding already awarded for Project/Program, if any $
$24,000
anticipated
from EFSP
In -Kind match amount or volunteer credit hours estimated amount $ S00

TOTAL REVENUE
$ 73,300

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment - No additional equipment needed
$ 0
Facilities/Rent/Insurance
$ 0
Supplies
$ 100
$ 0
Marketing
Services
$ 65,500
Food
0 Other
$ 0
Staffing Expense
THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT;
$ 7,700
HOWEVER PLEASE INCLUDE.

TOTAL EXPENSES
$ 73,300

TOTAL BUDGET
$
$ 73,300
City of Temecula Community Service Funding - Reinvestment In Temecula GRANT APPLICATION Page 10 of 13

PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT
IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE.

If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information.

If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30. 2022. In addition, all grant funds must be substantiated with proper back-up documentatlon. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent.

If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City, To substantlate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper hack -up documentation including the completed table below will) accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022.

1. Fill out table below (make additional copies if needed to explain all expenditures.)

2. Attach copies of receipts/Invoices (In the same order as listed to this table.)

3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022
Organization: Name of Project/Program:

FLY Amount of $
CSF Grant Fund Awarded: Month & Year CSF Grant Received from City:

Number of Beneficiaries Living In 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries If you do not have precise number):

E
Date on
Expenditure
Description
Purpose
E
Name of Company
Receiptlinvoice
Y x
on Receipt or Invoice

MUST BE ON OR BETWEEN
Amount

DESCRIBE THE EXPENDITURE

PURPOSE OF EXPENDITURE
JULY 1. 2021 -JUNE 30. 2022
1 2
3 $
4 $
5 6

EXPENDITURE TOTAL EXPENDITURE TOTAL MUST BE EQUAL TO
(OR GREATER) THAN TOTAL AWARD AMOUNT.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13

FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT
If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the Cf of Temecula, follow these Instructlons.

If your organization Is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional bark -up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approvedlawarded application, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation Including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page.

1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures.

A_ If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5.000 no later than June 30, 2024, to demonstrate grant funds were spent In accordance with the Application. (If you were awarded less than $5,000. submit Expenditure Report for that amount.)
B. If awarded grant funds exceeding $5,000, A) Follow #1.A above first. 13) To receive grant funds exceeding $5,000 (between $SK-$50K), submit the fallowing Expendi lure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10.000 Increments (but no less than $10.000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds,

2. Attach copies of receipts/invoices (in the same order listed in table below).

3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula"

EXPENDITURE REPORT DATED
Organization: Name of Project/Program:

TOTAL FY 2022-2023 Month & Year FIRST $5,000 check
Amount of Grant Fund Awarded: $ was received from City:

1. Is this Expenditure Report Is to provide documentation for first 35,000 awarded and received? Yes or No (already submlttsd),

2. My orpanbtatlon has Already recoivod S of the total FY 2022.23 Grant Fund awarded: by the City

3. Is this Expandituro Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request S Number of beneficiaries living In 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries If you do not have precise number) Date on Expenditure
u Name of Company Receiptllnvoice MUST SUPPORT PROJECTIPROGRAM IN APPLICATION a AWARD LETTER E on Receipt or Invoice MUST BE ON OR BETWEEN
a Z nn�.e March 20, 2020-JUKE 30, Amount Description Purpose EXPENDITURE TOTAL $

EXPENDITURE TOTAL
City of Temecula Community Service Funding - Reinvestment In Temecula GRANT APPLICATION Page 12 of 13

ACKNOWLEDGEMENT/SIGNATURE PAGE
The applicant acknowledges and agrees to the following:
• Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements.
• Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval.

Please allow time for checks to be processed.

The awarding of Community Service Funding does not constitute an automatic annual allocation.

The recognition for Community Service Funding should accrue to the City of Temecula. 0 Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election In which an awarding Council Member is on the ballot.
• The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete.

I/we hereby certify the information contained in this Application is true to the best of our knowledge and belief.

ORGANIZATION NAME: The Salvation Army
MAILING ADDRESS: 16941 Keegan Avenue
Carson, CA 90746
PHONE: (562) 264-3620
EMAIL:
cas, diyisiona€[email protected]
PRESIDENT ZAUTHIO R: J. Koebel, Captain - Divisional Secretary for Business

PRINT NAME TITLE
SIGNATUREDATE:

Moen FI, nAr, ..i

IF DIFFERENT THAN ABO ,
APPICATION PREPARED BY: Major Jessyca Carr, Corps Officer, The Salvation Army Murrieta Corps PRINT NAME TITLE.

SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO:

City of Temecula
Community Service Funding
Attn: City Manager's Office
41000 MAIN STREET
TEMECULA, CA 92590
Questions: [email protected] (951) 694-6413
Betsy. [email protected] (951) 693-3959
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
F T B PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 7/8/2022
ESL ID: 3734826934
Why You Received This Letter
According to our records, the following entity information is true and accurate as of the date of this letter.

Entity ID: 0078321
Entity Name: THE SALVATION ARMY
0 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. 0 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 through the Franchise Tax Board Administrative Dissolution process.

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

Department of the Treasury
ra
Dear Sir or Madam:

Internal Revenue Serv
ice
Tax Exempt and Government Entitles
note:

August 30, 2021
IRS PO Box 2508
Employer10 number:

Cincinnati, OH 45201
94-1166347
Form 990 required:
990, No

THE SALVATION ARMY
Person to contact:

Name: Mr. Flammer
TERRITORIAL HEADQ[JART ERS
ID number: 0203064

TERRY O HUGHES
30840 HAWTHORNE BLVD
RCH PALOS VRD, CA 90275
We're responding to your request dated November 17, 2020, about your tax-exempt status.

We issued you a determination letter in June 2011, recognizing you as tax-exempt under Internal Revenue Code (IRC) Section 501(c)(3).

We also show you're not a private foundation as defined under IRC Section 509(a) because you're described in IRC Sections 509(a)(1) and 170(b)(1)(A)(i).

Donors can deduct contributions they make to you as provided in IRC Section 170. You're also qualified to receive tax-deductible bequests, legacies, devises, transfers, or gifts under IRC Sections 2055, 2106, and 2522, In the heading, we indicated whether you must file an annual information return. If you're required to file a return, you must file one of the following by the 15th day of the 5th month after the end of your annual accounting period. . Form 990, Return of Organization Exempt From Income Tax . Form 990-EZ, Short Form Return of Organization Exempt From Income Tax . Form 990-N, Electronic Notice (e-Postcard) for Tax -Exempt Organizations Not Required to File Form 990 or Form 990EZ
Form 990-PF, Return of Private Foundation or Section 4947(a)(1) Trust Treated as Private Foundation According to IRC Section 60330), if you don't file a required annual information return or notice for 3 consecutive years, we'll revoke your tax-exempt status on the due date of the 3rd required return or notice.

You can get IRS forms or publications you need from our website at www.irs.gov/forms-pubs or by calling 800-TAX- FORM (800-829-3676).

If you have questions, call 877-829-5500 between 8 a.m. and 5 p.m., local time, Monday through Friday (Alaska and Hawaii follow Pacific time).

Thank you for your cooperation.

Sincerely,
--h#— a.. 'n�'
Stephen A. Martin
Director, Exempt Organizations Rulings and Agreements
Letter 4108 (Rev. 09-2020)
Catalog Number 686660

8/26/22, 3:29 PM
Details

HOME ABOUT MEDIA CAREERS REGULATIONS RESOURCES PROGRAMS CONTACT Registra[rilt �,":,etails
Entity type- Corporate Class as registered with the Secretary of State or based on founding R registration documents.

Organization Name: THE SALVATION ARMY IRS FEIN: 941156347 Entity Type: Religious SOS/FTB Corporate/Organization Number: 0078321 Registry Status: Exempt - Religious Renewal Due/Exp. Date:

I1t:71' Registration Number: EX565010 Issue Date:
lecord Type: Charity Registration Effective Date:

Date of Last Renewal: DBA:

Mailing Address
Street: 30840 HAWTHORNE BLVD.

Street Line 2:

City, State Zip: RANCHO PALOS VERDES CA 90275
Filings & Correspondence
No Related Documents
Annual Renewal Data
No Annual Renewal Data
12/31/1990
12/3 l / 1990
Aerated Registrations & Event Reports
The related records shown below depend on the record type being viewed:
r Charity Registrations relate to Professional Fundraising Events which relnte to Professional Fundraiser Registrations, • Raffle Registrations relate to Raffle Reports.
• Click on the RCT Registration No to navigate to the related record.

Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

ARTHUR ALLEY ASSOCIATED
Registration No:

U9029210
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
9/10/2016
Association Date:
10/3/2016
Expiration Date:
3/31/2016
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

AVERILL FUNDRAISING SOLUTIONS, LLC
Registration No:

E0021256
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
7/28/2014
Association Date:
7/16/2014
Expiration Date:
1/18/2015
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

AVERILL FUNDRAISING SOLUTIONS,
LLC
Registration No:

E0022749
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
2/11/2015
Association Date:
1/19/2015
Expiration Date:
7/17/2015
Prereq Type:

Prerequisite
Relationship:

Charily
Registrant:

AVERILL FUNDRAISING SOLUTIONS,
LLC
Registration No:

E0024763
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
8/21/2015
Association Date:
7/18/2015
Expiration Date:
7/14/2017
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

AVERILL FUNDRAISING SOLUTIONS,
LLC
Registration No:

E0032387
Registration Type:

Fundraising Event
Registration Status:

Complete
h;ps://rct.doj.ca.govNerification/Web/Details.aspx?result=el07b9bf-6594-4ab2-8b64-del8411723of 1/4

8/26/22, 3:29 PM
Details
Date Established:
2/8/2018
Association Date:
1/8/2018
Expiration Date:
4/7/2018
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

AVERILL FUNDRAISING SOLUTIONS, LLC
Registration No:

E0032764
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
2/27/2018
Association Date:
1/8/2018
Expiration Date:
4/27/2018
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

AVERILL FUNDRAISING SOLUTIONS,
LLC
Registration No:

E0034365
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
10/23/2018
Association Date:
11/1/2018
Expiration Date:
10/31/2020
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

COMMUNITY COUNSELLING SERVICE CO., LLC
Registration No:

E0011232
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
6/27/2011
Association Date:
11/30/2009
Expiration Date:
5/31/2010
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

COMMUNITY COUNSELLING SERVICE
CO., LLC
Registration No:
l.0025 Oil
Registration Type:

Fundraising; Event
Registration Status:

Complete
Date Estab11she►1:
2/12/2016
Association Date:
10/l/2015
Expiration Date:
12/31/2015
Prereq Typo:

Prerequisite
Relationship:

Charity
Registrant:

COMMUNITY COUNSELLING SERVICE CO., LLC
Registration No:

E0029414
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
2/2/2017
Association Date:
10/1/2016
Expiration Date:
12/31/2016
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

COMMUNITY COUNSELLING SERVICE CO., LLC
Registration No:

E0035295
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
2/13/2019
Association Date:
9/4/2018
Expiration Date:
9/28/2018
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

COMMUNITY COUNSELLING SERVICE CO., LLC
Registration No:

E0037408
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
10/1/2019
Association Date:
1/2/2019
Expiration Date:
5/31/2019
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

COMMUNITY COUNSELLING SERVICE CO., LLC
Registration No:

E0038800
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
2/28/2020
Association Date:
3/2/2020
Expiration Date:
2/24/2023
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

COMMUNITY COUNSELLING SERVICE CO., LLC
Registration No:
;004173t1
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
12/17/2020
Association Date:
8/3/2020
Expiration Date:
1/31/2023
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

COMMUNITY COUNSELLING SERVICE CO., LLC
Registration No:
j,;¢0,1039I
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
2/11/2022
Association Date:
1/3/2022
Expiration Date:
12/31/2022
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

GATEWAY COMMUNICATIONS INC
Registration No:

E0030815
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
7/17/2017
Association Date:
8/1/2017
Expiration Date:
12/31/2017
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

GATEWAY COMMUNICATIONS
INC
Registration No:

E0033634
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
5/30/2018
Association Date:
6/20/2018
Expiration Date:
12/31/2018
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

INNOV81VE DEVELOPMENT
Registration No:

E0035517
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
2/21/2019
Association Date:
3/9/2019
Expiration Date:
3/9/2019
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

LESTER CONSULTING GROUP, INC.
https:Hrct.doj.ca.govNerification/Web/Details.aspx?result=el07b9bf-6594-4ab2-8b64-dol8411723ef 214

8/26/22, 3:29 PM
Details
Registration No:

EO019177
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
1/23/2014
Association Date:
1/1/2014 Expiration Date:
11/30/2015
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH,

INC, DBA TRUESENSE MARKETING
Registration No:

E0031101
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
8/31/2017
Association Date:
9/15/2017 Expiration Date:
12/31/2017
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH,
INC. DBA TRUESENSE MARKETING
Registration No:

B0031258
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
9/28/2017
Association Date:
10/1 /2017 Expiration Date:
9/30/2019
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH,
INC. DBA TRUESENSE MARKETING
Registration No:

E0031360
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
10/20/2017
Association Date:

I1/1/2017 Expiration Date:
4/30/2018
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH,

INC, DBA TRUESENSE MARKETING
Registration No:
- l 1 3 9
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
10/9/2018
Association Date:
10/15/2018 Expiration Date:
12/31/2018
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH,
INC. DBA TRUESENSE MARKETING
Registration No:

E0037233
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
9/6/2019
Association Date:
10/1/2019 Expiration Date:
9/30/2020
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH,
INC. DBA TRUESENSE MARKETING
Registration No:

E0037445
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
10/9/2019
Association Date:
10/1/2019 Expiration Date:
9/30/2020
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC. DBA TRUESENSE MARKETING Registration No:

E0040453
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
8/4/2020
Association Date:
8/1/2020 Expiration Date:
9/30/2021
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC. DBA TRUESENSE MARKETING Registration No:

E0040828
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
9/11/2020
Association Date:
10/1/2020 Expiration Date:
9/30/2021
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC.

DBA TRUESENSE MARKETING
Registration No:

I;Q094914
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
9/15/2021
Association Date:
10/1/2021 Expiration Date:
9/30/2022
Prereq Type:

Prerequisite
Relationshlp:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC.

DBA TRUESENSE MARKETING
Registration No:

F0044915
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
9/15/2021
Association Date:
10/1/2021 Expiration Date:
9/30/2022
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC. DBA TRUESENSE MARKETING Registration No:

E0044916
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
9/15/2021
Association Date:
10/1/2021 Expiration Date:
9/30/2022
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC. DBA TRUESENSE MARKETING Registration No:

E0048164
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
8/24/2022
Association Date:
10/1/2022 Expiration Date:
9/30/2023
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

MAILING SERVICES OF PITTSBURGH, INC. DBA TRUESENSE MARKETING Registration No:

E0048205
Registration Type:

Fundraising Event Registration Status:

Complete
Date Established:
8/26/2022
Association Date:
10/1/2022 Expiration Date:
9/30/2023
Prereq Type:

Prerequisite
Relationship:
https:Hrct.doj.ca.govNerification/Web/Details.aspx?result=el O7b9bf-6594-4ab2-8b64-del8411723ef 314

6/26122, 3:29 PM
Details
Charity
Registrant:

MIRIAM HOUGHTON DBA EXPRESSIONS
Registration No:

EO 18684
Registration 1Typc:

Fundraising Event
Registration Status:

Complete
Date Established:
10/29/2013
Association Date:
1/I/2013
Expiration Date:
12/31/2012
Prereq 'ljpe:

Prerequisite
Relationship:

Charity
Registrant:

MIRIAM HOUGHTON DBA EXPRESSIONS
Registration No:

E0018688
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
10/29/2013
Association Date:
3/2/2013
Expiration Date:
12/31/2012
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

TSM DONOR ENGAGEMENT TEAM, INC.

Registration No:

E0030538
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
5/10/2017
Association Date:
5/15/2017
Expiration Date:
7/31/2017
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

TSM DONOR
ENGAGEMENT TEAM, INC.

Registration No:
it10'4 i 124
Registration Type:

Fundraising Event
Registration Staters:

Complete
Date Established:
9/5/2017
Association Date:
10/I/2017
Expiration Date:
9/30/2019
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

TSM DONOR
ENGAGEMENT TEAM, INC.

Registration No:

E0036403
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
5/9/2019
Association Date:
1/1/2018
Expiration Date:
12/31/2018
Prereq TI pc:

Prerequisite
Relationship:

Charity
Registrant:

TSM DONOR
ENGAGEMENT TEAM, INC.

Registration No:

E0037371
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
9/27/2019
Association Date:
1/1/2019
Expiration Date:
9/30/2020
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

TSM DONOR
ENGAGEMENT TEAM, INC.

Registration No:

OE 040826
Registration Type:

Fundraising Event
Registration Status:

Complete
Date Established:
9/11/2020
Association Date:
10/l/2020
Expiration Date:
9/30/2021
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

TSM DONOR ENGAGEMENT TEAM, INC.

Registration No:

E0044910
Registration Type:

Fundraising Evcnt
Registration Status:

Complete
Date Established:
9/15/2021
Association Date:
10/l/2021
Expiration Date:
9/30/2022
https://rct.doj.ca.govNerificationlWeblDetalls.aspx?result=el 07b9bf-6594-4ab2-8b64-del8411723ef 414

FY 2022/2023

COMMUNITY SERVICE FUNDING

REINVESTMENT IN TEMECULA

GRANT APPLICATION
THE SHELLA FOUNDATIll

CITY OF TEMMCUTA
FISCAL YEAR 2022.2023

COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA

PROGRAM APPLICATION
(Please Print or Type)
DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022

I PROJECT/PROGRAM INFORMATION I
Amount Requested: $ 50,000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Project/Program Title: In -Home Personal Care Respite Scholarship Start Date: 12/1/2022 End Date: 11/30/2023 Physical Address of Project/Program: 41593 Winchester Rd., Ste 200-440, Temecula, CA., 92590

INCLUDE IF DIFFERENTTHAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: THE SHELLA FOUNDATION Mailing Address: PO Box 263
Menifee, CA., 92586

ORGANIZATION AND GEOGRAPHIC AREA SERVED
Name of Applicant
Organization: THE SHELLA FOUNDATION
Website: www.shellafoundation.org
Number of Paid Staff: 0
Year Founded: 2004
Social Media: https://www.facebook.com/theshellafoundation Number of Volunteers: 13
Geographic Area(s) the Organization Serves: Riverside, San Bernardino, San Diego, and Orange Counties Geographic Area(s) the Prolect/Program Serves: Temecula, California NOTE: COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA.

Contact Name: Troy A. Small
Contact Person's Direct Telephone: (951) 491-1200
Title/Position: Grants Manager
Contact Person's Email: [email protected]

NONPROFIT STATUS
Is this organization incorporated as a nonprofit? Yes ® Date of Incorporation as a Nonprofit: 7/19/2004 No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Federal Identification Number: 20-1289365 State Identification Number: 2670022 PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS:

1. ® Attach IRS Deductibility Status using this link: hftD;11ar)r)s.iE§._qov/apD1eos1

2. 0 Attach State Entity Status Letter using this link:
https://www.ftb.ca-gov/online/self serve entity -status letterlindex.as

3. 0 Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: htt:/Irct.do'.ca. avNerificationNVeb/Search.as x?facilil =Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13

J APPLICATION AUTHORIZATION
Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No ® Yes ❑ IF YES, BRIEFLY DESCRIBE:

Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No ® Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION:

This Application has been authorized by the organization's:

Executive Committee ❑ Board of Directors ® Members -at -Large ❑

MISSION STATEMENT OF ORGANIZATION
BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES.

The Shelia Foundation mission is to provide comprehensive case management and assistance in all aspects of personal care, including financial assistance to community organizations and individual families affected by disabilities or functional needs.

The Shelia Foundation Chief Executive Officer, Michael Foster was inspired to form the 501(c)(3) charitable organization because of his firsthand experience with caring for family members with a disability. "Shelia" was named after Mike's parents Shelton and Della Foster, who spent their fives assisting their daughter (Debbie) through multiple disabilities until Parkinson's Disease took the life of Shelton in 2005. and Della at the age of 86 due to natural causes.

The Sheila Foundation offers In -Home Personal Care not only to seniors, but to individuals managing Autism, Down Syndrome, and Cerebral Palsy, as well as other disabilities. The Shelia Foundation provides financial assistance and personal care scholarships to populations needing in -home personal care services but are unable to receive the care through any other means. Over the last 17 years more than $50,000 in financial aid and scholarships have been provided to families in need of in -home personal

FINANCIAL STATEMENTS

UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13

FUNDING SOURCES
CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No ® Yes ❑ IF YES, PROVIDE BELOW.

NAME OF PROGRAM/PROJECT

FUNDED BY THE CITY GRANT OR SPONSORSHIP
AMOUNT
MONTH +YEAR

FUNDING RECEIVED

NAME OF CITY GRANT

OR SPONSORSHIP
N/A
$
OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECTIPROGRAM IN THIS APPLICATION? No ® Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW.

AMOUNT
MONTH + YEAR

RECEIVED

NAME OF ENITY

FUNDING RECEIVED
$
N/A
$
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13

GRANT PROJECT/PROGRAM DESCRIPTION

IMPORTANT - RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT

FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT, The Sheila Foundation In -Home Personal Care Respite Scholarship program is essential to our community and the populations we serve. Local families and organizations reach out to The Sheila Foundation with needs to care for their family and loved ones.

The individuals requiring care are either diagnosed at birth with disabilities or have been involved in an accident that caused a disability.

The Sheila Foundation also helps families that are caring for a loved one in their golden years, who can no longer care for themselves, but want to remain in their home. We provide the means for families to receive the care they need, while remaining in their home and maintaining their independence.

Individuals living with a disability and the elder community often require in -home, non -medical supports to maintain their i ndependence. There's often a lack of finances for this type of care. Programs may be available to these individuals, but The Shelia Foundation noticed "gaps" in coverage or their ability to pay. Individuals with resources and Medicaid can obtain the needed assistance. However, those in the financial "gap" are unable to obtain the in -home personal care service they need because some families don't have the means or money to pay for services. 2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED,

ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT.

The Sheila Foundation will use the grant funding to award Personal Care Respite Scholarships to populations within Temecula, California needing in -home personal care services but tackin the financiat means to receive the care.

The Sheila Foundation wilt use the funds to provide approximately 1700 hours of in -home personal care and respite support to families within Temecula, California under The Shelia Foundation In -Home Personal Care Respite Scholarship Prog ram. Our goal is to serve up to 70 families, by providing each family with 24 hours of in -home personal care under the scholarship program. The Shelia Foundation will pay for caregiving support on behalf of the Temecula resident and award the service as a personal care respite scholarship to Temecula families who qualify.

The family is not billed for any services.

The specific goals of the program:

1. Provide1700 hours of in -home personal care to families within Temecula, California.

2. Serve up to 70 families within Temecula, California by providing each family with an In -Home Personal Care Respite Scholarship.
3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.

The Sheila Foundation will use the grant funding to exclusively benefit populations within Temecula, California needing in -home personal care services but lacking the financial means to receive the care. Under The Sheila Foundation In -Home Personal Care Respite Scholarship Program, approximately seventy Temecula families will receive the benefit of twenty-four hours of in -home personal respite care with no out-of-pocket expense.

This will greatly impact our Temecula community by helping these families to receive the care they need and maintain their independence and inclusion during important life moments. 3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT FROM THIS PROJECT/PROGRAM:
70 3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM:
13 City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13

PROJECT/PROGRAM DESCRIPTION

CONTINUED
4 SUMMARY STATEMENT —SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.

The Shella Foundation will award In -Home Personal Care Respite Scholarships to populations within Temecula, California needing in -home personal care services but lacking the financial means to receive the care. The grant funding will exclusively benefit 70 Temecula families with 24 hours of in -home personal care with no out-of-pocket expense.
5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC

AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS.

The COVID-19 Pandemic had a drastic effect on The Shella Foundation's ability to serve the Temecula Community. The Shelia Foundation's primary sources of funding are donations and fundraising. Shella receives 100% of its funding from donations. The Shella Foundation volunteers routinely hold fundraising events to increase the amount of donations received in order to serve more clients. The pandemic prevented us from holding fundraising events due to lockdowns and social distancing. The lockdowns and social distancing prevented The Shella Foundation from providing in -home care. 6 1F APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL:
(1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM.

The monies used from this grant will be used to continue an existing project/program. The in -home personal care respite program will be focused on the residents of Temecula, California and will provide an increase of support to our community. The Shella Foundation will reserve the grant funds exclusively for Temecula populations, awarding personal care scholarships to those who qualify. There will be no out-of-pocket expense for the family receiving care.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13

PROJECT/PROGRAM BUDGET (do not fill in shaded areas)

LINE ITEMS FOR PROJECT/PROGRAM REVENUES

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount of money requested from this City of Temecula $ 50,000 Community Services Grant (Not to exceed $50,000)
Amount contributed to the Project/Program by the Applicant $ 0 Organization
Other grants or funding already awarded for Project/Program, if any $ 0 In -Kind match amount or volunteer credit hours estimated amount $ 0 TOTAL REVENUE $ 50,000

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment
Facilities/Rent/Insurance
Supplies
Marketing
I
Services
Food
Other
Staffing Expense

EXPENSES
$0
$0
$200
$200
$47,600
$0
$0
THIS IS INELIGIBLE TO BE FUNDED BY CITY'S GRANT;
HOWEVER PLEASE INCLUDE. $ 0
TOTAL EXPENSES $50,000
TOTAL BUDGET $ 50,000 1 $ 50,000
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13

PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT
IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE.

If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information.

If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit andlor require additional back-up information to substantiate how funds received from the City were spent.

If the funds were not spent in accordance with the approvedlawarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropr{ately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022.

1. Fill out table below (make additional copies if needed to explain all expenditures )

2. Attach copies of receipts/invoices (in the same order as listed in this table.)

3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022
Organization: NSA Name of Project/Program-
FY 2021-2022 Amount of $
CSF Grant Fund Awarded: Month & Year CSF Grant Received from City:

Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number):

E
Date on
Expenditure
Name of Company
Receeiptllnvoice
Description
_
Purpose
aon
Receipt or Invoice

MUST BE ON OR BETWEEN
Amount

DESCRIBE THE EXPENDITURE

PURPOSE OF EXPENDITURE
JULY 1, 2021 - JUNE 30, 2022
1 2
3 4
5 6

EXPENDITURE TOTAL EXPENDITURE TOTAL MUST BE EQUAL TO
(OR GREATER) THAN TOTAL AWARD AMOUNT
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13

FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT
If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions.

If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount of funds to the City. To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page.

1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures.

A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that arnount.)
B. If awarded grant funds exceeding $5,000. A) Follow #1.A above first. B) To receive grant funds exceeding $5,000 (between $5K-$50K), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (but no less than $10,000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds.

2. Attach copies of receipts/invoices (in the same order listed in table below).

3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92690, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula"

EXPENDITURE REPORT DATED
Organization: Name of Project/Program:

TOTAL FY 2022-2023 Month & Year FIRST'$5,000 check
Amount of Grant Fund Awarded: $ was received from City:

1. Is this Expenditure Report is to provide documentation for first $6,000 awarded and received? Yes_ or No (already submitted).

2. My organization has already received $ of the total FY 2022-23 Grant Fund awarded by the City

3. Is this Expenditure Report Is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) d Date on I Expenditure
E Name of Company Receipt/invoice MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER au E on Receipt or Invoice MUST BE ON OR BETWEEN
pZ March 20.2020-DUNE30. Amount Description Purpose
202a
2 f 1 I$
EXPENDITURE TOTAL $ EXPENDITURE TOTAL
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13

ACKNOWLEDGEMENT/SIGNATURE PAGE
The applicant acknowledges and agrees to the following:
• Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements.
• Every Community Service Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Temecula. • Funding is not immediately available to the recipient, and requires an award letter signature upon approval.

Please allow time for checks to be processed.
■ The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. • Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot.
• The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. • If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete. /we hereby certify the information contained in this Application is true to the best of our knowledge and belief.

ORGANIZATION NAME: THE SHELLA FOUNDATION
MAILING ADDRESS: PO Box 263
Menifee, CA 92586
PRESIDENT / AUTHORIZED OFFICER: Michael Foster
v,tll11 P}rrvU
&—Wffdl G f �
SIGNATURE:rn�turia.ro�cuSs.r,a,ao��lfi3r�r)e;
PHONE: (951) 723-8460
EMAIL: [email protected]
CEO
DATE: September 2, 2022

IF DIFFERENT THAN ABOVE,
APPICATION PREPARED BY: Troy A. Small [email protected] (951)491-1200 Grants Mana SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO:

City of Temecula
Community Service Funding
Attn: City Manager's Office
41000 MAIN STREET
TEMECULA, CA 92590
Questions: [email protected] (951) 694-6413
Betsy. [email protected] (951) 693-3959
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
tB)PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/7/2022
ESL ID: 5151771010
Why You Received This Letter
According to our records, the following entity information is true and accurate as of the date of this letter.

Entity ID: 2670022
Entity Name: THE SHELLA FOUNDATION
a1. The entity is in good standing with the Franchise Tax Board.

2. The entity is not in good standing with the Franchise Tax Board. 0 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 through the Franchise Tax Board Administrative Dissolution process.

Important Information
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: ftb.ca.gov
Phone: 800-852-5711 from 7 a.m. to 5 p.m. weekdays, except state holidays 916-845-6500 from outside the United States

Q HELPO MENU -
Home > Tax Exempt 0 ganixation Search > Shelia Foundation < Back Resu Its
Shelia Foundation
EIN: 20-1289365 1 Menifee, CA, United States
Publication 78 Data v
Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.

On Publication 78 Data List: Yes
Deductibility Code: PC
Form 990-N (e-Postcard) o
Organizations who have filed a 990-N (e-Postcard) annual electronic notice. Most small organizations that receive less than $50,000 fall into this category.

Tax Year 2021 Form 990-N (e-Postcard)
Tax Period:
2021 (07/01/2021 - 06/30/2022)
EIN:
20-1289365
Legal Name (Doing Business as):

Shelia Foundation

Mailing Address:

PO Box 263
Menifee, CA 92586
United States
Principal Officer's Name and Address:

Michael Foster
PO Box 263
Menifee, CA 92586
United States
Gross receipts not greater than:
$50,000
Organization has terminated:

No
Website URL:

Shella Care Management Services, LLC
Tax Year 2020 Form 990-N (e-Postcard)
Tax Year 2018 Form 990-N (e-Postcard)
Tax Year 2017 Form 990-N (e-Postcard)
Tax Year 2016 Form 990-N (e-Postcard)
Tax Year 2015 Form 990-N (e-Postcard)
Tax Year 2013 Form 990-N (e-Postcard)
Tax Year 2011 Form 990-N (e-Postcard)
Tax Year 2009 Form 990-N (e-Postcard)
Tax Year 2008 Form 990-N (e-Postcard)
Page Last Reviewed or Updated: 20-November-2020 f'► Share $ Print

x
I�JS DEPARTMENT OF THE TREASURY
► INTERNAL REVENUE SERVICE j
PHILADELPHIA PA 19255-002'
37 005537,132407.0022,001 1 NB 0.309 702
I II IIIIIIIIIII�IIIIIIIIIIIYIIIIIIIII YIIIYIII'IIOl llllllll'III'

SHELLA FOUNDATION

MICHAEL FOSTER
27626 ALTA VISTA WAY
SUN CITY CA 92585
Date of this notice: 07-07-2004
Employer Identification Number:
20-1289365
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 OF THIS NOTICE.

WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER
'Chank you for applying for an Employer Identification Number (EIN), We assigned you EIN 20-1289365, This EIN will identify your business account, tax returns, and documents even if you'have no employees. Please keep this notice in your permanent records.

When filing tax documents, please use the label IRS provided. If that isn't possible, you should use your EIN and complete name and address shown above on all federal tax forms, payments and related correspondence. If this information isn't correct, please correct it using the tear off stub from this notice. Return it to us so we can correct your account. If you use any variation of your name or EIN, it may cause s delay in processing and may result in incorrect information in your account.

It also could cause you to be assigned more than one EIN.

If you want to apply to receive a ruling or a determination letter recognizing your organization as tax exempt, and have not already done so, you should file Form 1023/1024, Application for Recognition of Exemption, with the IRS Ohio Key District Office. Publication 557, Tax Exempt Status for Your Organization, is available at most IRS offices and has details on how you can apply .

IMPORTANT REMINDERS;
* Keep a copy of this notice in your permanent records. * Use this EIN and your name exactly as they appear above on all your federal tax forms.
* Refer to -this EIN on your tax related correspondence and documents.

Thank you for your cooperation.

AIPCUi CrIFUI;t T1 "11
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eg,Y
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till: r, I ,I{ I I I , I, r, I .

Organization Name: THE SHELLA FOUNDATION
IRS FEIN:
201289365
Entity Type: Public Benefit
SOS/FTB Corporate/Organization Number:
2670022
Registry Status: Delinquent
Renewal Due/Exp. Date:
5/15/2021
RCT Registration Number: 125013
Issue Date:
12/31/1990
Record Type: Charity Registration
Effective Date:
12/31/ 1990
Date of Last Renewal: 5/28/2020
DBA:

It'"A
Street:

PO BOX 263
Street Line 2:

City, State zip:

C�Ay92586
�MENIFEE
p
Miscellaneous-Doetiments
Return envelope - 27626 Alta Vista Way
F'trrm RRF-
2017
Form RRF-1
2019
Form RRF-1
2014
Forlrt R K -1
2015
Form RRF-1
2016
Miscellaneo,u Upy.urnents
Return envelope - 1745 W Katella Ave
RCT 45 I-S_QeiinnucncyNgdey: - Ist
Click on Document Type at the left to open PDF
CT-451 1st UdjLnuency Notice
27626ALTA VISTA WY
CT-45I 1st D:rlitlyuency Notice
30353 GULF STREAM DRIVE
C 45 I I Sfl)[ linaUerlCy Nallc a
PO BOX 263
C T-451 ,[S1,_Qclitlutlency-Ngd�&
1745 W KA ELLA AVE STE E
l -,g jgor
2020
Form RItF-1
2019
0 547 MiSSing j2Q2U llt7flt5
Click on Document Type at the left to open PDF
.Form RRF-1
2013
An nua F
fie; ,ewa Da'.a
Status of Filing:

Accepted
Acruunting. Period Begin Date:

I/I/2013
Accounting Period End Date:
12/3 t/2013
Filing Received Date:
10/14/2011
Form RRF-I Reject/Incomplete Reason:

Form CT TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason
Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:

Ill/2014
Accounting Period End Date:
12/31/2014
Filing Received Date:
9/11/2019
Form RRF-1 Reject/Incomplete Reason:

Form CTTR-1 Reject/incomplete Reason;
IRS Form 990 Reject/Incomplete Reason;
Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:

I/ l/2015
Accounting Period End Date:
12/31/2015
Filing Received Date:
9/11 /2019
Form RRF-1 Reject/Incomplete Reason:

Form CTTR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

StatuA of Filing:

Accepted
Accounting Period Begin Date:
1/1/2016
Accounting Period End Date:
12/31/2016
Filing Received Date:
9/ 11/2019
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-I Reject/Incomplete Reason;
IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff.

Status of Filing:

Accepted
Accounting Period Begin Date:
1/1/2017
Accounting Period End Date:
12/31/2017
Filing Received Date:
9/11/2019
Form RRF-1 Re.ject/Incomplete Reason:

Form CT-TR-I Reject/Incomplete Reason;
IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
1/1/2018
Accounting Period End Date:
12/31/2018
Filing Received Date:
9/1 1/2019
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
1/1/2019
Accounting Period End Date:
12/31/2019
Filing Received Date:
4/9/2020
Form RRF-I Reject/Incomplete Reason:

Form CT-TR-I Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

III - . ,e-I Y� ..?I'. rr" , ,.!I;A, rt._III I I t •r• I. 1-41 L•I I ,: urrp ....I ir llr Lu 111',I i rI 'Ili". I I r i4 rl P 1,'rr,,2 ,1rI r "r i r•1Ifi �.i�rr.r %'r•,� ,1 (41 i,!1 4. J.i• r:lti" I r..Ir•.: i.1'r�.1

11..I III - .,,,1,... I: re.',., i r 1.Irrr I , u•sI . , I ■ IIrf nIr ttC'I Ile g is-tra Lion Na I.. i. r" •L. n I.:, rt .• I4•L r;.• 1 , No Related Records

FY 2022/2023

COMMUNITY SERVICE FUNDING

REINVESTMENT IN TEMECULA
GRANT APPLICATION #
61 THE TEMECULA VALLEY

MASTER CHORALE

CI'1'1 OF'11'-1�1 CCU LA.

FISCAL YEAR 2022.2023

COMMUNITY SERVICE FUNDING - REINVESTMENT IN TEMECULA

PROGRAM APPLICATION
(Please Print or Type)
DUE ON OR BEFORE: MONDAY, SEPTEMBER 12, 2022

PROJECT/PROGRAM INFORMATION
Amount Requested: $ $22,000 MAXIMUM ALLOWABLE: $50,000 PER ORGANIZATION Temecula Valley Master Chorale
Project/Program Title: Season 22-23 Start Date: 12/1122 End Date: 11/30/23 Physical Address of Project/Program: 42690 Margarita Rd, Temecula, CA 92592-5462

INCLUDE IF DIFFERENT THAN ORGANIZATION'S MAILING ADDRESS If Grant is Awarded, Make Check Payable to: The Temecula Valley Master Chorale Mailing Address: PO BOX 890204
Temecula, CA 92589-0204

ORGANIZATION AND GEOGRAPHIC AREA SERVED
Name of Applicant The Temecula Valley Master
Organization. Chorale Year Founded: 2001
Website: Ww`.temeculavalleymasterchorale.org Social Media: facebook.com Number of Paid Staff: two Number of Volunteers: 42
Geographic Area(s) the Orminization Serves: City of Temecula and surrounding area Geographic Area(s) the Project/Program Serves: City of Temecula and surrounding area NOTE. COMMUNITY SERVICE FUNDING GRANT PROGRAM FUNDING MUST BE EXCLUSIVELY USED TO SERVE TEMECULA.

Contact Name: Geneva Krag Title/Position: Board Member
Contact Person's Direct Telephone:951-505-5000 Contact Person's Email: [email protected] 111

NONPROFIT STATUS
Is this organization incorporated as a nonprofit? Yes E Date of Incorporation as a Nonprofit:

No ❑ IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Federal Identification Number: 330928024
State Identification Number: CT0190938
PRINT OUT AND ATTACH TO THIS APPLICATION VERIFICATION FROM FEDERAL (IRS) AND STATE (FTB) AS FOLLOWS:

1. 9 Attach IRS Deductibility Status using this link: 1711p:/lapps.irs.gov/apo/eos/

2. K Attach State Entity Status Letter using this link:
https.*// www.ftb.ca.gov/online/self serve entity status letterlindex.as

3. © Attach first page only of most recent IRS Form 990 or attach print out of detailed info about your charity found on this State Registry's Search Tool: hti .//rct. o .ca. v/VerificationfWe /Search.as x?faciiit =Y City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 5 of 13

APPLICATION AUTHORIZATION
Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Temecula City Council Member during the past 12 months? No Yes ❑ IF YES, BRIEFLY DESCRIBE:

Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization? No ® Yes ❑ IF YES, PROVIDE COUNCIL MEMBER'S NAME AND TITLE WITHIN THE ORGANIZATION:
[This Application has been authorized by the organizations:

Executive Committee ❑ Board of Directors #ij Members -at -Large ❑

MISSION STATEMENT OF ORGANIZATION
BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION/GOALS AND OBJECTIVES.

Motto: " SHARING A LOVE FOR MUSIC WITH THE COMMUNITY AROUND US " The Temecula Valley Master Chorale was created to provide a repertory of choral music which seeks to nurture the public's appreciation of the life -enhancing qualities of the choral arts. Our mission is to provide local performances that will enrich the educational and cultural life of the community, to help and encourage young artists to expand their musical experience, and to demonstrate a professional attitude while performing quality musical literature.

Chorale members come from all walks of life and professions. For some, music is their vocation as teachers and choir directors; but for many others it is their avocation, a great way to enrich their lives by coming together with others who love to sing and perform beautiful and challenging works of music.

FINANCIAL STATEMENTS

UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA's AUDIT, MAYBE NEEDED

UPON REQUEST TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT, DO NOT SUBMIT NOW, City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 6 of 13

FUNDING SOURCES
CITY OF TEMECULA—SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM THE CITY FOR ANY PROGRAM? No E Yes ❑ IF YES, PROVIDE BELOW.

OTHER OUTSIDE SOURCES —SINCE MARCH OF 2020, HAS THIS ORGANIZATION RECEIVED (OR IS

CONCURRENTLY REQUESTING) ANY OTHER SOURCES OF FUNDING FROM ENTITIES (NOT INCLUDING THE CITY) FOR THE SAME PROJECT/PROGRAM IN THIS APPLICATION? NO E Yes ❑ IF YES, PROVIDE INFORMATION IN TABLE BELOW,
AMOUNT MONTH + YEAR

RECEIVED NAME OF ENITY

FUNDING RECEIVED
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 7 of 13

GRANT PROJECT/PROGRAM DESCRIPTION

IMPORTANT- RECEIPTS/INVOICES IS REQUIRED TO BE SUBMITTED TO THE CITY TO VALIDATE THE ORGANIZATION SPENT GRANT

FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECT/PROGRAM AS DESCRIBED HERE 1 DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.

With a passion for the classics as well as modern masters, Temecula Valley Master Chorale is committed to excellence in the vocal arts. Through this grant opportunity, we are asking for support of season concerts while collaborating with Temecula schools and businesses with training, venues, music, and small equipment purchases. We hope to enhance our programs with local professional instrumentalists and soloists.
2 DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED,

ALSO, INCLUDE A LIST OF GOODS, EQUIPMEMENT, AND/OR SERVICES THIS ORGANIZATION HAS PURCHASED OR PLANS TO PURCHASE WITH AWARDED FUNDS TO SUPPORT THIS PROGRAM/PROJECT.

To accomplish our mission, we will spend the grant funds by using local Temecula businesses for concert venues, competition venues, musical score purchases, program and flyer printing, independent contract instrumentalists, and food vendors.
3 TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.

The Temecula Valley Master Chorale serves the community through encouraging a productive interaction for choir participants and audience through harmonious artwork. The audience is challenged to hear layers of art; the musicians practice to sing with others in harmony and share that with the audience. Regardless of age, gender, nationality, our organization spends our resources and time to create that connection. By involving Temecula venues, businesses, and supplemental musicians we can make an impact on the prosperity of the community.

We also want to nurture the talent and love for music for future musicians in our community.
3b ESTIMATED NUMBER OF PEOPLE FROM TEMECULA EXPECTED TO BENEFIT lover 500 FROM THIS PROJECT/PROGRAM:
3c ESTIMATED NUMBER OF VOLUNTEERS INVOLVED IN THIS PROJECT/PROGRAM:
+45
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 8 of 13

PROJECT/PROGRAM DESCRIPTION

CONTINUED
4 SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS.

Live music and art are fundamental to enhancing human experience. Choral music brings people together, builds relationships, and in its variety introduces the singer and listener to different cultures and styles. This grant opportunity helps brings value to the Temecula community through song and collaboration with Temecula businesses and residents.
5 IF APPLYING FOR MORE THAN $5,000, PLEASE EXPLAIN HOW THE COVID-19 PANDEMIC

AFFECTED THIS NONPROFIT ORGANIZATION'S ABILITY TO SERVE THE TEMECULA COMMUNITY. YOU MAY ALSO INCLUDE INFLATIONARY CONCERNS.

When the COVID-19 quarantine first started our season was cut short and we were not able to have our final concert and fund-raising event. For the next season, some of our members participated in " on-line " practices with no public performance, but a limited you -tube video performance. Last season (Sept. 2021- April 2022) we practiced with masks and had outdoor concerts, Not all our members were comfortable returning even with masks. Again, our fundraising activities were also limited, affecting us economically. We look forward to a new season of live performances and nurturing and developing new musicians, particularly those who live in Temecula. We would like to pass on our love of J music to the next generation.

I._
6 IF APPLYING FOR MORE THAN $5,000, EXPLAIN HOW FUNDS HAVE OR WILL:
(1) CREATE NEW PROJECT/PROGRAM, (2) EXPAND EXISTING PROJECT/PROGRAM, AND/OR (3) CONTINUE EXISTING PROJECT/PROGRAM.

Grant funds would expand our opportunities to reach more of the Temecula community through involvement in our Choir, in the audience capacity or as vendors of venues, supplies, or services. This creates an opportunity to collaborate with Temecula school choirs (public and private), and orchestras and their families. Our dream is to eventually host a fine arts festival at the Community Rec Center that would include school chairs, orchestras, and local vendors.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 9 of 13

PROJECT/PROGRAM BUDGET (do not fill in shaded areas)

LINE ITEMS FOR PROJECT/PROGRAM REVENUES EXPENSES

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount of money requested from this City of Temecula $ 22,000 Community Services Grant (Not to exceed $S0,000)
Amount contributed to the Project/Program by the Applicant $ 22,624 Organization
Other grants or funding already awarded for Project/Program, if any I $ 0 Supplies
Marketing
Services
Food
Other
Staffing Expense THIS 15 INELIGIBLE TO BE FUNDED BYCITY'S GRANT;

HOWEVER PLEASE INCLUDE,
In -Kind match amount or volunteer credit hours estimated amount $187,068 TOTAL REVENUE 1 $ 231,692

LIST OF EXPENSES FOR PROJECT/PROGRAM
/ q p sound equipment, vlderk production
T$1 ' 000
ools E ui ment
Facilities/Rent/Insurance $7,500
$2,000
___1 $1,500_
I $10,000
$14, 600
music scores
Ayers, programs
supplemental contract musicians

TOTAL EXPENSES
TOTAL BUDGET $
L$36,600
1 6,600
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 10 of 13

PREVIOUS* FISCAL YEAR (FY) 2021-2022 COMPLIANCE REPORT
IF YOUR ORGANIZATION WAS NOT AWARDED A COMMUNITY SERVICE FUNDING GRANT IN FY 21/22 (LAST YEAR), THEN SKIP THIS PAGE.

If your organization was awarded a Community Service Funding Grant in FY 2021-2022 (last year) by the City of Temecula, please submit this information.

If your organization was awarded a Community Service Funding Grant in Fiscal Year 2021-2022 by the City of Temecula, all grant funds received must have been expended anytime on or between July 1, 2021, and June 30, 2022. In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any future funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent.

If the funds were not spent in accordance with the approved/awarded application, the organization will be required to return the amount of funds to the City. To substantiate that Fiscal Year 2021-2022 funds received from the City were spent appropriately, proper back-up documentation including the completed table below with accompanying receipts/invoices, must be submitted to the City on or before due date: September 12, 2022.

1. Fill out table below (make additional copies if needed to explain all expenditures.)

2. Attach copies of receipts/invoices (in the same order as listed in this table.)

3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590 Attn: City Manager's Office — CSF EXPENDITURE REPORT due on or before September 12, 2022
Organization: The Temecula Valley Name of Project/Program: Temecula Valley Master MasterEherale GhGrale-Season� 23
FY 2021-2022 Amount of $
CSF Grant Fund Awarded:

Month & Year CSF Grant Received from City:

Number of Beneficiaries Living in 92590, 92591, 92592 that Directly Benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number):

Date on Expenditure
E Name of Company Receipt/Invoice
U a on Receipt or Invoice MUST RF ON OR AFTWEEN Amount Description Purpose Q z JULY 1, 2021 • JUNE 30, 2022 I

DESCRIBE THE EXPENDITURE PURPOSE OF EXPENDITURE
EXPENDITURE TOTAL $

EXPENDITURE TOTAL MUST BE EQUAL TO
(OR GREATER) THAN TOTAL AWARD AMOUNT.

City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 11 of 13

FISCAL YEAR (FY) 2022-2023 COMPLIANCE REPORT
If your organization is awarded a Community Service Funding - REINVESTMENT IN TEMECULA Grant in FY2022-2023 by the City of Temecula, follow these instructions.

If your organization is awarded a Community Service Funding Grant - REINVESTMENT IN TEMECULA in FY2022-2023 by the City of Temecula, all grant funds received must be expended anytime on or between March 20, 2020 and June 30, 2024. In addition, all grant Funds must be substantiated with proper back-up documentation. Failure to provide proper documentation may jeopardize any funding. City of Temecula reserves the right to conduct an audit and/or require additional back-up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved/awarded application, the organization may not receive and/or will be required to return said amount of funds to the City, To substantiate that grant funds from the City are spent appropriately, proper back-up documentation including the table below with accompanying receipts/invoices, must be submitted to the City as outlined on this page,

1. Fill out Expenditure Report table below. Make additional copies if needed to explain all expenditures.

A. If awarded $5,000. Submit the following Expenditure Report within 60 days after spending $5,000 no later than June 30, 2024, to demonstrate grant funds were spent in accordance with the Application. [If you were awarded less than $5,000, submit Expenditure Report for that amount.)
B. If awarded grant funds exceeding $5,000. A) Follow #1 A above first. B) To receive grant funds exceeding $5,000 (between $51K-$501<), submit the following Expenditure Report to be reimbursed for the remaining balance of award to demonstrate funds were spent in accordance with the Application. This report can be submitted in $10,000 increments (taut no less than $10.000 unless the remaining grant award funding amount is less than $10K). This report must be submitted to the City no later than June 30, 2024 to receive remaining grant funds.

2. Attach copies of receipts/invoices (in the same order listed in table below).

3. Send to: City of Temecula, 41000 Main St., Temecula, CA 92590, Attn: City Manager's Dept. "CSF-Reinvestment in Temecula"

EXPENDITURE REPORT DATED
The Temecula Valley Temecula Valle Master
Organization: Name of Project/Program: y
'et1urafe--Stra5-0
TOTAL FY 2022-2023 Month & Year FIRST $5,000 check
Amount of Grant Fund Awarded: $ was received from City:

1. Is this Expenditure Report is to provide documentation for first $5,000 awarded and received? Yes_ or No (already submitted).

2. My organization has already received $ of the total FY 2022.23 Grant Fund awarded by the City

3. Is this Expenditure Report is submitted to request reimbursement of funds? No or Yes If yes, Amount of Request $ Number of beneficiaries living in 92590, 92591, 92592 that directly benefitted from this Program/Project (approximate number of beneficiaries if you do not have precise number) Date on Expenditure
E Name of Company Receipt/Invoice MUST SUPPORT PROJECT/PROGRAM IN APPLICATION & AWARD LETTER U E on Receipt or Invoice MUST BE ON OR BETWEEN
March 20. 2020 - JUNE 30, Amount Description Purpose
Q Z qme
3 1 Is
EXPENDITURE TOTAL $ EXPENDITURE TOTAL
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 12 of 13

I ACKNOWLEDGEMENT/SIGNATURE PAGE I
The applicant acknowledges and agrees to the following:
• Recipient is subject to all Community Service Funding Program requirements including submittal deadlines and payment disbursements.
• Every Community Service Funding application is considered individually and on its own merit, • Awards will be given to organizations and activities that directly benefit the residents of Temecula. a Funding is not immediately available to the recipient, and requires an award letter signature upon approval.

Please allow time for checks to be processed.
• The awarding of Community Service Funding does not constitute an automatic annual allocation. • The recognition for Community Service Funding should accrue to the City of Temecula. ■ Community Service Funding must be spent as specified on the Application and records may be requested by the City of Temecula to ensure the funds were used appropriately. • Community Service Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot.
• The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement.

If awarded a Community Service Funding Grant by the City of Temecula last year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete, /we hereby certify the information contained in this Application is true to the best of our knowledge and belief.

ORGANIZATION NAME: The Temecula Valley Master Chorale
MAILING ADDRESS: P O BOX 890204 PHONE: ( ) 832-368-7163 Temecula, CA 92589-0204 EMAIL: [email protected]
PRESIDENT / AUT ORIZED OFF ER: Ann Mulder,
SIGNATURE:

TVMC Treasurer
DATE: Sept. 12, 2022
�'A('NI I :. IMY, YFn.r
IF DIFFERENT THAN ABOVE, Geneva Krag Board member
APPICATION PREPARED BY:
r°R,iIf NAME T.r
SUBMIT ORIGINAL APPLICATION BY MONDAY, SEPTEMBER 12, 2022, TO:

City of Temecula
Community Service Funding
Attn: City Manager's Office
41000 MAIN STREET
TEMECULA, CA 92590
Questions: [email protected] (951) 694-6413
[email protected] (951) 693-3959
City of Temecula Community Service Funding - Reinvestment in Temecula GRANT APPLICATION Page 13 of 13

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EIN: 33-0928024 1 Temecula, CA, United States
Pub 78 Data Form 990-N
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STATE OF CALIFORNIA

FRANCHISE TAX BOARD
T PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/10/2022
ESL ID: 4197036411
Why You Received This Letter
According to our records, the following entity information is true and accurate as of the date of this letter Entity ID: 2268147
Entity Name: THE TEMECULA VALLEY MASTER CHORALE

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.

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 through the Franchise Tax Board Administrative Dissolution process.

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

PRICI.NO• PAC
UPRICINO) 4 •VOUESTIONS)
< Take me to my billing (lapplblllingl
9TATP FILING
REOVIREMENTe (ISTAYE-
Fit.INO-INFORMATl ON-FOR-

NOHPROFITS)
THANK YOU FOR FILING WITH SIMPLE 990.

Your payment of $40.00 has been processed,

CONTACT
(CONTACT- tome ouiavelleymostarchoraI*agmIII-co
US)
Form 990 and 990-EZ returns undergo a quick technical revlew by our team. Our team will process your return as soon as this Is complete and email you regarding the results, Confirmation: OSIM P99OW U20SVOJQ7CGVXXYIJJSPRGJ
August 3, 2022
E-Flied 2021 Form 990-N
TEMECULA VALLEY MASTER CHORALE: 33-0928024
Total
$40.00 USD
$40.00 USD

r(0A'ECAL1FOnNIR
TRq. osrtol ry
WAIL TO:

Re®txtry of Ctsarstelsle Trusla
P-0 Box 903447
Sacramento, CA 94203-1470
r.REET ADDRESS.

J001 Siroet
Sacramento, CA 95814
(916) 210.-A00
WEBSITE ADDRESS:
wwNY Oagx,i g0vrcham,es

ANNUAL TREASURER'S REPORT

ATTORNEY GENERAL OF CALIFORNIA
Section 12566, California Govemment Code
11 Cal. Code Regs., section 301
The Temecula Valley Master Chorale
Name of Organization --
PO Box 890204
Address (Number and Street)
Temecula, CA 92589
City or Town, Male and ZIP Code
ASSETS
(FORM CT-TR-1)

DEPARMEW OF AW CE
PAGE e d < -
s')
For Registry Liso Only
CT0190938
Slate Charity Registration Number
Corporabon or Organization No, 2268147
Federal Employer I.D. No. 330928024
For annual accounting period ( beginning 01 / 01 / 2021_ ending 12 / 31 / 2021 )

BALANCE SHEET
Cash
Savings
$
$
200
12342
Investment
$
0 Land/Buildmgs
$
0 Other Assets
$
0 TOTAL ASSETS
$
I Z y

REVENUE

LIABILITIES
Accounts Payable $ 0
Salary Payable $ 0
Other Liabilities $ 0
L TOTAL LIABILITIES $ O

FUND BALANCE
l Total Assets less Total Liabilities $ 2 �� Z

REVENUE STATEMENT
Cash Contributions
$
6547
Noncash Contributions
$
0 Program Revenue
$
9851
Investments
$
0 Special Events
$
1483
Other Revenue
$
3140
TOTAL REVENUE $ p Z

NET REVENUE
L otal Revenue less Total Expenses $ D

EXPENSES
Compensaton of Officers/Dlrectors $
9985
Compensation of Staff
$
Fundralsing Expenses
$
2115
Rent
$
2504
Utilities
$
0 Supplles/Postage
$
411
Insurance
Other Expenses
$
$
716
330
TOTAL EXPENSES $ 16 Del
eby declare under penalty of perjury that I have examined this report, Including accompanying documents, and, to the best of my knowledge belief, the content Is true, correct and complete and I am nut o►l:ed to sign, Steven C. Woodbury Treasurer 5/13/22
Slgrlature of Authorized Agent frile Prd Na- _ Title ' W Dale

330928024

TEMECULA VALLEY MASTER CHORALE
Employer Identification Numbers Registry
Employer Identification Number (EIN) is a unique identification number that is assigned to a business entity so that it can easily be identified by the Internal Revenue Service (IRS). The Employer Identification Number is commonly used by employers for the purpose of reporting taxes. The EIN is also known as a Federal Tax Identification Number. When it is used to identify a corporation for tax purposes, it is commonly referred to as a Tax Identification Number. 2022

TEMECULA VALLEY MASTER CHORALE
EIN
330928024
An Employer Identification Number (EIN) is also known as a Federal Tax Identification Number, and is used to identify a business entity.

Generally, businesses need an EIN.

Business Name

TEMECULA VALLEY MASTER CHORALE
Conformed submission company name, business name, organization name, etc
CIK
N/S
Company's Central Index Key (CIK). The Central Index Key (CIK) is used on the SEC's computer systems to identify corporations and individual people who have filed disclosure with the SEC.

State of Incorporation
N/S
Company's State of Incorporation. The state of incorporation is the state where the entity has a domestic entity registration. Le. the entity was first registered, NOT necessarily where the entity does business.

Phone
N/S
Business address telephone number

BUSINESS ADDRESS
Address Line 1
PO BOX 890204
Business Address Line 1
Address Line 2
N/S
Business Address Line 2
City

TEMECULA
Business Address City
State
CA
Business Address State
ZIP 92589
Business Address Postal Code (ZIP)
-2-

Employer Identification Numbers Registry

MAILING ADDRESS
Address Line I
N/S
Mailing Address Line 1
Address Line 2
N/S
Mailing Address Line 2
City

TEMECULA
Mailing Address City
State
CA
Mailing Address State
ZIP
92592
Mailing Address Postal Code (ZIP)
-3-

Employer Identification NUmbers Registry
www. hipaaspace. cofn
FEDERAL TAX IDENTIFICATION NUMBER: 330928024 (ADDITIONAL

INFORMATION)

IEIN IPOSTCARD
- 4 -

r,�
Secretary of State
Business Programs Division
1500 11th Street, Sacramento, CA 95814
Ann Mulder
TVMC
31659 COUNTRY VIEW RD
TEMECULA, CA 92591
Description
Nonprofit Corp - Statement of Information
Certified Copy - BE
Payment - Web Credit Card
C
Receipt Detail
Document/Payment No.

BA20220949595
BA20220949595

42.......... 34381 Auth. No. 010033
Receipt Date: 10/06/2022
Receipt No.: 2704484
Total Amount Charged
Total Payment Received
Amount
-$20 00
-$5.00
$25,00
-$25.00
$25.00