Agenda — Temecula City Council, November 14, 2023 (part 2 of 4)

Amount Requested:* Project/Program Title:*
5,000.00 1 Client Care Program
MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program* 2023-06-01 C] 2024-05-31 n 41750 Winchester Rd. Suite O Preferred Payment Method: Make Check Payable to:
(if grant is awarded.) Birth Choice Centers
O Check Mailed O Check Picked Up
O Electronic File Transfer
Previous Next

Is the organization incorporated as a nonprofit?*
*Yes O N o

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Provide nonprofit status verification as follows:*
(one required, both preferred)
0 State of California Entity Status Letter
❑ IRS Deductibility Status
State of California Entity ID:
1800935
To find CA Entity Status Letter,
click the link below:
https://www.ftb.ca.gov/help/business/entit
y-status-letter.asp?WT.mc_id=akBEStatus
Date of Incorporation:
03/20/1989
Attach State of California Entity Status Letter:*
Files (1 uploaded)
0 Entity Status Letter 9_12_23.pdf 370.1 KB ;Remove
Provide further verification as follows:
(one required, both preferred)
© First Page of most recent IRS Form 990
O Detailed info about your charity found on the State Reqistry Search Tool (link below)

To find CA Entity Status Letter.
click the link below:
https://www.ftb.ca.gov/help/business/entit
y-status-letter. a sp?WT.m c_i d=a kS EStatus
Files (1 uploaded)
0 Entity Status Letter 9_12_23.pdf 370.1 K6 Hen -love
Provide further verification as follows:
(one required, Moth preferred)
0 First Page of most recent IRS Form 990
CI Detailed info about your charity found on the State Registry Search Tool (link below) You might find IRS Form 990
on the link below:
https://rct.doj.ca.govNerification/web/sea rch
facilityY
Attach First Page of Most Recent Form 990*
Files (1 uploaded)
0 2021 990 Form.pdf 0 150.28K8 I;eivove

The Heart of Southern California
Wine Country
Application Authorization

Page 4 of 10 ends

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? 0 Yes O No
Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization?
O Yes O No
This Application has been authorized by the organization's: * QExecutive Committee O Board of Directors Q Members -at -Large Previous Next

Ift
a Community Service Funding Application
The Heart of Southern California
Wine Country
Mission Statement

Page 5 of 10 ends

Briefly describe the nonprofit organization's mission/goals and objectives:* To support people facing pregnancy, parenting and reproductive health concerns. Birth Choice of Temecula allows families a place to go to deal with unplanned pregnancy and parenting concerns. We offer education and material needs support for families that are struggling with prouinding for their families and are desiring mentorshi a and parenting support.

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 TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW.

Rrevious
12 Understand
Next

�T��Rvr�v Wine Country
Funding Sources

Page 6 of 10 ends

Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula? Yes 0 N ❑

NAME OF

PROGRAM/PROJECT
FUNDED BY THE CITY AMOUNT:* MONTH +YEAR NAME OF CITY GRANTOR FUNDING RECEIVED* SPONSORSHIP

GRANT OR
SPONSORSHIP*
Client Care Progra
25,000.00 I
I January 2023
Community Servi(
X
Council Member ( X
I
Client Care Progra 11,000.00
September 2023
$ 500.00
Council Member i X
Client Care Progra
June 2021
Client Care Progra
2,000.00
June 2021
cil Member Gran X
+ Add
Previous
Next

RECEIPTS/INVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO

DEMONSTRATE THE ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECTIPROGRAM AS DESCRIBED HERE. 0 Understand Project/Program Title: Client Care Program

1. DESCRIBE THE PROJECTIPROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.

This funding will go to support our clients with some of the following items:
-Material Assistance: Provides various baby items that parents need for the successful raising and caring for their children.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.

ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY. - On goods such as: Hygiene Kits, Diapers, Wipes, Formula, Car Seats, Pak n Plays, etc. Provides good such as baby food, food and gas cards, clothing, diapers, hygiene items for mom and baby, etc. to families

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA 44 RESIDENTS.

TEMECULA RE51DEN T S MUST BENEFI T FROM THIS PROGRAM/PR JECT IFAWARDED CITY FINDING.

We usually serve close to 120 Temecula families annually. 3b. ESTIMATED NUMBER OF PEOPLE

FROM TEMECULA EXPECTED TO

BENEFIT FROM THIS
PROJECTIPROGRAIVI:
12-0
3c. ESTIMATED NUMBER OF

VOLUNTEERS INVOLVED IN THIS
PROJECTIPROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 'I — 3 ABOVE IN 54 WORDS OR LESS.

VVe would like to utilize this grant to continue supporting our families in Temeculathat need necessaryitems for the care of tl7eir children and some tern ; to assist with their own welfare and care. op

Project/Program Budget

Page 8 ends

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount requested from this City of Temecula Community
Services Grant
Amount contributed to the Project/Program by the Applicant Organization
Other grants or funding already awarded for Project/Program, if REVENUES*
$ 5,000.00
Refer to Page 2
80,000.00
any $ 26,000.00
Community Service Grant and Council Members Grant
In -Kind match amount or volunteer credit hours estimated amount 10,000.00

LIST OF LXPEN ES FOR PRWECT/PROGRAM
TooisiEquipment* EXPENSES*
CamputersfPhones/ff Equipment 5,500.1)0
Facilities/Rentfinsurance *
Rentflnsurar7ce $ 65,000.00
Supplies*
Bjns/organizational ToolslBags, Etc.

Marketing*
Social Medla/Emaily3JMi+ebsite
Services*
[E'YUBright Course, etc.

Food*
Baby Food/Formula/Food Cards, Etc.

Other*
r
$ 15,000.00
S,13UI no
i
# C,44Q.C10
Hygiene Items 12,5f]I,I}fl
Staffing Expense
INFUGIBI_F FOR GRANT RJND1NG, NOWEVER, INCLUDF t 75,000.00 TOTAL REVENUE:

TOTAL EXPENSES
s 121,000.00 $ 124,000.00

� The Heart of seuthern Ca6i(ort�,a
MA. cwmry
Compliance

Page 9 of 10 ends

If your organization is awarded a Community Service Funding Grant in Fiscal Year 2023- 2024 by the City of Temecula, all grant funds received must be expended anytime on or between July 1, 2023, and June 30, 2024.

In addition, al% 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 hack -up information to substantiate how funds received from the City were spent. If the funds are not spent in accordance with the approved purpose stated on the Application, the organization will be required to refund the amount of funds.

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receiptshnvoices, must be submitted to the City on or before due date:

Monday, September 16, 2024.

Compliance Expenditure Report Form
I have read and understand the above policy that if this organization is awarded a Community Service Funding Grant in FY 2023-2024 by the City of Temecula, a compliance expenditure report is due by Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
® Confirm
F'reuiaus Next

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

Name of Applicant +Organization: * Requested Amount:

Birth Choice Centers $ 5,000.00
President/Authorized Officer:* E-mail- * Phone:

Janette Chun/CEO I [email protected]
Name & Title
President/Authorized Officer 5ignatureDate
Date will he captured on farm submission
IF DIFFERENT THAN ABOVE, APPLICATION PREPARED BY:

Name, Title, & Organization
If you have any questions, please contact: [email protected] (951) 693-3959 or Stacey,BrowngTemeculaCA.gov (951) 694-6413
Previous

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/14/2023
ESL ID: 2001125528
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:

Entity Name: BIRTH CHOICE CENTERS, INC.
❑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)

0Department of the Treasury
Internal Revenue Service
IRSTax Exempt and Government Entities

BIRTH CHOICE CENTERS INC
% CORRINE FREY
27488 ENTERPRISE CIRCLE WEST
TEMECULA, CA 92590
Date:

September 17, 2019
Person to contact:

Name: Ms. Benjamin
ID number: 0196814
Employer ID number:
33-0302353
Form 990 required:

Yes
Dear Sir or Madam:

We're responding to your request dated August 30, 2019 about your tax-exempt status.

We issued you a determination letter in May 1989, 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)(vi).

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).

Letter 4168 (2-2018)
Catalog Number 66666G

Internal Revanue Service
Department of the Treasury
P 0 BOX 2350 ROOM 51.27 ATTN: E.O.

L_05 ANGELES, CA 900532350
Employer Identification Number:
33-0302353
Date: MAR. 20, 1989 Case Number:
959030023
BIRTHRIGHT OF TEMECULA Contact Person:

D 28677 Front 5t. THORNTON, B.

TEMECULA, CA 92390 P•O. Bo-. 2129 Contact Telephone Number:

Tenecula, CA. (213) 894-4170
52 {90
Accounting Period Ending:

December 31
Foundation Status Classification:
see attached
Advance Ruling Period Ends:

Dec. 31, 1992
Caveat Applies:
no
Oear Applicant:

Based on information supplied, and assuming your operations will be as stated in your application for recognition of exemption, we have determined you are exempt from Federal income tax under section 501(c)(3) of the Internal Revenue Code.

Because you are a newly created organization, we are not now making a final determination of your foundation status under section 509(a) of the Code. However, we have determined that you can reasonably be expected to be a publicly supported organization described in sections 509(a)(1) and 170(b) (1) (A) (vi).

Accordingly, you will be treated as a publicly supported organization, and not as a private foundation, during an advance ruling period. This advance ruling period begins on the date of your inception and ends on the date shown above.
klithin 90 days after the end of your advance ruling period, you must submit to us information needed to determine whether you have met the requirements of the applicable support test during the advance ruling period.

If you establish that you have been a publicly supported organization, you will be classified as a section 509(a)(1) or 509(a)(2) organization as long as you continue to meet the requirements of the applicable support test. If you do not meet the public support requirements during the advance ruling period, you will be classified as a private foundation for future periods.

Also, if you are classified as a private foundation, you will be treated as a private foundation from the date of your inception for purposes of sections 507(d) and 4940.

Grantors and donors may rely on the determination that you are not a private foundation until 90 clays after the and of your advance ruling period.

Lf you submit the required information within the 90 days, grantors and donors Letter 1045(CG)

-2-

BIRTHRIGHT OF TEMECULA
may continue to rely on the advance determination until the Service makes a final determination of your foundation status. However, if notice that you will no longer be treated as a section 509(a)(1) organization is published in the Internal Revenue Bulletin, grantors and donors may not rely on this determination after the date of such publication. Also, a grantor or donor may not rely on this determination if he or she was in part responsible for, or was aware of, the act or faiIure to act that resulted in your loss of section 509(a)(1) status, or acquired knowledge that the Internal Revenue Service had given notice that you would be removed from classification as a section 509(a)(1) organization.

If your sources of support, or your purposes, character, or method of operation change, please let us know so we can consider the effect of the change on your exempt status and foundation status. Also, you should inform us of all changes in your name or address.

As of January I, 1984, you are liable for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of $100 or more YOU pay to each of your employees during a calendar year. You are not liable for the tax imposed under the Federal Unemployment Tax Act (FUTA).

Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the Code. However, you are not automatically exempt from other Federal excise taxes. If you have any questions about excise, employment, or other Federal taxes, please let us know.

Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code.

You are required to file Form 990, Return of Organization Exempt from Income Tax, only if your gross receipts each year are normally more than $25,000. If a return is required, it must be filed by the 15th day of the fifth month after the end of your annual accounting period. The law imposes a penalty of $10 a day, up to a maximum of $5,000, when a return is filed late, unless there is reasonable cause for the delay.

You are not required to file Federal income tax returns unless you are subject to the tax on unrelated business income under section 511 of the Code.

If you are subject to this tax, you must file an income tax return on Form 990-T, Exempt Organization Business Income Tax Return. In this letter, we are not determining whether any of your present or proposed activities are unrelated trade or business as defined in section 513 of the Code.

You need an employer identification number even if you have no employees.

If an employer identification number was not entered on your application, a number will be assigned to you and you will be advised of it. Please use that number on all returns you file and in all correspondence with the Internal Revenue Service.

Letter 1045(CG)

-3-
13IRTHRIGHT OF TEMECULA
Because this letter could help resolve any questions about your exempt :status and foundation status, you should keep it in your permanent records.

If the heading of this letter indicates that a caveat applies, the caveat below or on the enclosure is an integral part of this letter.

If you have any questions, please contact the person whose name and telephone number are shown in the heading of this letter.

Sincerely yours,
C, N,
Frederick C. Nielsen
District Director
Letter 1045(CG)

-4-

BIRTHRIGHT OF TEMECULA
FOUNDATION STATUS:

L70(b) (1) (A) (vi) and 509(a) (1)
Letter 1045(CG)

CERTIFICATE OF AMENDMENT
OF

ARTICLES OF INCORPORATION
AWidi1
C N D 0 n 3 2 D
FILED
In tM ofke of the Secroory of Slow
of the $$ON of Coofonvo
'JUL 18 1994
Arlene Siroky and Margaret A. Ustick certify that: TORY MILLER, AcUng SmWq of S411.

1. They are the Director and the Secretary, respectively of BIRTHRIGHT OF TEMECULA, INC. a California Corporation.

2. Article I of the articles of incorporation of this
corporation is amended to read as follows:

BIRTH CHOICE OF TEMECULA, INC.

3. The foregoing amendment of articles of incorporation has been duly approved by the Board of Directors.

4. The corporation has no members.

We further declare under penalty of perjury under the laws of the State of Ca-lifornia that the matters set forth in this certificate are true and correct of our own knowledge.

DATE:

Arleen Siroky, Director
x� �.'
Margaret., . Ustick, Secretary

NONPROFIT

Dep lrtmcnt`If1th` 1TI�1 IsI'ly'III I'I(I I,lil I1III 1III I11I pate of this notice: JULY 25, 1994 f� Infernal Revenue Service Taxpayer Identifying Number 33-0302353 '► FRESNO, CA 93838 Form: Tax Period:
{II IfIII III ifnllnII{{{fI{Jt1I1I1{LJ,��{{{{�{I....{�{��n��{ For assistance you may call us at:
1-890-829-1040 ST. OF CA

BIRTH CHOICE OF TEMECULA INC
PO BOX 2129
TEMECULA CA 92593-2129297
Q

WE CHANGED YOUR NAME AND/OR ADDRESS
THANK YOU FOR YOUR CORRESPONDENCE. AS YOU REQUESTED, WE'VE MADE THE FOLLOWING CHANGES TO YOUR NAME AND/OR ADDRESS:

NAME AND ADDRESS PREVIOUSLY NAME AND ADDRESS NOW

SHOWN ON YOUR ACCOUNT SHOWN ON YOUR ACCOUNT

BIRTHRIGHT OF TEMECULA BIRTH CHOICE OF TEMECULA INC
PO BOX 2129 PO BOX 2129
TEMECULA CA 92593-2129297 TEMECULA CA 92593-2129297
IF YOU DON'T AGREE WITH THIS CHANGE, PLEASE LET US KNOW. .r<

A0804457
is iLtL
Secretary of
S'at� 1
CERTIFICATE OF AMENDMENT of CaI#forrti'

OF ARTICLES OF INCORPORATION OCT
The undersigned certify that:

1. They are the President and the Secretary, respectively, of BIRTH CHOICE OF TEMECULA, INC., a California Corporation.
follows:

Article 1 of the Articles of Incorporation of this corporation is amended to read as I.

The name of the corporation is BIRTH CHOICE CENTERS, INC.

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

4. The corporation has no members.

We further declare under penalty of perjury under the laws of the State of California that the matters set forth in this certificate are true and correct of our own knowledge.

Dated: I62/16 7; v V
Dated: _ i' /6 o 1-7
Lee J. Grattan, President
Douglas V. Gibbs, Secretary

On Sep 12, 2023, at 9:45 PM, Janette Chun {[email protected]> wrote:

CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.

Hi Betsy,
I have completed and submitted the grant application for the Community Service Grant. However, I did not receive receipt of the submission and am now concerned it did not go through.... and unfortunately I did not save it as a draft before completing so I am praying that it got to you as I am leaving for vacation tomorrow for the next 7 days.

If you could please verify that you received it. I have spent the last few hours completing it and will be so very sad if it didn't go through properly.

Blessings be upon you,
Chrome rile Edit WOW History Bookmarks Profiles Tab Window Help M E,4 M M% i - $ Wed Sep 15 7:25 PM Laserfiche Forms has encountered a problem.

An error occurred while processing your request. Please try resubmitting your data again later. (UT2107-Su bmissionError]

FY 23/24 Community Service Funding (CSF) Grant
Application

CADENZA STRING ORCHESTRA

Community Service Funding Application
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
c©„ fiFM
Applicant Organization
Name:

Cadenza String Orchestra
Mailing Address:*
92592
* Year Organization Website:

Founded: https://www.google.com/url ?
2018 sa=t&rct=j&q=&esrc=s&source=web&c
4B HWc N DwEQFnoECB IQAQ&url =https
String-
0 rchestra%2F10006720033646S%2F&
Number of Paid Staff:* Number of Volunteers:*
emecula, CA i
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Sandiwa del Rosario, Director
Does the nonprofit have a current City of Geographic Area(s) the Organization Serves:* Temecula Business License? Riverside County
Business License No.*
054351
Copy of Business License*
mage.jpg
https://css.temecuiaca.gov

1.6MB
Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$S,000.00 Young Musician Development Fund
MAX: $5,000 PER DRG
Start Date:` End Date:* Physical Address of Project/Program* 2023-10-01 2024-05-31
Preferred Payment Method:
(If grant is awarded.)
Check Mailed Check Picked Up
Dectronic File Transfer
mecula, CA 92592
Make Check Payable to:*
Cadenza String Orchestra

Nonprofit Staters
Is the organization incorporated as a nonprofit?*
Yes No
IF NO, THEN INELIGIBLET© RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of Calif6rnla Entity Status Letter
IRS Deductibility Status
State of California Entity 1D: *
C4196509
To find CA Entity Status Letter,
click the link below:
h ttps.// www.ftb . ca.gov/help/business/entity-
status-letter.asp?wT.mc_id=akBEStatus
Date of Incorporation:"
09/20/201 S
Attach State of California Entity Status Letter: *
E3858426-7A4D-4671-9❑A9-39184❑AFC059.1 Peg
Provide further verification as follows:*
(ore required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your chanty found on the State Registry Search Tool (link below) You might find IRS Form 990
on the link below:
https://rct.do'.ca.gow/Verif cation/Web/Search.aspx?
facilityrrY
Attach First Page of Most Recent Form 994*
B9E66A5C-4EC6--'❑33-99C❑-9B7A❑3517 F29.ipeg
(990, 990-EZ, 990-PF, 990-T)
58Q.69KB
194.9KB

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, ❑r interests in real property with a Temecula City Council Member during the past 12 months?
Yes No
Is a Temecula City Council Member a member of the Board of Directors or an Officer ❑f the organization?
Yes No
This Application has been authorized by the organizations: * Executive Committee Board of directors Members -at -Large

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* Providing quality music education to local students through private lessons, workshops, performance opportunities and community outreach programs.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?

NAME OF PROGRAM/PROJECT

FUNDED BY THE CITY GRANT
OR SPONSORSHIP *
Young Musician
Development Fund
AMOUNT,*
$5,000.00
MONTH +YEAR FUNDING
RECEIVED*
April 2a23
g $0.00 Q

NAME OF CITY GRANT OR

SPONSORSHIP
City of Temecula

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE, U{idprstand
ProjectlPrograrrit Tittle: Young Musician Development Fund

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT,* The Young Musicians Development Project Fund will support and further the education of the students.

The fund will also bring the fine arts to the community free of charge and also provide musical opportunities to the students. The program will also support students who are in financial need to continue with their music education.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.' ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED .4D WHY.

If awarded, the organization will allocate the funds to the ff. -workshops & masterclasses will be given by world class musicians that will be free or charge to students and open to the public to help the students become more versatile instrumentalists -pay for rehearsal, workshop and performance venues
-purchase sheet music, musical accessories such as bows, strings and instruments. Quality instruments will help develop technique and musicianship.
-concerts will be open to the general public in Temecula at no charge

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.*

TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING, Temecula students will be given high duality music education by internationally acclaimed musicians through Masterclasses, workshops and performance opportunities. In July, our string quartet, violin duet and solo pianist, placed 3rd in their respective categories in the biggest interstate competition in California, Southwestern Youth Music Festival (SYMF) held at CalState Long Beach.

Just last Aug 28, 2023, Michelle Kim, Assistant Concert Master of the New York Philharmonic gave a masterclass to our students at St. Thomas in Temecula. This Wonderful, educational and very inspiring event was open to the general public where the audience heard Ms. Kim teach and perform with Temecula students for everyone. The Masterclass was free of charge to all but our organization, Cadenza String Orchestra, sponsored the event. Prior to that event, our organization also sponsored "Cello Generation" concert in Temecula given by award winning performers, Rusian Biryukov & Nathan Le that was again open to the public at no cost to all. One of the feedbacks we got was we need to have more of these events in the community.

In March of this year, our executive director, Sandiwa del Rosario, taught and helped four orchestras in the TVUSD win first place in their competitions.

We also bring our students to perform at local senior homes, members of our community who are no longer mobile.

In addition to Concert Events in the community, we also partner with local nonprofit organizations and local churches to help with their fundraising efforts.

3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM;
300
3c. ESTIMATED NUMBER OF VOLUNTEERS
INVOLVED IN THIS PROJECT/PROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS." As a local non profit music organization, we focus on developing young musicians in the Temecula Valley by providing them with high quality education and bringing the performing arts to the community at no cost to the public. If awarded, we will have rehearsal/performance space, provide accessories, and invite world class musicians to teach/perform with our students for the community.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment*
Recording Equipment
Facilities/Rentflnsurance *
Rehearsal & Performance Space; Liability Insurance
Supplies*
Music Copies/copyright materials
Marketing*
Ads; Flyers
Services*
Musicians' Fees
Food*
Food Supply during concerts
Other*
Music accessories (strings, chin rest, shoulder rest, bows) copyright, musical arrangements
Staffing Expense
TOTAL REVENUE:

TOTAL EXPENSES
$16,250.00
*
$0.00
*
$ 5, 000.00
EXPENSES*
$1,000.00
$4,000.00
*
$800.00
*
$950.00
*
$4,500.00
*
$2,000.00
*
$3,000.00
* $6,500,00

Compliance
If your organization is awarded a Community Service Funding Grant in Fiscal Year 2023-2024 by the City of Temecula, all grant funds received must be expended anytime on or between July 1, 2023, and June 30, 2024.

In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation mayjeopardize 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 are not spent in accordance with the approved purpose stated an the Application, the organization will be required to refund the amount of funds.

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

Compliance Expenditure Report Form
have read and understand the above policy that if this organization is awarded a Community Service Funding Grant in FY 2023-2024 by the City of Temecula, a compliance expenditure report is due by Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

Acknowledgement/Signature
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 in a previous fiscal year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete.

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

Name of Applicant Organization: *
Cadenza String Orchestra
PresidentfAuthorized Officer:* E-mail:*
Sandiwa del Rosario, Director _
Name & Title
PresidentlAuthorized Officer Signature*
Requested Amount:
$5,000.00
❑ate Time
2023-09-08
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Paz Cecilio, Treasurer; Cadenza String Orchestra
Name, Title, & Organization
If you have any questions, please contact_:

Phone:*
Betsy.Lowrey@Temecu[aCA.gov (951) 593-3959 or

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/29/2023
ESL ID: 9114468760
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:

Entity Name: CADENZA STRING ORCHESTRA
✓❑

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.

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).

Search in document
Temecula ... Cadenza String Orchestra CA FTB Entity Status Letter LE 1 / 1 Fit windc v I
View plain text
F T 4l6.7
• � � nf�u h. ii"3 CR.iief.Min
Enbft Sys Llkhf
Owl. `.k32021
F_SL IQ W11111 OW
Wfl} W.. R.a.Ared Thl. LMUI
✓,i.rwFlli„ Ire Jn �.u.�. 11� Y.�nwwra ri,My Iiy.ie.A..i aAaAr and ><wr.la a■.f nr d.la of tl.a INtlx F�;IIr IC• d^-7f1M11F
Lair Mr,M+ F�?Ef1i/1 6triiMi# onGMEFfnA
A The en1Ary IR n 4� 61and.`q wrh tA',e Frprglvte id7 .

I] 2 Th.■.* I. not in goad alwtdrla n11h ft Pvch"Taa Board. ® 3 Tries" IR Gw wrdy vmrW tnm rat LPMer fawwA arg tap,3W Cacie{R 7C) SKWn 73701 d ❑ 4 W.d. nd h.xa.u—,e iiili—Mi- ab-1 i—'I"
5 The inVy WawlymA'-101Il.d en F.'o4+gir lr.F Fnn4ryIM Yu ip.ri AVwmWWa Dow 4A*n pm"@
Imprxtant I.dprm.teen
• this wdwre6oh doss W nn shy nm%d On wW ys wah kgo or sUNs wrar any offW Kvvy oft wale a CalMwrw et W w qaw www apm er best.

If tw . "Y— Ppa . r0'fflX, Phil FW tWM �R- M-PW-*d w Willikl.l aP awl ihra n tlu Pad, a If I- eryety dq bLow se n Ca"on,la at a Uwe v~ 4 was hot gi,*kd or AA41 mgMemd b do euwne" n.

La:ffw.b. rf a ink mtaha5 heat hw reaad the,a ar sm ea Id6ait of enNads eAas. ay Me, inlq IrkCaifprnn dwnp tht p. d •I..fYMi wM 1hhm.nded a fm mftd iNATC Srdkm 23302 1. 73304 6, I he 4nPry cMrrKKaL. GI mvwaf mW he" aems Ilmdawn or -ay .f the tmncbms"re4 wd eci ft cm p.ri—, -wh �Ritc Sdim 71MM5.

Corwrsl W It h L16
Vffib. Ab.ca.gov
PN[.+iP. ®fXl-®52-571T A+dw T#.n1 A66p.dA friilAdit.. ..a�pr .Isle r•,VIdR�nr 9 ia-Bay-Gb041+9�. wL.µdlr Mai 1J�twd 8ra�rF
C#Ilfcani.

Relay Seww Ft l ef!WO-73 -Mg if ff mrscm 01+ hearmg vspmch rxafhnenW

Search in document
Temecula ... 2023 Cadenza String Orchestra
1 / 1 Fit windc
T90
2022 -990-N (e-Postcard) ACCEPTANCE UTTER
Form 9W-N (e-Pasicard) GrWne Filing
,)M*vl d.b.PW Tr1 no W +WI. h- 6— r..q MM W. oth POW& f- he pMryr--4 I" W*MW 4W Ma— Ins scene vansa, wW Ipma wre B. .0 r W ff # pry-!
R MW 000M"In74
TiiFBY WFC10i YON
�Mr GYJ�+IIx �i+efY Cit7-i71w5
DIY fMi
T7�s7F[P�-N776+ Llnwv`
--RN
�€'�� C 1�649LFIrl1 �
'� liYfeWF
=T frlii
¢ riiiYY
1lIRUi }Rlfr A.COrrr Cf TIS LiTR�I Karl Md1� MtTIN6i
n� rlav �n is w+r � W rr �+� 41+-�i a Ater +ry rra- �w alnrrm r orl� rNpulf fM ti oMuf c�d-i. Yr`rl n u 9f Pia+ M 7U43k2m. 'hv.e Mw W MW "-W-kf
1,90M *AWM f r-
POO #1pM1
.~MM_P10 ur-
ftwEn.IM •i7WI EW4371-7M C~—. R-A 3uM AN-IldidiM...!C-ram IRS Form 990
View plain text
IN

FY 23/24 Community Service Funding (CSF) Grant
Application
9 CALIFORNIA CAREFORCE

Ift
Community Service Funding Application
—Z'O'Z�-FIN
(T , I h- CAF
. C-I.ti y
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY Mink above)
c©flfiFM
Applicant Organization Year Organization Website:

Name: Founded: www.californiacareforce.org
California CareForce 2011
Mailing Address:* Number of Paid Staff:Number of Volunteers:
9S0 Reserve Drive, Suite 120, Roseville, 3 -1,000
CA 9S678
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Carol Fisher carol @californiacareforce.org 9167494170
Does the nonprofit have a current City of Geographic Area(s) the Organization Serves:

Temecula Business License? California
Yes No
A current City of Temecula Business
License may be required to submit prior to
fund disbursement.

Geographic Area(s) the Project/Program
Serves:

Riverside County

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 Riverside County 2024 Free Healthcare Clinic
MAX: $S,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program * 2024-01-01 2024-04-30 empire polo club empirepoio.com 81800 avenue 51, Indio, CA 92201
Preferred Payment Method:
(if grant is awarded.)
Crieck Mailed Check Picked Up
Electronic File Transfer
Make Check Payable to:*
California CareForce

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of Callf6Fnla Entity Status Letter
IRS Deductibility Status
State of California Entity ID:*
452408171
To find CA Entity Status Letter.
click the link below:
h ttps:// www.ftb . ca.gov/help/business/entity-
statu s-letter.asp?WT.mc_i d=a kB EStatus
Provide further verification as follows:*
Date of Incorporation:"
08/06/2014
Attach State of California Entity Status Letter:"
CA Letter from Franchise Tax Board,pdr
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your chanty found on the State Registry Search Tool (link below) State Registry Search Tool: Attach State Registry Document/Info* 370.08KB
https://rct.+doj.ca.gov/Verification/Web/Search.aspx ? Attorney General Status. png 936.36KH facility=Y

Application Authorization
Has the organization or any members of the Board of ❑irectors 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?
Yes No
Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization?
Yes No
This Application has been authorized by the organization's:" Executive Committee Board of Directors Members -at -Large

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* California CareForce promotes the health and well-being of those in need through volunteer supported, no -cost healthcare clinics across. California.

Improvement in overall health through the reduction in patients' oral pain, elimination of oral infection, and prevention of tooth decay and tooth loss.

Healthcare financial burden removed for patients, with each patient receiving an average of $468 to S4,000 In services.

Improvement of everyday life by providing an accurate prescription for ongoing vision services and providing patients with a functioning pair(s) of glasses and referrals for undiagnosed or ongoing conditions.

A successful California CareForce project will: (1) Remove the long-term risk or life -threatening health problems caused by tooth infection by providing dental services such as extractions and fillings; (2) Help patients to see clearly again by providing comprehensive vision checks and prescription lenses made on site ensure that all our patients can leave the clinic with a new pair of glasses made just for them. The long-term result is the patient may now return to the workforce, or drive safely, or help their children with their homework or in their classroom, return to school, or just interact effectively socially, A simple pair of glasses provides an improvement in the quality of their life and their ability to participate in the workforce and community activities; (3) By providing services at no cost to, we give them peace of mind from having to choose between a visit to the doctor or putting food on the table,, and (4) Collaborating with community partners, we aim to assist patients with continuity of care to help patients along the road to more equitable health outcomes

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 TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. Understand

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
Yes Nc:

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
ProjectlProgram Title: Riverside County 2024 Free Healthcare Clinic

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT,* California CareForce is requesting a grant in the amount of $5,000 to offset the cost (disposable supplies, volunteer support, and equipment rental) of hosting a three-day Free clinic on March 8 -10, 2024, at the Empire Polo Grounds, Indio, CA, .providing free dental, vision, and medical care to 2,5DQ underinsured and underserved patients living in Riverside County. The key services California CareForce volunteers will provide are: (1) Dental - x-rays, fillings, cleanings, and extractions; (2) Vision - eye health checks, vision exams, and custom eye glasses made on site (we set up a full vision lab to make eye glasses); (3) Medical - generals exams, physicals, diabetes and hypertension screening; (4) Education - oral health, diabetes and hypertension management; and (5) Referrals - connect patients with a dental, vision or medical home and refer for follow-up care

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.* ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

The funds will be used to purchase disposable dental, vision and medical supplies and cover the cost of healthcare equipment transportation costs.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

Annually, California CareForce has held this free clinic with 1 % of the patients served were from Temecula. Each patient can receive from $500 to $5,000 worth of free dental, vision and medical care over the 3-day clinic. Additionally, patients who are missing teeth may receive a stayplate (partial) during the clinic. This significantly improves the quality of their life. 3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
40 3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECT/PROGRAM:
00 4. SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS.* California CareForce will hold a free healthcare clinic in March 202-, at the Ernpire Polo Grounds, Indio, CA, providing free dental, vision and medical care to 40+ disadvantaged and uninsuredlunderinsured Temecula residents, their families, seniors and veterans, each receiving $500 to $5,000 worth of quality healthcare.

Project/Program Budget

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount requested from this City of Temecula Community Services Grant REVENUES* $5,000.00
Defer to Page 2
Amount contributed to the Project/Program by the Applicant Organization $5,000.00
Other grants or funding already awarded for Project/Program, if any $100,000.00
In -Kind match amount or volunteer credit hours estimated amount $5,000.00

LIST OF EXPENSES FOR PROJECT/PROGRAM
ToolslEquiprnent* EXPENSES*
Equipment transportation costs, dental equipment $13,000.00 FacilitieslRentlinsurance*
NA $0.00
Supplies*
disposable dental, vision and medical supplies $25,000.00 Marketing*
printing flyers, marketing mailing, vol u ntee r t-s h i rts $5,800.00 Services*
hazadous waste disposal, patient registration system, security $3,950.00 Food*
Clinic Lead Volunteers travel, lodging, food $30,000.00 Other* '
NA $0.00
Staffing Expense
$69,350.00
TOTAL REVENUE: TOTAL EXPENSES
$ 115,000.00 $77,750.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization:* Requested Amount:

California CareForce $5,000.00
PresidentfAuthorized Officer:* E-mail:* Phone:*
Cyndi Ankiewcz [email protected] 9167494170 Name & Title
PresidentlAuthorized Officer Signature* Date Time
2023-08-15
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Carol Fisher, Program Director, California CareForce
Name, Title, & Organization
If you have any questions, please contact:

Betsy.Lowrey@Temecu[aCA.gov (951) 693-3959 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
❑ ate: 1 f 19/2023
ESL ID: 4551436928
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: 34'10502
Entity Name; CALIFORNIA CAREFORCE

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 abort 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 administrattve status with any other agency of the state of California or other governmental agency or body.

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)

More
Search in document
1 1/ 1 Fit winds v View plain text
JY�� dWlwl �.
r+�'...��i� 7�fY+Mr F �IYrir s�» fir. ti�w �a�y M �r� s T:iii •Y�^ �� T �#w:�.f �� '--aa++�Y.ay uy.®4 a.ws�fw�ar �rY. �rµrarrif�r.Krrsaa��'�YetiYa a. - ..�`l�ibrlfi.ri� UiYl�yiiP rllfsl.WafF�Bi�.w a'M1�i� rsiiidi�x K'�fr�3eK �4� Details Anr
Entry Properties
Modified 8/15/2
Created 8/15/2
Path \LFFor
Applic,
Ca re Fc
Detail!
Template
No template assi;

FY 23/24 Community Service Funding (CSF) Grant
Application
10 CAUSE FUR PAWS INC

Community Service Funding Application
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Confirm
Applicant Organization
Name:

Cause Fur Paws Inc
Mailing Address:*
* Year Organization
Founded:
2011
* Website:
www.causefurpaws.org
Number of Paid Staff: Number of Volunteers:
0 2
Contact Name & Title:* Contact's Email: * Contact's Phone Number:* Valerie Andrews President vall @causefurpaws.org
Does the nonprofit have a current City of * Geographic Area(s) the Organization Serves:* Temecula Business License? Riverside County
Yes No
A current City of Temecula Business
License may be required to submit prior to
fund disbursement.

Understand
Project/Program
*
Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Amount Requested:* Project/Program Title:*
$5,000.00 "Project Pawsitive: A Lifeline for Animals with Diabetes - Promoting Health and Happiness" MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program* 2023-10-15 2023-10-15 36522 Via Verde Temecula Ca 92552 Preferred Payment Method: Make Check Payable to:*
(If grant i5 awarded.) Cause Fur Paws Inc

Check Mailed Check Packed Up
Electronic File Transfer
Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Provide nonprofit status verification as follows:*
tole required, both preferred)
State of California Entity Status Letter
IRS Deductibility Status
IRS Employer Identification Number (EIN):*
27-5415050
To find IRS Deductibility Status,
141MRz-lmP41mi.
https://apps.irs.gov/app/eos/
Date of Incorporation:'
04/25/2011
Attach IRS Deductibility Status:*
non profit.jpg
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed into about your charity found on the State Registry Search Tool (link below) Attach First Page of Most Recent Form 990*
You might find IRS Form 990 ApprovalLetter_990N_255111.pdf on the link below: (990, 990-EZ, 990-PF, 990T)
https./Irct.doj.ca.govNerification/Web/Sea rch.aspx?
facility=Y
r41.n4KB
104.8KB

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?
Yes Nc
Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization?
Yes Nc:

This Application has been authorized by the organization's:* xecutive Committee Board of Directors Members -at -Large Mission Statement
Briefly describe the nonprofit organizations mission/goals and objectives:* Cause Fur Paws Is a nonprofit organization dedicated to supporting animals affected by diabetes. Our mission isto provide donated funds to veterinarians and animal hospitals, ensuring immediate access to vital medical care. Our primary goal is to improve the physical well-being of these animals by financing expenses related to medication, veterinary services, and hospitalization due to diabetes -related issues. We strive to prevent euthanasia resulting from financial constraints and promote a compassionate approach to animal care. Our objective is to disperse funds promptly and effectively, paying veterinary bills for eligible uses, and ultimately making a positive impact on the lives of our furry friends in need.

UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT. MAYBE NEEDED TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DC NOT SUBMIT NOW. i Understand Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
Yes No
Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE Understand PROJECTIPROGRAM AS DESCRIBED HERE.

ProjectlProgram Title: "Project Pawsitive: A Lifeline for Animals with Diabetes - Promoting Health and Happiness"

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WiLL SUPPORT.* Frcyect Pawsitive: ALIfeline ICot- Animais with Diabetes is an init,ative aimed at promoting the neaitn and happiness of anirrais suffering from diabetes. The project focuses on providing specialized care, treatment, and support to animals diagnosed with diabetes, ensuring they can lead fulfilling lives despite their- condition,
The primary goal of Project Pawsitive Is to offer comprehensive medical assistance to diabetic animals, including veterinary consultations, regular health check-ups, and access to essential medications like insulin. Additionally, the project emphasizes educating pet owners about diabetes management and the importance of adhering to treatment plans to enhance the well-being of their beloved pets.

One significant aspect of Project Pawsitive is the emphasis on promoting animal adoption. The project collaborates with animal shelters and rescue organizations to identify diabetic animals in need of forever homes. By creating awareness about the condition and highlighting the support available, the initiative alms to increase the adoption rate of diabetic animals and provide them with a loving and caring environment.

The Temecula Grant Funding plays a crucial role in supporting Project Pawsttive's mission, The grant likely provides financial assistance to the project enabling them to carry out their initiatives effectively. The funding may be utilized to cover veterinary expenses, purchase necessary medical supplies, conduct educational outreach programs, and establish partnerships with animal shelters and rescues.

Through the supportof the Temecula Grant Funding, Project Pawsitivecan expand its reach, provide enhanced care to a larger numberof diabetic animals, and create a lasting impact on animal welfare in the community. The ultimate vision is to improve the quality of life for animais with diabetes, raise awareness about their needs, and promote responsible pet ownership, ultimately leading to a happier- and healthier animal population in the Temecula region.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.' ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

With a $5000 grant for animals with diabetes, Project Pawsitive can allocate the funds in various ways to achieve its goals. Here are some potential uses for the grant money:

Veterinary Consultations: The grant can be used to cover the costs of veterinary consultations for diabetic animals. Regular check-ups are essential to monitor their health, adjust treatment plans if necessary, and ensure their well-being.

Medications and Medical Supplles: Insulin and other essential medications needed for managing diabetes in animals can be expensive. The grant can be used to purchase medications and medical supplies for diabetic animals who may not have access to them otherwise.

Education and Awareness Programs. A portion of the grant money can be allocated to creating educational materials and hosting awareness programs about diabetes in animals. Thls can Include brochures, workshops, and online resources to inform pet owners about diabetes management and the importance of adhering to treatment plans.

Adoption Support: Project Pawsitive can use the grant to offer adoption supportfior diabetic animals. This might include covering adoption fees or providing initial medical care and supplies to new adoptive pet parents, encouraging more people to consider adopting diabetic animals.

Outreach and Networking: The grant can be used to expand the project's outreach efforts and collaborate with more animal shelters and rescue organizations. Building a network of supporters and partners can help Identify and assist more diabetic animals in need, Research and Development: If applicable, a portion of the grant could be allocated to supporting research and development efforts related to diabetes treatment in animals. This could contribute to the advancement of medical knowledge and improved care for diabetic pets.

Emergency Medical Funds; Some of the grant money can be reserved as emergency medical funds to address critical situations where diabetic animals require immediate medical attention or treatments.

Website and Technology improvements: Improving the project's website and technological infrastructure can enhance its online Presence, allowing them to reach more people and provide resources and support more i_iently.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.-

TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CiTY FUNDING.

The grant funding provided to Cause Fur Paws for its ongoing assistance for animals with diabetes can directly benefit Temecula residents in several ways:

Financial Relief for Pet Owners: Temecula residents who have pets with diabetes may face significant financial burdens due to the ongoing costs of insulin, medications, glucose monitoring equipment, and prescription diabetic food. The grant can alleviate some of these financial pressures by subsidizing or coven ngthe expenses associated with diabetes manage mentfor their pets.

Access to Specialized Veterinary Care: The grant money can be used to provide regular veterinary check-ups and medical care for diabetic animals in Temecula. This ensures that pet owners have access to the specialized care required for managing diabetes, leading to better health outcomes for their furry companions
Support for Diabetic Animal Adoptions: Cause Fur Paws' emphasis on promoting animal adoption means that Temecula residents interested in adopting a pet have a higher chance of finding a diabetic animal in need of a loving home. By covering adoption fees or initial medical costs, the grant can encourage more residents to adopt these pets and provide them with a caring environment.

Educational Resources and Workshops: The grant money can be utilized to organize educational workshops and resources specifically tailored for Temecula residents. These workshops can provide valuable information on diabetes management, proper care for diabetic animals, and the importance of adherence to treatment plans.

Emergency Medical Assistance: The grant's emergency fund can be used to provide immediate medical assistance to diabetic animals in critical situations. This ensures that Temecula residents who encounter sudden medical emergencies with their pets receive timely support and potentially Ilfe-saving care.

Community Engagement and Awareness: With improved social media presence and outreach efforts, the organization can better engage the Temecula community. By raising awareness about diabetes in animals and the resources available through the grant, more residents may become aware of the support they can receive for their diabetic pets.

Strengthening the Local Animal Welfare Network: The collaboration between Cause Fur Paws and local animal shelters and rescue organizations benefits the Temecula community by creating a stronger animal welfare network. This partnership can Mead to more effective care and assistance for animals with diabetes within the region.

Overall, the grant funding directly impacts Temecula residents by providing tangible support and resources for managing diabetes In their pets. it enhances the quality of life for diabetic animals, relieves financial burdens on pet owners, and fosters a more compassionate and educated community regarding pet care and animal welfare,
3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
1On
3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECTIPROGRAM:

4. SUMMARY STATEMENT— SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.* Cause Fur Paws will benefit Temecula diabetic animals through financial assistance, specialized veterinary care, educational resources, and adoption support. The grant will Improve the well-being of diabetic pets, relieve financial burdens on pet owners, and foster a more compassionate community for animal welfare in Temecula.

Project/Program Budget
I��'�r��►J��i�i��I�LiI�]ul��]:��:Ii1�1x+��1.tilel:7=�i�! Amount requested from this City of Temecula Community Services Grant REVENUES* $5,000.00
Refer to Page

Amount contributed to the Project/Program by the Applicant Organization ' $2,500.00
Other grants or funding already awarded for Project/Program, if any So.00
In -Kind match amount or volunteer credit hours estimated amount $0.00

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools}Equipment* EXPENSES`
Facilities/Rentli ns ura nce *
o $0.00
Supplies*
5ii{ .JiJ $500M
Marketing*
75 $75.00
Services*
0 $0.00
Food*
0 $0.00
Other*
0 $0.00
Staffing Expense
$0.00
TOTAL REVENUE:

17.510.;50

TOTAL EXPENSES
$575.00
Compliance
If your organization is awarded a Community Service Funding Grant in Fiscal Year 2023-2024 by the City of Temecula, all grant funds received must be expended anytime on or between July 1, 2023, and June 30, 2024.

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 purpose stated on the Application, the organization will be required to refund the amount of funds.

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or Before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm
Acknowledgement/Sig nature
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 in a previous fiscal year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete.
f hereby certify the information contained in this Application is true to the best of our knowledge and belief.

Name of Applicant organization: Requested Amount:

Cause Fur Paws Inc $5,000.00

President/Authorized Officer:* E-mail:* Phone:*
Merle Andrews /President [email protected]
Dame & Title
President/Authorized Officer Signature* Date Time
2023-G7-3
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Name, Title, & Organization
If you have any questions, please contact:

Betsy. [email protected] (951) 693-3959 or
Stacey. [email protected] (951) 694-6413

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 8/1 /2023
ESL ID: 8565175365
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:

Entity Name: CAUSE FUR PAWS, INC.
❑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.

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).

INTERNAL REVENUE SERVICE
P. A. BOX 2508
CINCINNATI, CH 45201
Date. JUN 1 8 2020

SMILES BY ANGELS FOUNDATION

CIO LUIS PERALTA
925 STH PLACE
HERMOSA BEACH, CA 90254-0000
Dear Applicant:

DEPARTMENT OF THE TREASURY
Employer Identification Number:
84-1991401
DLN:
26053561001600
Contact Person:

CUSTOMER SERVICE ID# 31954
Contact Telephone Number:
(877) 829-5500
Accounting Period Ending:

December 31
Public Charity Status:
509(a)(2)
Form 990/990-EZ/990-N Required:

Yes
Effective Date of Exemption:

June 7, 2020
Contribution Deductibility:

Yes
Addendum Applies:

No
We're pleased to tell you we determined you're exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). Donors can deduct contributions they make to you under IRC Section 170. You're also qualified to receive tax deductible bequests, devises, transfers or gifts under Section 2055, 2106, or 2522. This letter could help resolve questions on your exempt status. Please keep it for your records,
Organizations exempt under IRC Section 501(c)(3) are further classified as either public charities or private foundations. we determined you're a public charity under the IRC Section listed at the top of this letter.

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

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

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

-2-

SMILES BY ANGELS FOUNDATION
Sincerely,
Director, Exempt Organizations
Rulings and Agreements
Letter 947

TAX 990
Keep c xt ' Coact
2022 - 990-N (e-Postcard) ACCEPTANCE LETTER
Farm 990-N (e-Postcard) online Filing
Congratulations? Your 2022 tax return has been accepted by the IRS. Thank you for preparing your exempt tax return. IRS Form 990-N, with Tax990. Your return information is listed below and we hope you had a pleasant experience e-filing with Tax990.

FORM INFORMATION
TAX YEAR: 2022
IRS SUBMISSION ID 32133920231962000015

TAXPAYER INFORMATION

NAME CAUSE FUR PAWS INC
DBA NAME:

ADDRESS:

STATE/OOUNTRY: California
PHONE:

RETURN ID: 4B001962399247-3
E-FILE TIME STAMP 7115/2023 10:10:51 AM
TIN. 27-5415050
CITY: TEMECULA
ZIP-92592-9132
ENTAIL. [email protected]
Thank you again for your business. If you have any questions or need any assistance, please contact our customer support via live online chat. email at support@a tax990.com, or by phone at 704-839-2321. We're here to help? Sincerely,
Tax990 Support Team
(704) 839-2321
[email protected]
Span Enterprises - (704) 839-2321 • 2685 Celanese Road Suite 100 • Rock Hill, SC • 29732

FY 23/24 Community Service Funding (CSF) Grant
Application
11 CHARITY FOR CHARITY

a Community Service Funding Application
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Confirm
Applicant Organization
Name:

Charity for Charity
Mailing Address:*
27479 Ynez Road
* Year Organization Website:

Founded: www.charityforcharity.org
2007
Number of Paid Staff:* Number of Volunteers:*
1 50
Contact Name &Title: * Contact's Email: * Contact's Phone Number:* Charity Prestifiiippo 9S1-777-8277
Does the nonprofit have a current City of * Geographic Area(s) the Organization Serves:* Temecula Business License? Temecula Valley
Yes No
Business License No.*
OS5614
Copy of Business License*
business license.jpeg
im
I s it
https://css.temeculaca.gov
24T.7KB
*
Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
ss,000.00 Stars of the Valley Golf and Gala
MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program* 2024-02-02 2024-02-03 44501 Rainbow Canyon Road Temecula 92592 Preferred Payment Method:
(If grant is awarded.)
Check Mailed Check Picked Up
Dectronic File Transfer
Make Check Payable to:

Charity for Charity

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS Deductibility Status
State of California Entity ID:*
3065037
To find CA Entity Status Letter,
click the link below:
http s:llwww.ft b.ca.govth e l p/bu s i ness/e n t i ty- status-letter.asp?WT.mc_id=a kBEStatus
IRS Employer Identification Number (EIN): *
26-0242616
To find IRS Deductibility Status,
click the link below:
https:lla pps. irs.gov)a ppleosl
Date of Incorporation:*
10/01 /2007
Attach State of California Entity Status Letter:*
entity letter.pdf
Attach IRS Deductibility Status:*
Copy of IRS Determination Letter (5),Ipg
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Too] (fink below) You might find IRS Form 990
Attach First Page of Most Recent Form 990 *
990 2021.PDF
370.04KB
394.59KB
on the link below: (990, 990-EZ, 990-PF, 990 T)

httpl.//rct.doj, aa.gov/VerificationIWeb/Search.aspx?
facilityY
State Registry search Tool. Attach State Registry Documentlinfo* https:/Irct.doj.ca.govNerification/Web/Search.aspx? state registry.ypeg 372.44K8 facility=Y

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:' Charity for Charity is a local non profit Wish fulfilling Organization, fulfilling Wishes to individuals with life threatening illness or traumatic injury. Our mission is to make a significant difference in the lives of others.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
yC

NAME OF PROGRAM/PROJECT

FUNDED BY THE CITY GRANT
OR SPONSORSHIP *
Stars of the Valley 2021
AMOUNT:*
$5,000.00
MONTH + YEAR FUNDING
RECEIVED*
1/2021

NAME OF CITY GRANT OR

SPONSORSHIP
Community service
grant

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. i. nd�a stand
ProjectlPrograrn Title: Stars of the Valley Golf and Gala

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT' The funding will be supporting our mission to make a significant difference in the lives of others. We fulfill wishes locally to individuals with life threatening illness or traumatic injury. We take these individuals who are struffling with life changing circumstances and fice hope to them and their families.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED." ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

The funds will be used to host the golf tournament including 5 holes to serve food, food for our 50+ volunteers, banners and signage at each hole and printed materials at each hole. The banners and printed materials will be advertising for local businesses who support our cause.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS." TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

A requirement to be a Charity for Charity volunteer is to be a Temecula Valley resident. Also, our beneficiaries are all local and nominated by Temecula Valley Hospital nurses and doctors, TV Fire fighters and local business owners. ONLY Temecula Valley residents benefit from our cause. 3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
1,000
3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECTIPROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.* Specifically, grant funds will be used to host our 3rd annual golf tournament fundraiser by paying for the necessities needed for our volunteers and local business advertising. The funds raised at our event will be spent on fulfilling wishes to individuals with life threatening illness or traumatic injury.

Project/Program Budget

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount requested from this City of Temecula Community Services Grant REVENUES* $5,000.00
Refer to Page 2
Amount contributed to the Project/Program by the Applicant Organization $120,486.00
Other grants or funding already awarded for Project/Program, if any NA $0.00
In -Kind match amount or volunteer credit hours estimated amount $9,000.00
1111111[3&i]0::N,01i•6ymy; Eil:4N11f1U: 14 111111N10k; Cile]:7=1►►1 Tools/Equipment* EXPENSES'
D Lighting $7,150.00
Facilities/Rent/Insurance *
Pechanga and Golf Course $32,191.00
Supplies'
Costumes, frames, drink toppers, tickets $1,700.00
Marketing*
Golf towels, signs by Tomorrow, golf balls, mouse graphics, Temecula $5,095.00 Trophy
Services*
Audio Visual, Starway Productions, Amore Event Planning, Timmy D, $21,450.00 Dances, videographer
Food*
Volunteer, thank you dinner and drinks $6,506.00
Other*
Auction Costs $19,198.00

Staffing Expens
TOTAL REVENUE:

TOTAL EXPENSES
$134,486.00 $93,290.00
$0.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization:*
Charity for Charity
PresidenttAuthorized Officer:* E-mail:*
Charity Prestifilippo, President _
Name & Title
PresidentlAuthorized Officer Signature*
C1It arty fcltifrYrC
Requested Amount:
$5,000.00
Date Time
2023-09-11
IF DIFFERENT THAN ABOVE, APPICATION PREPARE❑ BY:

NA
Name, Title, & Organization
If you have any questions, please contact.

Phone:*
951-777-8277
[email protected] (951) 693-3959 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 8/1512023
ESL ID: 2276617758
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: 3065037
Entity Name; CHARITY FOR CHARITY

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 abort the entity.

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

Search in document
Temecula ... 2023 Charity for Charity CA Registrant Details / 1 Fit winds v View plain text
P.R.
:a.]E C+ }i.�J_ FEaCi7�` cr-JLa'YhM:. ^_ua'rrr.

Registrant Details _
.' _ �
{yVll11� t�{xifYS lv:a e-'.nn.Yl1Y ■R 1'!RMl K
Caws 4w° 1. + i>.—.k IMIMM
Re*tr} Ratus: Cv"vy7l Reaewal Due1EIµ. DaD: 5111.2023
RCI %mb6 - RQI T6773 I—P— M1�I
R—d11'w! � ryl.S.l .. [M.M.W. r Y62 W4
Oak
Mailing Address
Ilse. : M71 F71Ei lY7.v�
YISI llr a.

Y fre TRULMs.a a na]
Filings & Correspondence
Tbve!' z h R..e ftM NWO la R.9bW-a,..d#A"
iiYCAWH k. RyKr
iaului .- -"Mm".
ld.*%M" Ox�1Is�
o %IP>ii GP�IIIk
ice w.lssei�rc RIYf.slaYll]�! 11rIIIr
�'�_Y�ALIEIrlrylfa llir crirllll il'.I��f
�CorRi c�l:oe •�'
Rme+rLYllme
i nutirl�ssa�

I RXF, I
-
-
7f711 RNF-I
x
AI: IRb 1�ml �1'i
i
'.At,NPiKaf WY'.MFNI..�lwu.ia�+s.'�cwil-�IlijiR�Ij #1 7�i! lei

Search in document
Temecula ... 2023 Charity for Charity
1 / 1 Fit windc v
IRS Determination Letter
?" l RSli
'.tl, ■as 24R♦! In 1111Y r.tar tol .2465i T37"
;nclana tl uN 44261 L7P i17UC El
et psne;14 84409F FF
4981Ik",
4d11@1 TF
CTlAR1TY FUN CNANITT
tt CM ea 1 TY Flo mT If IL["a
A..rTH LEA FLIRT
1 267al YIIEI ET ND A
tL MCCULA c; 9
21l1
Poet lbat rhulrm
sirFrYIl5a6Tall Fra■ ipXuaba-l7•!I#-0Carr 1a.PaYera
rh33 Ss an rasprasa to yrur ra"mat at act. 25,�- 2922, Faa ■rtlla@ Cie tax-araiPt aT�atas of CharltY Far Char L#Y.
bur t.,5at4! FadjCakkpat a $- Lam l.tler ..1 J'aaw.! IMF Rarzi 25l4� lta ntla! tbss arlsnizs lsea tseap4f an FrF4 F;q lrFL l ni 6aa tax Y9.ar saitlan 59JSCJ{S1 at thr LntrrnaI Bar.M1a! Laos. btlr r.e.rtlr ■;!a LaAlgat• thla arlaJll a; tiFa }} aaR ; Er L4 at■ Yeunaatimn iW sthin the aaaa ln! ar s.ct lea 4!4[a] ar the Cad• r. rtoul.

It is 6.accJbtd In sactiam(a} Sa 4f.}tl1 ■a■ 17!{Y}61J{AI lea ats ■.w Aa:olt eantrliwtiaes t8 tb1A rrl;n3ratic, aF IrpeLtled Fn sea tl.n 179 .t the Caaa. ■aquests, la lac2es �. d■w.s.s,r transR.rs. ar .Itts [a Lhe .r lawsu■tian ih tar lt• a . aa.WsL101e !nr F.d.ral .stet■ ;M1tl llrt t.a p<a'tpaaF! Ll th.V ... t�IMP FAA#lea¢1. ArFw141Faa at sections 21154. 21nr,r and 2522 mt tn. Co..,
R lain rblar f'i 8wl NF4itti I ,tr L.Va'r rli FaF Inr.rlyRlin rr4ardlA} il1LM1■ ragl}IraRlM1ti� Soat1rliaLlY. .fetLan F0Zh qt tYa C. era villas that rall.— t. tllr an annual InF.raatkan ratarn Far three r Pn s.rutlw■ Years razults Ir
rer.c.ti.n Pf tax-■saipt status a1 Pf
1hl it Siam #f4F '1lS4 Pr 4i.. khl rq rFINrn iFr Fre-11'.ktPnF rF;Yir FF k. ♦I1.. .a Will publlsh a list or or I... 11tlarl r. a1.e ta.-aY .apt status was rrr:,;ad under s.Ct... 6!&};yl mF the Go -de .n .ur ..belie 8r95nnLn! Ln sorl:p 1911,
Jt Yar haws any R.astians, please call as at the trl..hrna n..bar sh.wn ■t__
View plain text

TAX RETURN FILING INSTRUCTIONS
FORM 990

FOR THE YEAR ENDING
December 31, 2021
...................................................

Prepared for
Charity For Charity
27479 Ynez Road
Temecula, CA 92591
Prepared by
Noon & Associates Cpas, Inc.
27555 Ynez Rd, Ste 135
Temecula, CA 92591
Amount due
Not applicable
or refund
Make check
payable to
Not applicable
Mail tax return
and check (if
applicable) to
Not applicable
Return must be
Not applicable
mailed on
or before
Special
This return has been prepared for electronic filing.

If you
Instructions
wish to have it transmitted electronically to the IRS,
please
sign, date, and return Form 8879-TE to our office. We
will
then submit the electronic return to the IRS. Do not
mail a
paper copy of the return to the IRS.
1 cMi1
c=-c1-21

FY 23/24 Community Service Funding (CSF) Grant
Application
12 CULTIVATING INCLUSION INC

Aft
Community Service Funding Application
T1,1.,,.

Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
confirm
Applicant Organization Year Organization Website:

Name: Founded: http:ll www.cultivatinginclusionfarm.cc
Cultivating Inclusion Inc. 2015
Mailing Address:* Number of Paid Staff:* Number of Volunteers:* Temecula, CA D -1 8
92592-1504
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Mary Ann Tams, Garden ❑irector 951-296-7756
Does the nonprofit have a current City of
Temecula Business License"?
-_ :-
Business License No.*
055099
Copy of Business License*
BusLILTem-2023U ntitled.pdf 364.69KB
https://css.temeculaca,gov
Geographic Area(s) the Organization Serves:*
Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
ss,000.00 Cultivating Inclusion Inc.

MAX: $5,000 PER ORG
Start ❑ate:* End Date:* Physical Address of Project/Program* 201 s-02-15 2023-09-01
Preferred Payment Method:
(If grant is awarded.)
Check Mailed Check Picked Up
Dectronic File Transfer
397s5 Alta Murrieta, Murrieta, CA 92563
Make Check Payable to:*
Cultivating Inclusion Ir r-

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of Califomia Entity Status Letter
IRS Deductibility Status
State of California Entity 1D: *
4127453
To find CA Entity Status Letter,
click the link below:
h ttps:// www.ftb.ca.gov/help/business/entity-
status-letter.asp?wT.mc_id=akBEStatus
IRS Employer Identification Number (EIN):
82-4809510
To find IRS Deductibility Status,
click the link below:
https:/Iapps.irs.gov/app/eos/
Date of Incorporation: *
06/26/2018
Attach State of California Entity Status Letter:"
Secretary of State 03-17-2023.pdf
Attach IRS Deductibility Status:*
IRS 501c3 determination-06-2018-pg1 (1).pdf
Provide further verification as follows: *
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your chanty found can the State Registry Search Tool (link behow.) You might find IRS Form 990
on the link below:

Attach First Page of Most Recent Form 990*
990 for 2022 year - submitted 2023.pdf
(990, 990-EZ, 990-PF, 990-T)
https://rct.doj . ca.govNerification/web/Search.aspx?
facility YY
State Registry Search Tool: Attach State Registry Documiantllnfo 451,02KB
480.43KB
353.31 KB
ht;tp5a/.frct.doj.ca_gov/verifceationiWeb/Search.a$PK7 Charity/TrustCAUntttlerd.pdF 487.93KB facility=Y

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* Cultivating Inclusion is a one of kind community farming project. We welcome special needs adults enrolled in day programs subsidized by the State of California. The following day programs have Cultivating Inclusion farm as a job site location for their client, i.e. Care Rite Vocational Services, Towards Maximum Independence and Achieveability.

Once the day program participants enter through our garden gate we greet them with a smile and a garden task that we mentor them through. We educate our visitors in all things garden related, they learn from seed to harvest we nurture produce together. Produce that we in turn donate to local food banks, three of which are located in the City of Temecula. Community Mission of Hope, Western Eagle Foundation and St. Vincent de Paul. In addition, they go about the garden tasks while working collaboratively with our mentors - weeding, watering and planting. Along the way we have fun, socialize and become more educated about the benefits of eating healthy foods in proper proportion.

Cultivating Inclusion is a 3 tier- operation. We welcome special needs adults with a smile, introduce them to all kinds of produce that they themselves grow and let them experience cooperative working relationship with peers and volunteers.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
Yes No

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
Project/Program Title: Cultivating Inclusion Inc.

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT' The farming project that Cultivating Inclusion represents the experience for special needs adults to learn about produce, the importance of being a co-worker and helping their community by providing healthy food to food banks in our area. Three of these food banks are Community Mission of Hope, Western Eagle Foundation and St. V incent de Paul are located in the City of Temecula. Therefore, residents of Temecula grew the produce at the Cultivating Inclusion farm and the food challenged residents of Temecula are directly benefitting from this farming project.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.{ ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

In order for us to continue enhancing the lives of special needs adults, we need garden benches and tables to sort, taste test and educate them about the produce they are growing. Along with new garden furniture, the entire shade and education area is in need ground leveling so that we may be more inviting to those participants who have mobility issues, as we have special needs adults in wheelchairs and walkers visit our farm weekly. In addition, we still need to pay for ongoing pest control, waterline and hose repairs and general maintenance of our garden space.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS." TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT iF AWARDED CITY FUNDING.

Temecula Residents do benefit directly from Cultivating Inclusion. Many of the special needs adults who visit the farm on a weekly basis are Temecula residents and a valuable part of the citizenry of our City of Temecula. Whenever the adults enrolled in day prograrns visit the farm they know right away what they are doing is vital and important. They know that the care that they provide the produce that we grow is going to food banks located inside the City of Temecula. Therefore, they realized and are reminded that their fellow citizens of Temecula need the food that we grow, so that they too can enjoy the benefits of healthy vegetables. This gives our special needs adults a sense of pride and accomplishment.

Something that is not always readily available for them to experience, that feeling of helping others who need help.
3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
100
3c. ESTIMATED NUMBER OF VOLUNTEERS
INVOLVED IN THIS PROJECTIPROGRAM:

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

Cultivating Inclusion is a unique community farm. Unique in that it expressly involves special need adults growing produce from seed to harvest. And because of their commitment to caring for their farm, fellow citizens will enjoy healthy fresh food. We all want to feel a sense of accomplishment and the adults who come to our farm, feel that sense of accomplishment.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment*
rototiller, hoses, waterlines, weed whackers
Facilities/Rentlinsurance *
0 $10,000.00
*
$0.00
EXPENSES"
$1,500.00
*
$0.00
Supplies*
crafts, educational literature wlstudy models, log books, paper, printer ink $500.00 Marketing*
website, domain fee
Services*
Pest control
Food*
snacks, special events snacks, water
Other*
Liability Insurance for Board and Volunteers
Staffing Expense
TOTAL REVENUE•. TOTAL EXPENSES
S20,000,00 $5,000.00
*
$500.00
*
$1,500.00
*
$250.00
*
$750.00
*
$0.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: *
Cultivating Inclusion Inc.

PresidenttAuthorized Officer:* E-mail:*
Mary Ann Tams, Garden Director _
Name & Title
PresidentlAuthorized Officer Signature*
Watt tt f
Requested Amount:
$5,000.00
Date Time
2023-09-03
IF DIFFERENT THAN ABOVE, APPICATION PREPARE❑ BY:

Name, Title, & Organization
If you have any questions, please contact:

Phone:*
951-296-7756
Betsy.Lowrey@Ternecu[aCA.gov (951) 69 3-395 9 or

�FX OF i,
e; = �a Secretary of State
Certificate of Status
I, SHIRLEY N. WEBER, PH.D., California Secretary of State, hereby certify:

Entity Name:

CULTIVATING INCLUSION INC.

Entity No.:
4127453
Registration Date:
03/09/2018
Entity Type:

Nonprofit Corporation - CA - Public Benefit
Formed In:

CALIFORNIA
Status:

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

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

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

IN WITNESS WHEREOF, I execute this certificate and affix the Great Seal of the State of California this day of March 17, 2023.

SHIRLEY N. WEBER, PH.D.

Secretary of State
r�.m �C1wion niS►tme
To verify the issuance of this Certificate, use the Certificate No. above with the Secretary of State Certification Verification Search available at b1zfile0n1ine.sos.ca.gov.

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/6/2023
ESL ID: 7437691940
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:

Entity Name: CULTIVATING INCLUSION INC.
❑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.

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).

" N? ABOUT MEDIA CAREERS REtsULATIONS RES;�URCES PROGRAMS C`Ci i C.

Registrant Details
Entity type: Corporate Class as registered with the Secretarl ofS~ate or eased on founding & registration darument� .

Organization Name: Ci1LT1vxrI G INCLUSION INC. IRS FEIN; 814809510
Entity'Eype: Public Benefit
SOSfFTB Corporate/Organization Number:
4127453
Registry Status; Current
Renewal Due/Exp, Date;
5/15/2024
RC'T Registration Number: CT0265665
issue Date:
10114i2019
Record Type; C:laari€y Registration
Effective Date:
10/14/2019
Date of Last Renewal: 4120/2023
DBA;
Mailing Address
Street:

Street Line 2:

City, State Zip: T'EVECULA�C+eA 92592
Filings
Correspondence
Renewal Filing
2022
Form RRF-1
2021
Form CT-TR-1
2021
&13ewal Filing
2020
Form CT TR-1
2020
Form RRF-1
2020
Form RRF-1 �
2019 - ATMENDED
CL 5_50 Fo1Tn RRF-I 1ncoLn-p1gk
2018
CT-470 Confft'mUJion of RP g Stratloll
Click on Document Type at the left to open .PD
Founding Q2g mentS
Click on Document Type at the left to open PDF
Annual
eeal Datta
Status of Filing:
.Accepted
Accounting Period Begin Date:
if l i2018
Accounting Period End Date:
12-31/2018
Filing Received Date:

I i1.29f1019
Form RRF-2 Reject/Incomplete Reason:

Form CT_ ['R-1 Rejeetllncomplete Reason:

IRS Form 990 Reject/[ncom+plete Reason:

Dotes From Registry Staff:

Status of Filing:

E :Accepted
Accounting Period Begin Date:
1/1/2019
Accounting Period End hate:
12/31/201.9
Filing Received hate:
1127,2020
Form RRF-1 Rejectllncomplete reason:

Form CT TR-1 Rejettllncomplete. Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:.

INTERNAL REVENUE SERVICE
P. 0. BOX 2508
CINCINNATI, OH 45203.

Date: 1 U N 2 6 2018

CULTIVATING INCLUSION INC
MURRIETA, CA 92563-0000
Dear Applicant:

DEPARTMENT OF THE TREASURY
Employer Identification Number:
82-4809510
DLN:
26053569009448
Contact Person:

CUSTOMER SERVICE ID# 31954
Contact Telephone Number:
(877) 829-5500
Accounting Period Ending:

December 31
Public Charity Status:
509(a)(2)
Form 990/990-EZ/990-N Required:

Yes
Effective Date of Exemption:

March 9, 2018
Contribution Deductibility:

Yes
Addendum Applies:

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

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

Letter 947

Form 990-N Electronic Notice (e-Postcard) OMB No. 1545-2085 Department of the Treasury for Tax -Exempt Organization not Required to File Form 990 or 99(1-4 �� Internal Revenue Service ,.

ONOpe on
A For the 2022 Calendar year, or tax year beginning 2022-01-01 and ending 2022-12-31 B Check it available C Narne of Organization: CULTIVATING INCLUSION INC b Employee Identification Terminated for Business Number 82-480951 a
Gross receipts are normally $50,000 or less
Temecula, CA, US, 92592
E Website: F Name of Principal Officer: Mary Ann Tams
b2p'fl www.cultivatinginclusionfarm.com
Temecuia&& US, 92592 +
Privacy Act and Paperwork Reduction Act Notice: We ask for the informs# vn on this form to carry out the Internal Revenue laws of the United States.

You are required to give us the information. We need it to ensure that you are complying with these laws.

The organization is not required to provide information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. The rules governing the confidentiality of the Form 990-N is coveted in code section 6104.

The time needed to complete and file this form and related schedules will vary depending on the individual circumstances. The estimated average times is 15 minutes.

Note: This image is provided for your records only. Do Not mail this page to the IRS. The IRS will not accept this filing via paper. You must file your Form 990-N (e-Postcard) electronically.

FY 23/24 Community Service Funding (CSF) Grant
Application
13 FAVORS FOR NEIGHBORS

Ift
Community Service Funding Application
—Z,O,Z�(T , I h- CAF.,
.�
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY Mink above)
c©f1fiFM
Applicant Organization Year Organization Website:

Name: Founded: favorsforneighbors.org
Favors for Neighbors
Mailing Address:* Number of Paid Staff:Number of Volunteers:* Murrieta, CA 0
92553
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Randy Sanders [email protected]
Does the nonprofit have a current City of Geographic Area(s) the Organization Serves:* Temecula Business License? Tpmecu!
A current City of Temecula Business
License may be required to submit prior to
fund disbursement.

Geographic Area(s) the Project]Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
s5,000.00 Temecula Favors for Neighbors
MAX: $5,000 PER ORG
Start Date:` End Date:* Physical Address of Project/Program* 2023-10-01 2024-07-01
Preferred Payment Method:
(If grant is awarded.)
Check Mailed Check Picked Up
Electronic File Transfer
Murrieta, CA 92562
Make Check Payable to:

Michael Saiz

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
-State of California Entity Status Letter
IRS Deductibility Status
State of California Entity 1D: *
5355393
To find CA Entity Status Letter.
click the link below:
h ttps:// www.ftb . ca.gov/help/business/entity-
status-letter.asp?wT.mc_i d=a kB EStatus
IRS Employer Identification Number (ElN):
92-1208019
To find IRS Deductibility Status,
click the link below:
https://a pps. irs.gov/a pp/eos/
Date of Incorporation:"
12/01 /2022
Attach State of California Entity Status Letter:"
State Letter,pdf
Attach IRS Deductibility Status:*
IRS Tax Exempt Leiter_92-1208019_FAVORSFO RNEIGH80RS
_01302023_00 (1).pdf
Provide further verification as follows: *
(one required, both preferred)
First Page of most recent IRS Form 990
Detaiied info about your charity found on the State Registry Search Tool (link below) Attach First Page of Most Recent Form 990"
You might find IRS Form 990 990 epost card.png
on the link below:
https://rct.doj.ca.govNerification/Web/Search.aspx ?
facillty4Y
370.23KB
133.45KB
4,78M8

(990, 990-EZ, 990-PP, 990T)
State Registry Search Tool. Attach State Registry Documentlinfo https:llrct.doj.ca.govNerification/Web/Search.aspx? Registrant ❑etails 2.docx 17.53KB facility=Y

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:'` The founder, Michael Saiz, had the painful loss of his grandmother and decided he wanted to create a loving network for seniors and others in need. Our Mission is to change the state of mind of those who retreat from society more each year. can social media, Micheal says he will do minor home repairs for FREE. What Mike additionally delivers is KINDNESS. He chats while fixing, then sits with them up to 3 hours and gets them to talk about themselves, laugh, cry - It's all transformative. At first, they were skeptical of "FREE", afterwards it's all hugs and smiles and calling friends they hadn't spoken to in years saying, "You won't believe what this Temecula group just did for me." Our other goal is to keep them off ladders and situations that can likely hurt them. Temecula can't reach all residents, but we gladly reach the invisiblelsilent segment to bring them a much -appreciated slice of the Temecula "Healthy and Livable" pie.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
Yes No

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
ProjectJProgram Title: Temecula Favors for Neighbors

9. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.* We started giving Favors in 2021, incorporated to non-profit in 2022. The "FREE repair" gets us in the door, to deliver the KINDNESS. Then we call every 2 Weeks for 2 months and we look for neighbors who might do the same. Our Circle of Kindness continues. After a job, when we have permission, we pass out a flyer in the neighborhood saying who we helped, and asking if anyone might give an occasional call or maybe a dinner invitation once a month. Most people are actually more kind than they realize, theyjust need an opportunity placed in front of them. Because I was on Senator Emerson's "Senior Scam Panel, we also help with scams. Our motto is: "Kindness is Valuable -Share It."

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.* ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

With no overhead, everything is spent on supplies for favors: 1. House repair supplies - paint, lumber to repair fences, replace moldy cabinets or sink, replace flooring or the that might cause a fall, collapsed awning, garbage disposal, fans, smoke alarm, etc. We never replace for beautification, only to normalize or prevent risk of injury. 2. Rentals: truck/trailer for hauling and to the dump, pressure washers, commercial weed eaters, etc. 3. Car parts: occasionally to get a car running for a senior: brakes, battery, spark plugs, alternator, refrigerant, etc. 4. Gas for Favors and taking them to doctor/hospital appts and sometimes to bring food.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

As our volunteerism becomes more widely known, our preventive approach is helping an increasing number of Temecula people in need to avoid falls, injury, scares and unnecessarily living in substandard conditions. Most importantly, our "Circle of Kindness" tends to reorient some people back into socializing as they proactively make their "You won't believe what a Temecula group did for me'' calls. For example - across the street from Temecula Senior Center, a lady said her porch and driveway was dangerously slippery from aged gunk - so we power washed it. After her excited "You won't believe it'' calls - we did 13 more of her neighbors. Keeping people safer is important in Temecula. 3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
35 3e. ESTIMATED NUMBER OF VOLUNTEERS
INVOLVED IN THIS PROJECTIPROGRAM:

4. SUMMARY STATEMENT —SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS." Nobody does what we do. We deliver a special life -changing KINDNESS, a social thread, along with FREE Home Repair. A paralegal/retired businessman making a difference in the community. We minimize Dr./hospital visits and scams by taking seniors out of risky situations. With no overhead, ALL Temecula Grant money goes to Temecula resident needs.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
ToolslEquipment*
Rental trucks/trailers, power washers, weed eaters, etc.

Faci I itieslRentllnsu rance *
Insurance
Supplies*
House repair supplies
Marketing*
Word of mouth
Services*
None
Food*
Lunch for Volunteers
Other*
None
Staffing Expense
TOTAL REVENUE:
$11,%00.00

TOTAL EXPENSES
$5,950.00
EXPENSES*
$700.00
$450.00
*
$4,300.00
$0.00
*
$0.00
*
$500.00
$0.00
*
$0.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization:*
Favors for Neighbors
PresidentlAuthorized Officer:*
Randy Sanders/CFO
Name & Title
Requested Amount:
$5,000.00
E-mail:*
[email protected]
President/Authorized Officer Signature* date Time
2023-09-11
earr / 6wr"le-oi
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Name, Title, & Organization
If you have any questions, please contact:

Phone: *
[email protected] (951) 593-3959 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/712023
ESL ID: 7041057673
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: 5355395
Entity Name; FAVORS FOR NEIGHBORS

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) Secuon 23701 . 11 4.

We do not have current information abort the entity.

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

of the Treasury
Date:
riDepartment
Internal Revenue Service
02/06/2023
Tax Exempt and Government Entities
I R P.O. Box 2508
Employer ID number:
92-1208019
Cincinnati, OH 45201
Person to contact:

Name: Customer Service
ID number: 31954
Telephone: 877-829-5500

FAVORS FOR NEIGHBORS
Accounting period ending:

CIO MICHAEL SAIZ
December 31
Public charity status:

MURRIETA, CA 92562
170(b)(1)(A,)(vi)
Form 990 1 990-EZ 1990-N required:

Yes
Effective date of exemption:

December 01, 2022
Contribution deductibility:

Yes
Addendum applies:

No
DLN:
26053432004583
Dear Applicant:

We're pleased to tell you we detei-inined you're exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3 ). Donors can deduct contributions they make to you under IRC Section 170. You're also qualified to receive tax deductible bequests, devises, transfers or gins under Section 2055, 2106, or 2522. This letter could help resolve questions on your exempt status. Please keep it for your records.

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

If we indicated at the top of this letter: that you're required to file Form 9901990-EZ1990-N, our records show you're required to file an annual information return (Form 990 or Form 990-EZ) or electronic notice (Forrn 990-N, the e-Postcard). If you don't file a required return or notice for three consecutive years, your exempt status will be automatically revoked.

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

For important information about your responsibilities as a tax-exempt organization, go to wwwdrs.gov/cliarities.

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

Sincerely,
a- - A� -
Stephen A. Martini
Director, Exempt Organizations
Rulings and Agreements
Letter 947 (Rev. 2-2020)
Catalog Number 35152P

FY 23/24 Community Service Funding (CSF) Grant
Application
14 FINE ARTS NETWORK

Community Service Funding Application
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Confirm
Applicant Organization
Name:

Fine Arts Network
Mailing Address:*
41391 lea l m i a St. #200
* Year Organization
Founded:
;i94
Website:
www.fantheater.com
Number of Paid Staff:Number of Volunteers:*
-100
Contact Name & Title:* Contact's Email:* Contact's Phone Number:` Lena Sinclair
Does the nonprofit have a current City of Geographic Area(s) the Organization Serves:* Temecula Business License? IemeCLlla Valley
Business License No.*
0055889
Copy of Business License*
Business License Application Packet COM-2023
08141642309323.pdf
https://css.temeCLilaca.gov
1011111141141391
Geographic Area(s) the Project/Program
Serves:

Old Town Temecula Theater guests

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 PUMP UP the volume 2
MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program * 2024-01-05 2024-10-01
Preferred Payment Method:
(if grant is awarded.)
Check Mailed Check Picked Up
Electronic File Transfer
420S1 Main Street, Temecula
Make Check Payable to:

Fine Arts Network

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
-State of California Entity Status Letter
IRS Deductibility Status
State of California Entity ID:*
1872912
To find CA Entity Status Letter,
click the link below:
h ttps:// www.ftb . ca.gov/help/business/entity-
status-letter.asp?1NT.mc_i d=a kB EStatus
IRS Employer Identification Number (EIN):
33-0624570
To find IRS Deductibility Status,
click the link below:
https://a pps. irs.govla ppleosl
Date of Incorporation:
10/04/1994
Attach State of California Entity Status Letter:*
FAN State Cer[ 1994.pdf
Attach IRS Deductibility Status:*
IRS DEDUCTABILITY.pdf
Provide further verification as follows:*
(ane required, both preferred)
First Page of most recent IRS Form 990
Detaiied info about your chanty found on the State Registry Search Tool (link below) Attach First Page of Most Recent Form 990*
You might find IRS Form 990 FAN-2019 Exempt Organization Tax Return.pdf on the link below: (990, 990-EZ, 990-PF, 990-T)
https./Irct.doj.ca.govNerif ication/Web/Search.aspx?
facility=Y
521.48KB

28.93KB
3,57MB

State Registry search Tool: Attach State Registry Documentlinfo* https:f/rct.doj.ca.govNerification/Web/Search.aspx? IMG_0681.jpg ".18M8 facility=Y

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* Fine Arts Network Theater Company is committed to creating community opportunities for high quality theatrical productions. Fine Arts Network Theater Company strives to give every performer a chance to better their craft. We work within the community to help with other local productions and offer support to theatrical events throughout the Inland Empire. Our FANmiiy's goal is to provide excellent productions that leave the community better for having produced them.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
ec.

NAME OF PROGRAM/PROJECT

FUNDED BY THE CITY GRANT
OR SPONSORSHIP *
Pump up the volume
AMOUNT:*
$10,000.00
MONTH + YEAR FUNDING
RECEIVED*
2023

NAME OF CITY GRANT OR

SPONSORSHIP
CSFG

Project/Program ❑escription

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. Understand
ProjectlProgram Title: Pump up the volume 2

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT,* The Grant funding will support our Pump the Volume program which is committed to replacing the 20 year old mics currently being used and held together with haling wire with new miss for the listening enjoyment of the community when attending events at the Old Town Temecula Community theater.

Additionally, we will use a portion of the funds to Pump up the Volume on our marketing program by getting the word out about the great shows performed in this first class facility.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.* ALSO, INCLUDE EQUIPMENT, SERVICES TO DE PURCHASED AND WHY.

We will purchase miss to replace the mics that are beyond repair and use funds to market the great shows performed at the OTTCT and the first class experience guests will have with top quality sound equipment.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

This specifically benefits Temecula residents that support the productions done at the OTTCT by making sure the acoustics are clean and crisp. There is nothing worse than attending a program where listening is 1 /2 of the experience and not being able to hear what is being said and/or sung. 3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
5,000
3c. ESTIMATED NUMBER OF VOLUNTEERS
INVOLVED IN THIS PROJECT/PROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.* Providing new mics will enhance the experience local residents and guests will have at the Old Town Theater. Informing residents and guests of this through marketing will allow all to know we maintain a first class facility with state-of-the-art equipment.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment* EXPENSES*
lavalier microphones and transmitters $14,500.00
Facilities/Rentllnsurance *
rental mics
$4,000.00
Supplies`
batteries, latex gloves, cleaning materials
$1,000.00
Marketing*
launch, follow-up promotion of new equipment
$1,000.00
Services*
N/A
$0.00
Food
NIA
$0.00
Other*
NIA
$0.00
Staffing Expense
TOTAL REVENUE: TOTAL EXPANSES
$6,000.00
$20,500.00 $20500.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization:*
Fine Arts Network
PresidentlAuthorized Officer:* E-mail:*
Joe Arreola
Name & Title
PresidentlAuthorized Officer Signature*
o7ee T>
Requested Amount:
$5,000.00
Date Time
2023-09-11
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Beverly Stephenson, Founding ❑irector, Fine Arts Network Name, Title, & Organization
If you have any questions, please contact:

Phone:*
Betsy.Lowrey@Temecu[aCA.gov (951) 693-3959 or

0 California

SECRETARY OF STATE'S OFFICE
ia()11P0RA'['1.()N DIVISION
18 72312
I, TONY MILLER, Acting Secretary of State of the
State of California, hereby certify:

That the annexed transcript has been compared with
the corporate record oil file ill this office, of which it purports to be a copy, and that same is full, true and
correct.

IN WITNESS WHEREOF, I execute
this certificate and affix the Great
Seal of the State of California this
JUL 2 7 1994
SEGISTATF FORM GE-107 fRFV- 2J941 94 �5178

Tax Exempt Organization Search Details I Internal Revenue Service https: lapps.irs.gov/app/eos details/

FINE ARTS NETWORK
E I N: 33-0624570 1 United States
Copies of Returns (990, 990-EZ, 990-PF,
990-T)
Electronic copies (images) of Forms 990, 990-EZ, 990-PF or 990-T returns filed with the IRS by charities and nonprofits.

Tax Year 2019 Form 990
f
v Tax Year 2018 Form 990
J v Tax Year 2017 Form 990
' i v Tax Year 2016 Form 990EZ
f
Tax Year 2015 Form 990EZ
1 of 1 91912023, 11:55 PM

LESLIE A DOHERTY CPA APC
41880 KALMIA ST STE 115
MURRIETA, CA 92562
(951) 698-2260

FINE ARTS NETWORK
LAKE ELSINORE, CA 92530
Dear Board of Directors:

February 8, 2021
Your 2019 Federal Return of Organization Exempt from Income Tax will be electronically filed with the Internal Revenue Service upon receipt of a signed Form 8879-EO - IRS e-file Signature Authorization. No tax is payable with the filing of this return.

Your 2019 California Exempt Organization Annual Information Return will be electronically filed with the State of California upon receipt of a signed Form 8453-EO. No tax is payable with the filing of this return.

Enclosed is your California Registration/Renewal Fee Report to the Attorney General. The original should be signed at the bottom of page one. There is a fee due of $50 payable by November 16, 2020. Make the check or money order payabl to "Department of Justice'" and mail your California report on or before November la4,

REGISTRY OZX
0ri
P. 903447
SACRAMENTO, CA 94203-4470
Please be sure to call us if you have any questions.

Sincerely,
LESLIE A. DOHERTY, CPA

FY 23/24 Community Service Funding (CSF) Grant
Application
15 GOD'S FAN CLUB

PROJECT TOUCH

Community Service Funding Application
a �
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
c0f1f1F ,
Applicant Organization Year Organization Website:

Name: Founded: www.projecttouchonline.com
Gods Fan Club dba Project 2003
TOUCH
Mailing Address:* Number of Paid Staff:* Number of Volunteers:" 30141 Antelope Rd Menifee CA 92584 l
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Anne Unmacht [email protected]
Does the nonprofit have a current City of
Temecula Business License?
Yes
Business License No.*
g5080-3
Copy of Business License*
PT -BUSINESS LICENSE-TEMECULA.pdf 75.74KB
https://css.temeculaca,gov
Geographic Area(s) the Organization Serves:*
Teniecul
Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 Reunification and Rental Assistance Program
MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program* 2023-07-01 2024-06-30 Temecula CA 92591
Preferred Payment Method:
(if grant is awarded.)
Check Mailed Check Picked Up
Electronic File Transfer
Make Check Payable to:

Project Touch

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS Deductibility Status
State of California Entity 1D: *
2553261
To find CA Entity Status Letter.
click the link below:
h ttps:// www.ftb . ca.gov/help/business/entity-
statu s-letter.asp?VvT.mc_i d=a kB EStatus
IRS Employer Identification Number (ElN):
73-1681483
To find IRS deductibility Status,
click the link below:
https://a pps. irs.govl'a ppleosl
Date of Incorporation:"
©9/03/2003
Attach State of California Entity Status Letter:"
Project-] ouch Entity Letter.pdf
Attach IRS Deductibility Status:*
Project Touch IRS Status.pdf
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (link below) State Registry Search Tool: Attach State Registry Document/info* 37©,12 KB
G6.12KB
https://rct.doj.ca.govNerification/web/Search.aspx ? Project Touch State Registry.pdf 2; 8.26KB facility=Y

Mission Statement
Briefly describe the nonprofit organi,zation's mission/goals and objectives:* The mission is "working together within our communities together and the civil and business organizations to effectively overcome homelessness and establish effective methods of homeless prevention." Project Touch immediately cares and advocates for the well-being of anyone left homeless or unsheltered; providing them a home, food, clothing, supplies, assistance obtaining social service benefits, medical and mental health care, counseling, training, and employment.

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
`re' ',j'_;

NAME OF PROGRAM/PROJECT

FUNDED BY THE CITY GRANT

OR SPONSORSHIP'S
Reunification -Rental
Assistance
Reunification Program
AMOUNT:*
$35,000.00
$5,000.00
MONTH + YEAR FUNDING

RECEIVED
January 2023
January 2022

NAME OF CITY GRANT OR

SPONSORSHIP
Community
Reinvestment Grant
CSP

Project/Program Description
RECEIPTSIINV©ICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
ProjecVProgram Title: Reunification and Rental Assistance Program

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT,* Grant funding supports the Reunification program, supporting the purchase of gas cards, bus passes and airline tickets. It is Project TOUCH's first priority to reunite those left homeless and/or- suddenly left unsheltered with their families. If not possible, funding is used to support rental assistance, food, necessities, gas cards, and bus passes to support housing and recipients seeking and maintaining employment to grow towards self-sufficiency,

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.* ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY. $5,000 of Grant funding is used to support the following:

Gas Cards
Bus Passes
Airline Tickets
Rental assistance

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

An estimated 25 Temecula residents are supported in either being reunited with family or securing basic needs, such as housing and food, to promote the wellbeing of the individual or family unit as they work towards self-sufficiency. Project TOUCH works close with the City of Temecula Homeless Task Force and is available 247 to take in individuals and/or families needing a "safe" home, while other social service offices are closed..
3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM;
3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECT/PROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.` Grant funding supports reunification of those in Temecula, suddenly left homeless or unsheltered, with their families by providing gas cards, bus passes and airline tickets. If not possible, funds assist in providing a "safe" home for families, with food, necessities and assistance in gaining employment.

Project/Program Budget

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount requested from this City of Temecula Community Services Grant REVENUES` $5,000.00
Refer to Page 2
Amount contributed to the Project/Program by the Applicant Organization $200,000.00
Other grants or funding already awarded for Project/Program, if any Grants -Contributions $200,000.00
In -Mind match amount or volunteer credit hours estimated amount $50,000.00

LIST OF EXPENSES FOR PROJECT/PROGRAM
ToolslEquipment* EXPENSES*
tools $0.00
FacilitieslRentllnsurance*
rental assistance $400,000.00
Supplies*
supplies
$0.00
Marketing*
marketing
$0.00
Services*
Utilities
$20,000.00
Food*
FOOD $20,000.00
Other*
Reunification (gas cards, bus passes, transportation) $15,000.00 Staffing Expense
TOTAL REVENUE: TOTAL EXPENSES $80,000.00
$.455,000.00 $455,000.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: * Requested Amount:

God's Fan Club dba Project TOUCH $5,000.00
PresidenttAuthorized Officer:* E-mail:* Phone:*
Anne Unmatcht [email protected] _
Name & Title
PresidentlAuthorized Officer Signature* date Time
2023-09-11
IF DIFFERENT THAN ABOVE, APPICATION PREPARE❑ BY:

Name, Title, & Organization
If you have any questions, please contact:

Betsy.Lowrey@Ternecu[aCA.gov (951) 69 3-395 9 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
D ate: 9l812023
ESL ID: 8472573953
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: 2553261
Entity Name; GOD'S FAN CLUB A NON-PROFIT ORGANIZATION

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) Secuon 23701 d.

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

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

918123, 6:21 PM
Details
HOME ,.B(-)UT MEDIA GAREER-3 REGULATiGf-k- kiESOURGES, 1 RC)Gs;AMS C:t iTACT Registrant Details
Entity type- Corpr4rat= Class as r-eclistered ,,qQh the Sr- retsr� of gate or based on founding & registration documents Organization Name: GOD'S FAN CLUB ANON -PROFIT ORGANIZATION IRS FEIN: 731681483 Entity Type: Public Benefit SOSIFTB Corporate/Organization Number: 2553261 Registry Status:

RCT Registration Number:

Record Type:

Date of Last Renewal:

Current Renewal Due/Exp. Date: 5/15/2023
CT0167671 Issue Date: 12/27/2010
Charity Registration Effectir-e Date. 12/27/2010
1131,12023 DBA:
`
Mailing Address
Street:

Street Line 2:

City, State Zip:
30141 ANTELOPE ROAD D-103
MENIFEE CA 92594
Filings & Correspondence
Founding Documments
Founding Documents
Founding Documents
founding Documents
Fee Notice
Fee Notice
IRS Fonn 990 Series
Ending November 30 2015
CT-550 2009
CT-550 2009
Confirmation of Registration Letter Confirmation of Registration Letter Renewal Filing
2021
Renewal Filing
2020
Renewal Filing
2019
Renewal Filing
2018
Renewal Filing
2017
IRS Form 990 Series
2016
Farm RRF-1
2016
2015 RRF-1
2015 RRF-1
2015 RRF-1
2015 RRF-1
2015 IRS Form 990
2015 IRS Form 990
CT-547 Missing Documents 2015
RRF-1 2014
2014 RRF-1
IRS Form 990 2014
2014 IRS Form 990
RRF-1 2013
2013 RRF-1
IRS Form 990.2013
2013 IRS Form 990
RRF-1 2012
2012 RRF-1
IRS Form 990 2012
2012 IRS Form 990
RRF-1 2011
2011 RRF-1
https:llrct_doj.ca.gov(VerificationfWeblDetails.aspx?result=8eM8fd-97fa-45b7-b93a-dd2f9d l49Dc5 114

918123, 621 PM
Details
IRS Form 990 2011
2011 IRS Farm 990
RRF-1 2010
2010 RRF-1
IRS Fonn 990-EZ 2010
2010 IRS Form 990-EZ
RRF-1 2009
2009 RRF-1
IRS Fonn 990-EZ 2009
2009 IRS Form 990-EZ
RRF-1 2008
2008 RRF-1
IRS Form 990-N 2008
2008 IRS Form 990--N
RRF-1 2007
2007 RRF-1
RRF-1 2006
2006 RRF-1
IRS Form 990-EZ'_006
2006 IRS Form 990-EZ
RRF-1 2005
2005 RRF--1
Annual
Renewal Data
Status of Filing:

Accepted.

Accounting Period Begin Date:
12%L'2009
Accounting Period End Date:
11 30l2010
Filing Received Date:

9. 1212011
Form RRF-1 Rejectllncomplete 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:
12/1/2010
Accounting Period End Date:
11/30/2011
Filing Received Date:
7116f2012
Form RRF-1 Rejectflucomplete Reason:

Form CT-TR 1 Reject/Incomplete Reason:

IRS Form 990 Rejectflneomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
12 1.2011
Accounting Period End Date:
11 30/2012
Filing Received Date:
7 1/2013
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:
12/1/2012
Accounting Period End Date:
11130/2013
Filing Received Date:
7/21/2014
Form RRF-1 Rejectlincomplete Reason:

Form CT-TR-1 Rejectllncomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry- Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
1MI2013
Accounting Period End Date:
11/30/2014
Filing Received Date:
8/24'2015
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Reject/lncomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
bttps:llrct_da}.ca.govfVerifcationNVeblDetails.aspx7result=8e9P38fd-97fa-45b7-b93a-dd2f9d I490c5 214

9/8/23, 6:21 PM
Details
Accounting Period Begin Date:
12/1/2014
Accounting Period End Date:
11130/2015
Filing Received Date:
9/29/2016
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 RejectAncomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
12,11/2015
Accounting Period End Date:
12/31/2015
Filing Received Date:
9129/2016
Form RRF-1 Rejectllncomplete 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:
1/112016
Accounting Period End Date:
12/31/2016
Filing Received Date:
11/22/2017
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:
1/1/2017
Accounting Period End Date:
12/31/2017
Filing Received Date:
11/19/2018
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:
1/1/2,018
Accounting Period End Date:
12/31/2018
Filing Received Date:
8/21/2019
Form RRF-1 Rejectllneomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 RejectJIncomplete 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:
11/17/2020
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject,Rncomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
1/1/2020
Accounting Period End Date:
12/31/2020
Filing Received Date:
11/16/2021
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 RejectAncomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
1/1/2021
Accounting Period End Date:

12.'31: 2021
https','rct.doj.ca.govlVerification/WeblDetails.aspx7result=8e9f38fd-97fa-45b7-b93a-dd2f9d 1490c5 314

918123, 621 PM Details
ig Received Date: 1111712022
n RR.F-1 RejectrIncomplete Reason:
n CT-TR-1 Reject/Incomplete Reason:

Form 990 Reject/Incomplete Reason:
!s From Registry Staff:

Related Registrations & Event Reports
T6Me retested Mcom-- sl-�crvrrr Lvevft ie ro ol-, t1-rr recUrG tyW trairy Charity Registroctions relate to Professional Fundralsing Events which r--late to Pmfessionai Fundraiser Kegs otratlofis;.

Rare Registrations relate to Ral ic- itepo►ts
Click on they RCF Registration No to vavigale to the related ret-or .

No Related Records
https:llrct-des}.ca.govlVerificationNVeb{Details.aspx?result=8e9P38td-97fa-45b7-b93a-dd2f9d l49Dc5 4/4

918123. 6.19 PRl
Tax Exempt Organization Search Details I Intemai Revenue Service Gods Fan Club
ElN: 73-1681483 1 Menifee, California, United States
Publication 78 Data
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
https://apps . irs. govi''appieosrdetaiis/ 10 1

FY 2023-24 Community Service Funding (CSF) Grant
Applications
16 GREEN ACRES

INTERACTIVE THERAPY

Community Service Funding Application
a �
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Conf1FM
Applicant Organization
Name:

Green Acres Interactive
Therapy
Mailing Address:*
35750 De Portola Road
* Year Organization
Founded:
2014
* Website:
www.gaitprogram.org
Number of Paid Staff:* Number of Volunteers:*
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Michelle Robinson [email protected]
Does the nonprofit have a current City of Geographic Area(s) the Organization Serves:* Temecula Business License? Temeuula
Yes �:_
Business License No.*
054723
Copy of Business License*
Gait City of Temecula Business Lice nse.pdf
https://css.temeculaca,gov

93.58KB
Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 Green Acres Interactive Therapy Program
MAX: $5,000 PER QRG
Start Date:* End Date:* Physical Address of Project/Program* 2024-01-01 2024-03-31 35750 De Portola Road Temecula CA 92592 Preferred Payment Method:
(if grant is awarded.)
Check Mailed Check Picked Up
Electronic File Transfer
Make Check Payable to:*
Green Acres Interactive Therapy

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS Deductibility Status
State of California Entity ID:*
3547698
To find CA Entity Status Letter.
click the link below:
h ttps:// www.ftb . ca.gov/help/business/entity-
statu s-letter.asp?1NT.mc_i d=a kB EStatus
Provide further verification as follows:*
Date of Incorporation:*
08/18/2014
Attach State of California Entity Status Letter:*
GAIT California Status Letter.pdf
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry .Search Tool [link below] Attach First Page of Most Recent Form 990*
You might find IRS Form 990 2021 990 E2.pdf
on the link below: (990, 990_Ea 990-PF, 990 T)
https:/Irct.doj.ca.govNerif ication/web/Search.aspx?
facility=Y
►IF? WM31:I
793.29KB

Mission Statement
Briefly describe the nonprofit organizaton's mission/goals and objectives:* To enrich the lives of children with special needs and disabilities by providing therapeutic riding.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
yes

NAME OF PROGRAM/PROJECT

FUNDED BY THE CITY GRANT
OR SPONSORSHIP *
Walk Run Ride
Gait -Tack
AMOUNT;*
%5,000.00
$2,500.00
MONTH + YEAR FUNDING
RECEIVED*
05/2023
07/2023

NAME OF CITY GRANT OR

SPONSORSHIP
Community Funding
Temecula Councilman

Project/Program ❑escription

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE, Understand
ProjectlProgram Title: Green Acres Interactive Therapy Program

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.* This will support our general therapeutic riding program as donations are at an all time low.

We provide therapeutic riding to help core strength and physical and mental advancement of our students with special needs and help veterans as well.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED." ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

This will support the overall program by providing us with funds to pay for the facility and some of the horse expenses incurred by the therapeutic riding.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.' TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

The funding will help the Temecula residents because GAIT is the only therapeutic riding facility in the area. We set -vice the residents in Temecula because we are local and open 5 days a week. 3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
-I e
3c. ESTIMATED NUMBER OF VOLUNTEERS
INVOLVED IN THIS PROJECTIPROGRAM:

4. SUMMARY STATEMENT- SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS.` The Gait program relies on the community support to get the doors open since covid our donations and funds have been limited to serve the Temecula residents.

This program help so many kids with special needs, emotional and mental issues and even helps local veterans.

Project/Program Budget

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount requested from this City of Temecula Community Services Grant Amount contributed to the Project/Program by the Applicant Organization Other grants or funding already awarded for Project/Program, if any In -Kind match amount or volunteer credit hours estimated amount

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment*
NIA
Faci I ities/Rentll nsu ranee *
Facility
Supplies*
NIA
Marketing
NIA
Services*
NIA
Food*
NIA
Other*
Horse Expenses
Staffing Expense
TOTAL REVENUE:
$5, 000.O D

TOTAL EXPENSES
$ S, 000.00
REVENUES*
$5,000.00
Refer to Page 2
$0.00
$0.00
$0.00
EXPENSES*
$0.00
$2,SOO.00
$0.00
*
$0.00
$0.00
$0.00
$2,500.00
$0.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization:*
Green Acres Interactive Therapy
PresidentiAuthorized Officer:*
Margaret Rich
Name & Title
Requested Amount:
$5,000.00
E-mail:*
[email protected]
President/Authorized Officer Signature* date
2023-09-12
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Name, Title, & Organization
Phone: *
If you have any questions, please contact. [email protected] (951) 693-3959 or [email protected] (951) 694-6413

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/3/2023
ESL ID: 2655003078
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: 3547698
Entity Name: GREEN ACRES INTERACTIVE THERAPY, INC.

1. The entity is in goad 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.

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 Cal ifomia, this information dues 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 impairmenIs) FTB 4263A WEB (REV 12-2019)

FY 23/24 Community Service Funding (CSF) Grant
Application
17 HABITAT FOR HUMANITY

INLAND VALLEY

Ift
Community Service Funding Application
—Z'O'Z�-FIN
(T , I h- CAF
. C-I.ti y
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY Mink above)
C©nf rn,
Applicant Organization Year Organization Website:

Name: Founded: www.habitativ.org
Habitat for Humanity Inland
Va I I ey
Mailing Address:" Number of Paid Staff:" Number of Volunteers:" 27475 Ynez Road #390, Temecula, CA 411 1,S74
92591
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Mary Stein, Chief Financial [email protected] 9S1-296-3362 Officer
Does the nonprofit have a current City of Geographic Area(s) the Organization Serves:* Temecula Business License? Southwest Riverside County
Yes No
Business License No."
055012
Copy of Business License*
Business L cense - Commerce Center Drive.jpg
H
h ttps:llcss.temeculaca,gov

3.29 M B
Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE

TEMECULA,

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 A BrUsh With Kindness
MAX: $S,000 PER ©RG
Start Date:* End Date:* Physical Address of Project/Program* 2023-07-01 2024-06-30 4161 S Winchester Road, Suite 214, Ternecula, CA 92590 Preferred Payment Method:
(if grant is awarded.)
Check Mailed Check Picked Up
Eiectronic File Transfer
Make Check Payable to:*
Habitat for Humanity Inland Valley

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Provide nonprofit status verification as follows:*
(one required, bath preferred)
.State of California Entity Status Letter
IRS Deductibility Status
State of California Entity ID:*
C1681922
To find CA Entity Status Letter,
click the link below:
h ttps:// www.ftb.ca.gov/help/business/entity-
status-letter.asp?WT.mc_id=akBEStatus
IRS Employer Identification Number (EIN): *
33-0461804
To find IRS Deductibility Status,
click the link below:
https://apps.irs.gov/app/eos/
Date of Incorporation:
02/11 /1991
Attach State of California Entity Status Letter:*
CA State Entity Letter.pdf
Attach IRS Deductibility Status:*
501 c 3.pdf
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (link below) Attach First Page of Most Recent Form 990*
You might find IRS Form 990 IRS Form 990 1st page.pdf
on the link below: (990, 990-EZ, 990-PF, 990-T)
h tt p s. // rct. d of .ca.govNe ri f icat i o n /Web/Sea rc h.a s px? facility=Y
Mate Registry Search Tool: Attach Slate Registry Document/Info https:llret.doj.ca.govrVerlflcadori/ UeUSearrh.aspx' CACi7arltyRglsuaiJcn.pd 302.6,5K9 Facility=Y
370A 1 KB
158.02KB
191.29KB

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:

The mission for Habitat for Humanity inland Valley, in partnership with God, is to facilitate the dream of homeownership as well as improve the living conditions for those in the community.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
`P. ;,j

NAME OF PROGRAM/PROJECT
FUNDED BY THE CITY GRANT AMOUNT;' MONTH YEAR FUNDING
OR SPONSORSHIP'° REE CEIVED
Pathway to $7,236.00 July 2023
Homeownership
Program
Real Estate and $45,000.00 November 2022
Education Center
Critical Home Repairs $49,724.00 March 2022
A Brush with Kindness $5,000.00 January 2022.

Critical Home Repairs $500,000.00 April 2023

NAME OF CITY GRANT OR

SPONSORSHIP
CDBG 23/24
CS F 22/23
CDBG 22/23
CSF 21f22
CDVID Reinvest Funds

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
Project/Program Title: A Brush With Kindness

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT,* The A Brush with Kindness Program (ABWK) is our minor home repair program providing qualified, low- income Temecula residents with no -cost minor exterior home repairs and maintenance services with the goal of protecting and preserving home affordability. We serve any low-income resident in need, the majority of those seeking services are seniors. Typical repairs include weed abatement, exterior painting, fencework, accessibility and miner repairs that are outside of the scope of eligible repairs through our Critical Home Repair Program, which is currently funded by the City of Temecula. .

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.' ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

Habitat for Humanity Inland Valley will spend the grant funding on the ABWK Program, serving any qualified, low-income resident within the City of Temecula, who is in need of minor exterior home repairs and maintenance services. Projects can include landscaping, weed abatement, exterior painting, fencework:, accessibility and other repairs. Funds will provide the basic materials and supplies needed for repairs such as nails, lumber, paint, tools, siding, volunteer and other supplies. In addition, funds will be used to purchase a utility trailer to be used on ABWK projects.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

This project is only available to qualified, low-income Temecula residents and will help keep neighborhoods beautified while protecting affordable housing and stabilizing residents. Many times simple repairs can cause struggling residents to quickly become financially unstable, but with A Brush with Kindness, residents can gain some financial stability. Over 90% of those served by this project are fixed -income seniors, and 100% live at or below the poverty line. 3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
10 3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECT/PROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 3 ABOVE IN 50 WORDS OR LESS.* Funds would be utilized to provide no cost, exterior rninor home repair or maintenance projects to low- income residents within the City of Temecula with the goal of preserving home affordability.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
ToolslEquipment* EXPENSES*
Small tools and trailer $3,000.00
FacilitieslRentllnsurance*
Facility rent and insurance $9,000.00
Supplies*
ABWK Program Supplies $6,000.00
Marketing*
Marketing/Advertising $1,000.00
Services*
NIA $0.00
Food*
Volunteer Supplies $500.00
Other*
NIA $0.00
Staffing Expense
$5,000.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: * Requested Amount:

Habitat for Humanity Inland Valley $5,000.00
PresidentfAuthorized Officer:* E-mail:* Phone:*
Tammy Marine, Chief Executive [email protected] 951-296-3362 Director
Name & Title
President/Authorized Officer Signature* Date Time
T" #,t
2023-09-08
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Name, Title, & Organization
If you have any questions, please contact_:

Betsy.Lowrey@Temecu[aCA.gov (951) 593-3959 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
D ate: 916/2023
ESL ID: 3825130499
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: 1681922
Entity Name; HABITAT FOR HUMANITY INLAND VALLEY, INC.

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) Secuon 23701 d.

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

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

916/23, 5:58 AM
Details
HomE ABOUT mEMA ijAREERw =4EGLjL.,\TlGr-1:� RE:aOl.Rk'-'ESS PROGRAMS C:OPJA-�;T Registrant Details
Entity type- "`omorate Cfass as reniAered With the Secretary of State or !rased on Founding & registration documents.

Organization Name: HABITAT FOR FICTNLANIT'Y INLAND VALLEY. INC. IRS FEIN: 330461804 Entity- Type: Public Benefit SOSIFTB Corporate/Organization dumber: 1681922 Registry Status:

RCT Registration Number:

Record Tape:

Date of Last Renewal:

Current - Awaiting Reporting Renewal Due/Exp. Date: 11/15/2022 081196 Issue Date: 6:30.'2006
Charity Registration Effective Date: 6'30,'_'006
DBA:

Mailing Address
Street:

Street Line 2:

City; State Zip:
41615 WINCHESTER RD #214
TENMCULA CA 92590
Filings & Correspondence
Founding Documents
Founding Documents
CT-550 2010
CT 550 2010
Form RRF-1
2021
IRS Form 990 Series
2021
Renewal Filing
2020
Renewal Filing;
2019
Renewal Filing
2018
Renewal Filing
2017
2016 IRS Forin 990 Series 2016 IRS Form 990 Series
2016 Fonrn RRF-1
2016 Form RRF-1
2015 RRF-1
2015 RRF-1
2015 IRS Form 990
2015 IRS Form 990
RRF-1 2014
2014 RRF-1
IRS Form 990 2014
2014 IRS Form 990
RRF-1 2013
2013 RRF-1
IRS Form 990 2013
2013 IRS Form 990
RRF-1 2012
2012 RRF-1
IRS Form 990 2012
2012 IRS Form 990
RRF-1 2011
2011 RRF-1
RRF-1 2011
2011 RRF-1
IRS Form 990 2011
2011 IRS Farm 990
RRF-1 2010
2010 RRF-1
IRS Form 990 2010
2010 IRS Farm 990
RRF-1 ?009
2009 RRF-1
https:llrct_doj.ca.gowVerificationfWeblDetails.aspx7result=3cce0141-489a-485b-bcd7-4acc592604d0 114

916/23, 5:58 AM
Details
IRS Form 990 2009
2009 IRS Form 990
RRF-1 2008
2008 RRF-1
IRS Form 990 2008
2008 IRS Form 990
RRF-1 2007
2007 RRF-1
IRS Fonn 990 2007
2007 IRS Form 990
RRF-1 2006
2006 RRF-1
IRS Form 990 2006
2006 IRS Form 990
RRF-1 2005
2005 RRF-1
IRS Fonn 990 2005
2005 IRS Farm 990
RRF-1 2004
2004 RRF-1
RRF-1 2003
2003 RRF-1
IRS Form 990 2003
2003 IRS Form 990
RRF-1 2002 -
2002 RRF-1
IRS Form 990 20021
2002 IRS Form 990
RRF-1 2000
2000 RRF-1
1st Delinquency Notice
1st Delinquency Notice
Annual
Renewal Data
Status of Filing:

Accepted
Accounting Period Begin Date:

7. 1:2009
Accounting Period End Date:

6.30'2010
Filing Received Date:
9 1712012
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Rejectllncomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Status of Piling:

Accepted.

Accounting Period Begin Date:

7.' 1.?010
Accounting Period End Date:

6. 30, 2011
Filing Received Date:
- 16'2012
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Rejectllneomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:

71.12011
Accounting Period End Date:
613012012
Filing Received Date:
11/19/2012
Form RRF-1 RejectlIncomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 RejectlIncomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
7!1l2012
Accounting Period End Date:
6/3012013
Filing Received Date:
2/20/2014
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:
7/1/2013
https:llrct_day.ca.govNerificationMeblDetails.aspx7result=3ece0 t 41-489a-485b-bcd7-4acc592604d0 2!4

916/23, 5:58 AM Details
Form RRF-1 Rejectrincomplete Reason: Resubmission/CorrectionAccepted Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Related Registrations Vie. Event Reports
i he related records shown below devefld on the record type teeing vie)Ved:

Chai tty Registrations relate to IProfessi€mai Fundralsircg Everts Which plate txr profes!ionFal Fundr-aiher ftegist;miksosA • Raffle Registrations relate to Raffle Reports_
Click on the 'RCT Registration Pin to navigate to the related record.

Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

BEYOND DIRECT MARKETING LLC
Registration No:

E0019193
Registration TI -pc:

Fundraising Event
Registration Status:

Complete
Date Established:
1/23/2014
Association Date:
1/1,2014
Expiration Date:
12/31'2014
Prereq Type:

Prerequisite
Relationship:

Charity
Registrant:

BEYOND DIRECT MARKETING LLC
Registration No:

E0022449
Registration Type:

FundraisinLy Event
Registration Status:

Complete
Date Established:
1/20/2015
Association hate:
1/1/2015
Expiration. Date:
12/31/2015
https:llrct_dui.ca.gov Verification=eblDetails.aspx?result=3cce0l41-489a-485b-bod7-4acc592604d0 4.14

�, InLl:rrldl {SGV�liuc .�c� v�.+o
1 n
Date: OCT 2-4 2001
Habitat for Humanity Intemational, Inc.

Inland Valley
clo Deborah Hollingsworth
27475 Ynez Road, #390
Temecula, CA 92591.4612
Dear Madam:

P, Q, Box 2508
Cincinnati, CH 45201
Person to Contact:

Brett Siereveld 31-02633
Customer Service Specialist
Toll Free Telephone Number:

8.00 A.M. to 9:30 P.M. EST
877-829-5500
Fax Number:

Federal €dentification Number: }
/ 33-0401504 �!
Group Exemption Number:
8545
We have received your request for affirmation of your organization's tax exempt status.

Please note that the Federal Identification Number you provided- in your letter is not the correct one for your organization. The number shown in the heading of this letter is the one ass€fined to you and is the only one you should use.

Your organization is exempt under section 501(c)(3) of the Code because it is included in a group ruling issued to Habitat for Humanty International, Inc., located In Americus, Georgia,
Individual exemption letters are not available to organizations included in group rulings.

The group exemptiari letter applies to all of the subordinate organizations on whose behalf Habitat for Humanity International, inc. has applied for recognition of exemption. if you want a copy of the group exemption letter, please contact your parent organization.

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

Donors may deduct contributions to your organization as provided in section 170 of the Coda. Bequests, legacies, devises, transfers, or gifts to your organization or for its use are deductible for federal estate and gift tax purposes if they meet the applicable provisiorls of sections 2055, 2106, and 2522 of the Cods, The law requires you to make your organizabon's annual rot um available for public inspection without charge for three years after the due date of the return. You can charge only a reasonable fee for reproduction and actual postage costs for the copied materials. The law does not require you to provide copies of public inspection documents that are widely available, such as by posting them on the Intemet (World Wide Web). You may be liable for a penalty of $20 a day for each day you do not make these documents available for public inspection (up to a maximum of $10,000 in the case of an annual return).

_2-
Habitat for Humanity International, Inc.

Inland Valley
33-0481804
If you have any questions, please call us at the telephone number shown In the heading of this letter.

Sincerely,
John E. Ricketts, Director, TE/GE
Customer Account Services

FY 23/24 Community Service Funding (CSF) Grant
Application

HIS LITTLE FEET

Ift
Community Service Funding Application
—Z'O'Z�-FIN
(T , I h— CAF
. C-I.ti y
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY Mink above)
c©f1fiFM
Applicant Organization Year Organization Website:

Name: Founded: http://www.hislitfeet.org
His Little Feet n i
Mailing Address:* Number of Paid Staff:* Number of Volunteers:* Temecula, CA 92592 3 41S
Contact Name & Title:* Contact's Email:' Contact's Phone Number:* Erin Wilson [email protected]
Does the nonprofit have a current City of * Geographic Area(s) the Organization Serves:* Temecula Business License? Temecula, Long Beach, Orange A current City of Temecula Business
License may be required to submit prior to
fund disbursement.

Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 New Shoe Outreach for Underserved Youth
MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program* 2023-07-14 2023-08-03 41 G69 WINCHESTER RD, SUITE 101, Temecula, CA 92590 Preferred Payment Method:
(if grant is awarded.)
Check Mailed Check Picked Up
Dectronic Fife Transfer
Make Check Payable to:

His Little Feet

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS Deductibility Status
IRS Employer Identification Number (EIN):*
47-3769966
To find IRS Deductibility Status,
click the link below:
https:/Iapps.irs.gov/app/eos/
Date of Incorporation:
01 /18/2014
Attach IRS Deductibility Status:`
HLF 501C3 IRS dccumengpg
Provide further verification as follows:
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (link below) You might find IRS Form 990
on the link below:
http s://rct.d of .ca.goyNe ri f icat i o n /Wa b/Sea rc h. a s px? facilityY
State Registry Search Tool
Attach First Page of Most Recent Form 990*
2022 Tax Returns - His Little feet copy.pd`
(990, 990-EZ, 990-PF, 990-T)
Attach State Registry Document/Info*

95.89KB

90.88KB
https://rct.doj.ca.govNerification/Web/Search.aspx ? State of CA Attorney General.gif 3B facility=Y

Mission Statement
Briefly describe the nonprofit orga n ization's mission/goals and objectives. * His Little Feet empowers youth ages 1.5-24 years cold experiencing neglect and extreme poverty by opening the door to self -love and confidence, athletics, and healthy peer relationships at school through the vehicle of new, high quality, well -fitting shoes. We serve underprivileged youth who are in the foster care and child services system or experiencing homelessness in Los Angeles, Riverside and Orange Counties. His Little Feet collects, purchases, and distributes new shoes, socks and supplies to shelters, programs, and schools.

His Little Feet is one of the only organizations in California that solely provides new footwear to children experiencing homelessness and/or living in foster care. Shoes are the number- one need for poorer children, and coupled with the fact that children's feet grow so fast, it is nearly impossible for a struggling family to purchase new shoes several times a year. New shoes provide safety, physical fitness, confidence, and positive peer interactions. It is no surprise the demand is high. An area of intense growth for our organization is Riverside County, where we have nearly tripled the number of youth served since 2021. This coming fiscal year we predict 300 pairs of shoes will be distributed in Riverside County alone, 90% of which are children experiencing neglect, homelessness, or housing instability.

Support from the City of Temecula would specifically offset HLF costs in Temecula, where we serve hundreds of children year around that are experiencing trauma and need our resources.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?

NAME OF PROGRAM/PROJECT
MONTH +YEAR FUNDING
FUNDED BY THE CITY GRANT AMOUNT;*
RECEIVED*
OR SPONSORSHIP"
New Shoes for $5,000.00 June 2022
Michelle's Place
Youth(cancer patients)
New Shoes for Rose $5,000.00 June 2023
Again Foundation
Youth

NAME OF CITY GRANT OR

SPONSORSHIP
City of Temecula
Reimbursement
City of Temecula
Reimbursement

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECTIPROGRAMAS DESCRIBED HERE. U{iderstand
Project/Program Tittle: New Shoe Outreach for Underserved Youth

9. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT,' His Little Feet has increased shoe outreaches and partnerships in Riverside County by 25:6 in the last two years. Over 4,000 children are in foster care services in Riverside County each year, where the poverty rate is higher than the national average. HLF is specifically doing more programming in the City of Temecula, where last year alone (June 22-June 23) we distributed over 200 pairs of shoes to the following partners:

Rancho Damacitas, Temecula- Formerly Thessalonika Family Services, a foster home for young girls removed from their homes due to severe abuse and neglect, is focused on at -risk single mothers to empower them with skills and education that will help them keep their children out of the system and Rose Again Foundation in Temecula- serving children In the foster system through placement, therapy, tutoring and resources, and Michelle's Place, in Temecula, an agency that provides wrap around supportive services to children and families undergoing cancer treatment.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.

ALSO, INCLUDE EQUdPMENT, SERVICES TO BE PURCHASED AND WHY.

If grant support is awarded by the City of Temecula, HLF will apply it toward our program partnership with Michelle's Place. Just last month we hosted a shoe outreach there and donated 100 pairs of shoes to youth suffering from cancer. We plan to host another outreach in June of next year. Children living at Michelle's Place are undergoing difficult, painful cancer treatment plans, and their families are extremely overwhelmed- financially, emotionally, and physically. Through the donation of new athletic shoes, that fit properly and are of the highest standard, children are safe in the right fitting shoes while also feeling socially accepted and worthy of new and nice things.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.- TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

All youth receiving new shoes will live in Temecula and/or be participating in a Temecula -based service organization . The Assistance League doesn't provide new shoes any longer. New shoes are the highest price item a lot of families and have become too expensive will have to use hand me down and used shoes which can lead to a variety of skin and bone issues. Hlf is the only organization in the area providing for shoe insecurity and we truly are an education support since kids need them everyday to attend school. Temecula student that receive new shoes will start each day with confidence and comfort knowing they can participate at school with out the fear of being singled out from peer for their shoes and participate in actives knowing they will be saved from injury due to properly fitted shoes.

3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECTIPROGRAM:
101
3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECT(PROGRAM:
15 4. SUMMARY STATEMENT— SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS." HLF donaCes new, fitted„ high quality tone of the costliest expenses for a struggling farniiy) [o youth ages

1.5-18 experiencing trauma, poverty or health concerns.

Project/Program Budget

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount requested from this City of Temecula Community Services Grant Amount contributed to the Project/Program by the Applicant Organization Other grants or funding already awarded for Project/Program, if any In -Kind match amount or volunteer credit hours estimated amount

LIST OF EXPENSES FOR PROJECT/PROGRAM
ToolslEquipment*
Labels
Facilities/Rentlinsurance *
Storage
Supplies*
Shoes for 100 children
Marketing*
Community communications
Services*
none
Food*
none
Other*
none
Staffing Expense
TOTAL REVENUE:
13, 500.00

TOTAL EXPENSES
$7, 500.00
REVENUES*
$5,000.00
Defer to Page 2
*
$6,000.00
*
$1,000.00
*
$1,500.00

EXPENSES'
$0.00
*
$750.00
$6,500.00
$250.00
*
$0.00
*
$0.00
$0.00
*
$6,000.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization:* Requested Amount:

His Little Feet $5,000.00
President/Authorized Officer:* E-mail:* Phone:*
Hali Wolf [email protected] _
Name °.: Title
President/Authorized Officer Signature* date
2023-09-12
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Erin Wilson, Grantwriter, His Little Feet
Name, Title, & Organization
If you have any questions, please contact: [email protected] (951 ) 693-3959 or [email protected] (951.) 694-r,413

INTERNAL REVENUE SERVICE
P. C. BOX 2508
CINCINNATI, OH 45201
Date: D E C 14 2015

HIS LITTLE FEET INC
PO BOX 11572
SANTA ANA, CA 92711
Dear Applicant:

DEPARTMENT OF THE TREASURY
Employer identification Number:
47--3769966
DLN:
17053308318025
Contact Person:

MICHELLE A GLUTZ ID# 31213
Contact Telephone Number:
(877) 829-5500
Accounting Period Ending:

December 31
Public Charity Status:
170(b) (1) (A) (vi)
Farm 990/990-EZ/990-N Required:

Yes
Effective Date of Exemption:

April 13, 2015
Contribution Deductibility:

Yea
Addendum Applies:

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

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

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

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

FY 23/24 Community Service Funding (CSF) Grant
Application
19 HORSES SERVING HEROES

COMPANY

Community Service Funding Application
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
c©nfiFM
Applicant Organization Year Organization x Website:

Name: Founded:

Horses Serving Heroes
Company
Mailing Address:* Number of Paid Staff:* Number of Volunteers:" PO Box 893864 l "o
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Kimber Poyner
Does the nonprofit have a current City of Geographic Area(s) the Organization Serves:* Temecula Business License? Temecula
A current City of Temecula Business
License may be required to submit prior to
fund disbursement.

Geographic Area(s) the ProjectfProgram
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 Rejuvenation to VolunteerNeteran program
MAX: $5,000 PER ©RC
Start Date:* End Date:* Physical Address of Project/Program* 2023-1 D-01 2023- i 2-31
Preferred Payment Method:
(if grant is awarded.)
Check Mailed Check Picked Up
Eiectronic File Transfer
Temecula, CA 92592
Make Check Payable to:*
Horses Serving Heroes Company

Nonprofit Staters
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS Deductibility Status
State of California Entity ID: *
4862718
To find CA Entity Status Letter.
click the link below:
https://www.ftb.ca.govfhelp/business/entity-
status-letter.asp?Wi.mc_id=a kBE5tatus
Provide further verification as follows:*
Date of Incorporation:
01/01/2022
Attach State of California Entity Status Letter:"
HSH Entity Letter as of Aug 2023.pdr
(one required, both preferred)
Forst Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool !link below) State Registry Search Tool: Attach State Registry Documentllnfo* 370.25KB
https://rct.doj.ca.govINerification/web/Search.aspx ? HSH State Registry.docx 172.08KB facility=Y

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* The main mission of Horses Serving Heroes Company is to provide no -cost equine therapy to Veterans, Current Military, Current and prior First Responders, and in some cases; family members and Gold Star Families. Our secondary mission is to provide an opportunity for local high school students to earn their required community service 'hours to graduate. Our newest mission is to provide information to high school students regarding vocational choices in trades such as Carpentry, Electrical, and general hands- on ,professions.

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 TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. Understand

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
Yes Nc:

Project/Program Description
RECEIPTSIINV©ICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
ProjectlProgram Title: Rejuvenation to VolunteerNeteran program

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT,* Rejuvenation of existing voiunteer supplies and purchase of new supplies and equipment to better provide safety and comfort for our volunteers. To shore up and retouch any training issues the existing horses have to better provide for our recipients (heroes).

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.* ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

The grant will be disbursed in a few Ways: Board for the current and anticipated addition of herd. Safety and comfort equipment and clothes/supplies for our volunteers (T-shirts, gloves, goggles, boots, and hats. Landscaping and cleaning equipment for herd and property maintenance). Professional horse trainer to come in a make a few tweaks to the existing herd and to work With new additional horse (1) to make them the best therapy horse for our program. Tax expert to assist with federal filings to become compliant and to teach our board members/secretary how to file and how to keep good accounting books throughout the year. Hire a marketing person to help us get a better social media presence.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. 100 percent of our high school volunteers are from TVUSD school districts. The majority of our purchases are from local stores and services (Temecula Creek Vet, Inland Vet Supply, Tractor Supply, Dan's Feed, and Big Horse).
3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
so
3c. ESTIMATED NUMBER OF VOLUNTEERS
INVOLVED IN THIS PROJECT/PROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 54 WORDS OR LESS.* Funding will provide much -needed rejuvenation of supplies, equipment, training, board, and vet care for the existing herd and Deep us on track to move forward so we may best serve our "Heroes" and provide opportunities for our graduating high schoolers.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment* EXPENSES*
Weed eaters, goggles, tools, wheelbarrows, shovels, rakes, etc. $1,300.00 Facilities/Re ntli ns u ra nce *
Board and Transportation $2,100.00
Supplies*
T-shirts, gloves, hats $400.00
Marketing*
Local High School Social Media wizard $500.00
Services*
Tax prep $700.00
Food*
Waters, snacks $500.00
Other*
Training $2,000.00
Staffing Expense
TOTAL REVENUE: TOTAL Expmsrms $0.00
7, 50D. DD 7, 500- 00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: *
Horses Serving Heroes Company
PresidentlAuthorized Officer:* E-mail:*
Kimberly Poyner _
Name & Title
PresidentlAuthorized Officer Signature*
Requested Amount:
$5,000.00
Date Time
2023-09-06
IF DIFFERENT THAN ABOVE, APPICATION PREPARE❑ BY:

Name, Title, & Organization
If you have any questions, please contact:

Phone:*
Betsy.Lowrey@Ternecu[aCA.gov (951) 69 3-395 9 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 8/17/2023
ESL ID: 2047852951
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: 4862718
Entity Name; HORSES SERVING HEROES COMPANY

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 . 11 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.

M Your drak has been saved. - hs. X © R,-.— Submission
X Q SearchResulls
X © Det is
X + v — .EP x
C Q
i rct.doj,ca.gov/Veuifir ion/Web/Details.aspx?resutt=bQO77995-bO95-43d2-baf5-f7.84fle997e L y` 5 ' 0
fr Los Angeles and So...
() Farehook M kimherkinard@gma...
p eyesigncertifled@y... t% Edit Profile • Instagr.
0 Kimher Kinard, Real,..
y Kimber Knaves Real,,. © The Strength oifhe... Mr' AAA - Manage My... » State of California Office of the
Department of Justice Attorney General
Or puization N— HORSES SEM-PiG HEROES COMPAINTY IRS FEZ\:

F.6ty T,T- Public Benetir SOSIFFR Coipontal anization\umher: 486-271S Registry Status: Not Registered Renewal Due/Exp. Date:

FY 23/24 Community Service Funding (CSF) Grant
Application
20 INLAND VALLEY SYMPHONY

TEMECULA VALLEY SYMPHONY

Community Service Funding Application
—/;, 00-A��
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
confirm
Applicant Organization * Year Organization Website:

Name: Founded: temeculava lleysymphony.org
Inland Valley Symphony, dba 1999
Temecula Valley Symphony
Mailing Address:* Number of Paid Staff: Number of Volunteers:* Pa Box 637, Temecula, CA 92593 4 25
Contact Name S Title:* Contact's Email:* Contact's Phone Number:* Susan Miyamoto
Dues the nonprofit have a current City of * Geographic Area(s) the Organization Serves:* Temecula Business License? Temecula Valley
Yes No
Business License No.*
OS4739
Copy of Business License*
css.temeculaca.gov_ 2.webloc
htLps://css.temeculaca.gov
404B
*
Geographic Area(s) the Project/Program
Serves:

Temecula Valley

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title: *
s5,000.00 Andiamo alla musica!
MAX: $5,000 PER DRG
Start Date:* End Date:* Physical Address of ProjectJProgram * 2023-09-30 2024-04-27 Various locations in Temecula
Preferred Payment Method:
(If grant is awarded.)
Check Mailed Check Picked Up
Electronic File Transfer
Make Check Payable to:*
Temecula Valley Symphony

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS. Deductibility Status
IRS Employer Identification Number (EIN):*
33-0862000
To find IRS Deductibility Status,
click the link below:
https://apps.irs.gov/app/eos/
Provide further verification as follows:'
Date of Incorporation:
07/01 /2000
Attach IRS Deductibility Status:*
IRS Tax determination letter date 2005.pdf
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your chanty found on the State Registry Search Tool (link below) Attach First Page of Most Recent Form 990*
You might find IRS Form 990 Tax Return 2021_IV5_990EZ.pdf on the link below: (990, 990-EZ, 990-PF, 990-T)
httpE //rct.do].ca.govNerif ication/Web/Search.aspx?
facilitpYY
489.81 KS

4.49 M S

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* Temecula Valley Symphony aspires to provide quality, innovative and compelling music programming and serves as a leader of the arts in our community, through an organization that provides the support necessary for these efforts, in an atmosphere that is fun, positive, and supportive.

Our vision is to present high duality symphonic concerts performed with artistic excellence. We also airn to educate young musicians and give them performance opportunities in Temecula as a way of giving back to the community.

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
y C

NAME OF PROGRAM/PROJECT
FUNDED 6Y THE CITY GRANT
OR SPONSORSHIP*
Season of Hope
AMOUNT:*
$5,000.00
MONTH + YEAR FUNDING
RECEIVED*
05/04/23

NAME OF CITY GRANT OR

SPONSORSHIP
Community Service
Funding 2022-2023

Project/Program Description
RECEIPTSIINV©ICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
ProjecfJProgram Title: Andiamo alla musica!

9. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.* The Temecula Grant funding will support our 2023-2024 Concert Season: Andiar no alia musical- Let's go to the music! We will perform S concerts this season- 4 at venues in Temecula and although our preference was here in Temecula, no venue of the appropriate size was available to us in May, so we had to reserve a high school theater in Murrieta.

Our holiday concert will feature local jazz legend and singer, Sherry Williams.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.=

ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY - The symphony will spend the grant funding on concert production expenses for our adult symphony:

Flyers to advertise the concerts, printing of concert programs, rental costs for venues- high school theaters and Grace Presbyterian Church and liability insurance..

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

There are so many benefits to having a symphony that a community can call it's own. A symphony of our size and quality brings prestige and a positive image to the City of Temecula. We particularly try to improve the lives of seniors by offering free tickets in senior living communities such as Fountain Glen in Temecula. Many seniors who live here are on a limited fixed income and have trouble keeping up with rising cost of living. They can't afford concert tickets and we plan to give free tickets as we did last year, to our Holiday Concert and spring concerts. I know it brought joy to those who attended and was especially satisfying because some also do not have family living close by. Depression and loneliness can result and studies have shown that live music can improve emotional well being especially the our elderly population.

We also give free tickets to Temecula students to introduce them to symphonic music and continue to educate our youth in the arts.
3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
400
3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECT/PROGRAM:

4. SUMMARY STATEMENT- SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OFF LESS.* Producing duality orchesUal corckrt_, i•erluires a large budget. We are still i-ecoveriri4s t,om Me ef#ec�-- Covid - expenses and audience attendance has been slow to recover but we are opurnistic. As well knownjaza musician Byron stripling said at a recent American symphony orchestras conference, ""We have a treasure, a hidden gem in our own backyard". We are trying to create a legacy for our children in the community. According to the League of American Orchestras, ticket sales only cover 36% of an orchestras expenses. Our support must come from private and government sources if we want to keep this legacy in our city alive.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
ToolslEquipment* EXPENSES'
phone, music $1,200.00
FacilitieslRent/Insurance*
Rent of performance venues, liability insurance, storage, $9,000.00 Supplies*
Paper, postage $600.00
Marketing*
Flyers,' brochures, mailers $5,0()0.00
Services*
Bookkeeping, $3,600.00
Food *
Food for musicians $1,200.00
Other*
Music Licensing, $500.00
Staffing Expense
$58,000.00
TOTAL REVENUE: TOTAL EXPENSES
$30,640.00 $21,100.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: *
Inland Valley Symphony, dba Temecula Valley
Symphony
PresidentfAuthorized Officer:* E-mail:*
Susan Miyamoto, President -
Name &Title
President/Authorized Officer Signature*
IL s! ♦ •rr
Requested Amount:
$5,000.00
Date Time
2023-09-12
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Name, Title, & Organization
If you have any questions, please contact_:

Phone:*
Betsy.Lowrey@Temecu[aCA.gov (951) 593-3959 or

6r:6; 2006 14: 14513 P3 3739T 'iF/:GE GX'.�.I., 1 100Cr`Ci{..'' internal Revenue service
Date; June 26, 2006

INLAND VALLEY SYMPHONY
% TREASURER
PO BOX 154
MURRIETA CA 92564-4154 646
Clear Sir or Madam:

Department of the Treasurer
P. Q. BOX 2508
Cincinnati, OH 45201
Person tO'ontact:
his. Juilus 3,1108345
Cti$torner Servir,,a Representative
Toi! Free Telephone Number:
977-829-5560
Federal tden6ficz0on Number:
33-0862066
This is in response to your raquest wf June 26, 2606, ;egardl:�g yc�ur organlzatlon's tax- exempt status.
if) July 2000 we issued a determination letter that recognized your organizatior as bxernPt from fedora, income taxi Our records indicate that your organiza.tlon Is currently exempt under section 501(u 3} of the Internal Revenue Colo..

Our records indicate that your organ17-ation is also classified as a public charity under eaciton 509(a;(2) of the Internal Revenue Codo.

Otrr records indicate that contrIbutions to your organization are deductible under section 170 of b-ie Code, and that you are quallied to raGeive tax deductib,e bequests; deulses, transfers or gifts under section 2655, 2106 or 2522 of the Internal Revenue (coda. if y0u h;avu arty questions, please Gail us at the telephone nurnber sl OWr in the hearing of this letter.

S incere ly,
fS �
Janna K. Skurca.

Director, TE/GE
Custarner Account Services

DocuSign Envelope ID: B552DC83-95A3-4A1C-8AD8-E53F24FQE712

NOTTINGHAM & ASSOCIATES
43460 RIDGE PARK DR, STE 240
TEMECULA, CA 92590
951-296-1698
November 11, 2022

INLAND VALLEY SYMPHONY
PO BOX 637
TEMECULA, CA 92593
Dear Maria:

Your 2021 Federal Return of Organization Exempt from Income Tax will be electronically filed with the Internal Revenue Service upon receipt of a signed Form 8879-TE - IRS e-file Signature Authorization. No tax is payable with the filing of this return.

Your 2021 California Exempt Organization Annual Information Return will be electronically filed with the State of California upon receipt of a signed Form 8453-EO. No tax is payable with the filing of this return.

Enclosed is your California Registration/Renewal Fee Report to the Attorney General. The original should be signed at the bottom of page one. There is a fee due�75 payable by November 15, 2022. Make the check or money order payabl pa t of Justice'" and mail your California report on or before November 1 22

REGIS O CH E TRUSTS
CSIU.OB�X 903447
NTO, CA 94203-4470
Please be sure to call us if you have any questions.

Sincerely,
JODY D. NOTTINGHAM, CPA

FY 23/24 Community Service Funding (CSF) Grant
Application
21 INTERNATIONAL CHRISTIAN

ADOPTIONS (ICA)

r Community Service Funding Application
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Confirm
Applicant Organization Year Organization Website:

Name: Founded: 4achiid.org
International Christian 1990
Adoptions (ICA)
Mailing Address:* Number of Paid Staff: Number of Volunteers:* 41745 Rider Way, Suite 2, Temecula, CA 53 0
92590
Contact Name & Title:* Contact's Email: * Contact's Phone Number:* Charlotte Paulsen [email protected] (951) 695-3336 Does the nonprofit have a current City of * Geographic Area(s) the Organization Serves:* Temecula Business License? State of California and North Carolina Yes No
Business License No.*
042918
Copy of Business License*
business license.pdf
https://css.temeculaca.gov
3(74.94KB
*
Geographic Area(s) the Project/Program
Serves:

Temecula Valley Residents

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 Community Counseling for Children
MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program* 2023-07-01 2025-06-30 41745 Rider Way, Suite 2, Temecula, CA 92590 Preferred Payment Method:
(If grant is awarded.)
Check Mailed Check Picked Up
Dectronic File Transfer
Make Check Payable to:*
International Christian Adoptions

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Provide nonprofit status verification as follows:*
(one required, bath preferred)
State of California Entity Status Letter
IRS Deductibility Status
State of California Entity ID:*
1664688
To find CA Entity Status Letter,
click the link below:
h ttps:// www.ftb.ca.gov/help/business/entity-
status-letter.asp?WT.mc_id=akBEStatus
IRS Employer Identification Number (EIN): *
33-0412343
To find IRS Deductibility Status,
click the link below:
https:/Iapps.irs.gov/app/eos/
Date of Incorporation:
12/ 14/ 1990
Attach State of California Entity Status Letter:*
entety status letter.pdf
Attach IRS Deductibility Status:*
501 {c} (3) letter .pdf
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found can the State Registry Sewch Tool (link below) You might find IRS Form 990
on the link below:
http s:!/rct. d of . ca.govNa ri f Fcat i o n/ We b/Sea rc h. a s px? Attach First Page of Most Recent Form 990*
990.pdf
(990, 990-EZ, 990-PF, 990-T)
facility=Y
State Registry Search Toot: Attach State Registry Documentlinfo* https:lfrct,d4j,ca.gavfl+erificatianlWe#�l5earch esx? IRS starus_pdf facility=Y
370 ! KB

32.82KS
964.9K8

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* International Christian Adoptions Institute for Children's Aid (ICA) is not just an adoption agency. The institute began in 1990 as a non-profit 501(c)(3) corporation with its principal office in Temecula, CA. The institute consists of two major divisions: International Christian Adoptions and the Institute for Children's Aid (ICA) which is inclusive of the Child Trauma & Learning Center. We stand on Biblical principles in all we do, lending hospitality and sanctuary to all who are in need. We are a voice For those who cannot speak for themselves, believing that all life is sacred. OUr staff Is multi-lingual, mr_liti-ethnic and professionally trained to assist in various capacities.

International Christian Adoptions (ICA) believes in the sanctity of life in that all children born and unborn are valued and uniquely made. Our overriding mission is to offer children hope in the love and compassion of Jesus Christ; hope for basic needs; hope for an education and bright future, and hope for a home in a family they can call their own. The mission is fulfilled through adoption, foster care, humanitarian aid, counseling and support..

ICA is a well -established organization that meets the standards and qualification of many accreditations such as Accreditation of Rehabilitation Facilities (CARF), Intercountry Adoption Accreditation and Maintenance Entity, Inc. (IAAME), United States Agency of international Development (USAID), National Council for Adoption (NCFA) and Evangelical Child and Family Agency (ECFA). In addition, ICA is a full - service foster care and adoption agency for International and Domestic Adoptions, as well as multi - County Domestic Foster Care and Refugee Foster Care programs. ICA also operates a Jubilee Exchange Fair -Trade Store in efforts to educate the community of the benefits and impact of purchasing fair-trade items both locally and world-wide. Our beautiful hand-crafted fair-trade items can be found in our office or at various educational events. (Farmers Markets, conferences, pop -ups) UPON REQUEST, COPIES OF THE ORGAN IZATI ON'S CURRENT BUDGETrFINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED To DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DC NOT SUBMIT NOW. Understand

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
Yes No

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
ProjectlProgram Title: Cornniunity Counseling for Children

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT,` The Child Trauma & Learning Center at the Temecula ICA Office offers therapeutic services for children and youth under the age of 18 in the Temecula Valley, specializing in foster/adoptive background, ADHD, trauma, grief/loss, addictions, anxiety, depression, and family issues. In addition to standard therapeutic services, we are Wanting to launch Sand Tray Therapy. Sand Tray Therapy blends with Play Therapy using textured sensory sands and miniature figurines, allowing clients to create stories of what is going on within themselves and to help them to process through their traumas.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.

ALSO, I NCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

ICA Child Trauma & Learning Center is requesting a grant of $5,000 to go towards the launching of Sand Tray Therapy at the Temecula office. Items needed would include: a variety of Sand Tray Therapy Sands, Miniature Figurines, Sand Tray Table, Airtight Sand Storage Containers, and approved sand sanitizing spray. Also, the funding would go toward the purchase of Sensory Items for our Sensory Treasure Box, Oculus for Therapeutic Services, Needed Office Items (for example: waiting room DV❑ player, DVDs for the waiting room, decor), and administrative costs.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.` TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

The majority of the Counseling Center's clients are Temecula residents. The set -vices provided to our Temecula children and youth, will aid in the healing, empowerment, and growth for children in our local community, families, and schools.
3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
3c. ESTIMATED NUMBER OF VOLUNTEERS
INVOLVED IN THIS PROJECT/PROGRAM:
0 4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.` The Child Trauma & Learning Center wants to help those in our Temecula cormunity by offering therapeutic services to local children and youth. We would like to include Sand Tray Therapy as an evidenced -based modality, as well as other needed therapeutic items to help meet the needs of children and youth in our community.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
ToolslEquipment* EXPENSES -
Variety of Sand Tray Therapy Sands, Sand Tray Table, Miniature Figurines, $4,000.00 Airtight Sand Containers, Approved Sand Sanitizing Spray, Oculus, Sensory Treasure Box items, Therapy Office waiting room items
FacilitieslRentlinsurance*
Facilities/Rent/Insurance $12,083.00
Supplies*
Off ice/Administrative Supplies, computers, desks, phones $1,282.00 Marketing*
Brochures, Flyers, Design, Website $181.00
Services*
Therapeutic Services $13,371.00
Food*
Water, Snacks for clients, lollipops $200.00
Other*
NIA $0.00

Staffing Expense
TOTAL REVENUE;

TOTAL EXPENSES
$10,000.00 $351,117.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: * Requested Amount:

International Christian Adoptions (ICA) $5,000.00
PresidentlAuthorized Officer:* E-mail:* Phone:*
Charlotte Paulsen [email protected] 951-695-3336
Name & Title
PresidentlAuthorized ❑fficer Signature* date Time
2023-09-12
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Jennifer Mitchell, Office Manager of the Child Trauma & Learning Center, ICA Name, Title, & Organization
If you have any questions, please contact:

Betsy.Lowrey@Temecu[aCA.gov (951) 693-3959 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/11/2023
ESL ID: 6064531393
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: 1664688
Entity Name; INTERNATIONAL CHRISTIAN ADOPTIONS

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 Taxabon 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.

9111I23, 1:03 PIN
Details
HOME =tile(_)uT mED A. -I' A K EER REGULATIGfi : RESOURCES ;ES PROG-RAMS C,6rJ %OT Registrant Details
Entity type- Corporate Ctass as registered with Vhe Sr-,_3 Ptary of State or based on founding & registration document_:.

Organization Name: IlVTERNATIONAL CFIPJSTIANADDPTIONS IRS FEIN: 330412343 Entity 71�-pe: Public Benefit SOSIFTB Corporate/Or-ganization Number: 1664688 Registry Status:

RCT Registration Number:

Record TF pc:

Date of Last Renewal:

Current Renewal Due/Exp. Date: 11/15/2023
119072 Issue Date: 63W2006
Charity Registration Effective Date: 6 30; 2006

4. 10/2023 DBA:

Mailing Address
Street:

Street Line 2:

City, State Zip:
41745 RIDER WAY #2
TEIVIECULA CA 92590
Filings & Correspondence
IRS Farm 990 Series
2022
Form RRF-1
2022
IRS Fonn 990 Series
2021
Form RRF-1
2021
Renewal Filing
2020
Renewal Filing
2019
Renewal Filing
2018
Form RRF-1
2017
CT-550 Ford] RRF-I InCDml7lete 2017
IRS Forin 990 Series
2017
2016 RRF-1
2016 RRF-1
2016 IRS Form 990
2016 IRS Form 990
2015 RRF-1
2015 RRF-1
2015 RRF-1
2015 RRF-1
2015 Return. Check Notice 2015 Return Check Notice
2015 IRS Form 990
2015 IRS Form 990
2015 IRS Form 990
2015 IRS Form 990
RRF-1 2014
2014 RRF-1
IRS Form 990 2014
2014 IRS Form 990
RRF-1 2013
2013 RRF-1
IRS Form 990 2013
2013 IRS Form 990
RRF-1 2012
2012 RRF-1
IRS Form 990 201-1
2012 IRS Form 990
RRF-1 2011
2011 RRF-1
https:llrct_doj.ca.goylVerifieationMeblDetails.aspx7result=b3fd99bb-7d2c-4259-ad84-ade8a80dbdca 1l4

9111123, 1-03 PM
Details
IRS Form 990 2011
2011 IRS Form 990
RRF-1 2010
2010 RRF-1
IRS Fonn 990 2010
2010 IRS Form 990
RRF-1 2009
2009 RRF-1
IRS Form 990 2009
2009 IRS Form 990
Annual
Renewal Data
Status of Filing:

Accepted
Accounting Period Begin Date:
7 1 '2009
Accounting Period End Date:
6 30 2010
Filing Received Date:
1 I S.'2011
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:
7 1 "2010
Accounting Period End Date:
6:30/2011
Filing Received Date:
1119/2012
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:
7i112011
Accounting Period End Date:
613012012
Filing Received Date:
1/16/2013
Form RRF-1 Rejectllucomplete 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:
7/1,12012
Accounting Period End Date:
6 30/2013
Filing Received Date:
5/19/2014
Form RRF-1 RejectlIncomplete 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:
711/2013
Accounting Period End Date:
6/3012014
Filing Received Date:

5.1812.015
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:
7 VM14
Accounting Period End Date:
6 30'2015
Filing Received Date:
5 -�0 '016
Form RRF-1 Rejectllncomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:
_-Votes From Registry Staff:

Status of Filing:

Accepted
bttps:llrct_do}.ca.govNerificationNVeblDetails.aspx7result=b3fd99bb-7d2c-4259-ad84-ade8a80dbdca 2l4

9141123, T=43 PM
Details
Charity Registrations relate to Proto-mal Fundratsino Events Yuhicvt Ll t to Profess onai Fundr-oise- Wgistrdrtons. + Raffle Reol rat:lorns relatr to Raf t Re-Dorts.
€licit on the RCT Itegistmtion 14a to ieaVigatc In the +elated record No Related Records
https llrct_do}.ca.goviVedficationNVeblDetarls.aspx?result=b3fd99bb-7d2c-4259-ad84-ade8a8adbdca 414

INTERNAL REVENUE SERVICE

DISTRICT DIRECTOR
2 CUPANIA CIRCLE
MONTEREY PARK, CA 91755-7.406
Date MAY 17 1995

INTERNATIONAL CHRISTIAN ADOPTIONS

C/O LAURA DUKE
41745 RIDER 2
TEMECULA, CA 92590-4826
Dear Applicant:

DEPARTMENT OF THE TREASURY
Employer Identification Number:
33-0412343
Cage Number:
955f30011
Contact Person:

TYRONE THOMAS
Contact Telephone Number:
(213) 894-2289
Our Letter Dated:

November 26,,1990
Addendum Applies:

No
This modifies our letter of the above date in which we stated that you would be treated as an organization that is not a private foundation until the expiration of your advance ruling period.

Your exempt status under section 501(a) of the Internal Revenue Code as an organization described in section 501(c)(3) is still in effect. Based on the information you submitted, we have determined that you are not a private foundation within the meaning of section 509(a) of the Code because you are an organization of the type described in section 509(a)(2).

Grantors and contributors may rely on this determination unless the Internal Revenue Service publishes notice to the contrary. However, if you lose your section 509(a)(2) status, a grantor or contributor may not rely on this determination if he or she was in part responsible for, or was aware of, the act or failure to act, or the substantial or material change on the part of the organization that resulted in your loss of such status, or if he or she acquired knowledge that the Internal Revenue Service had given notice that you would no longer be classified as a section 509(a)(2) organization.

As of January 1, 1994, you are liable for taxes under the Federal Insurance Contributions Act (social security taxes), on remuneration of $100 or more you pay to each of your employees during a calendar year. You are not liable for the tax imposed under the Federal Unemployment Tax Act (FUTA), You are required to file Form 990 only if your gross receipts each year are normally more than $25,000. For guidance in determining whether your gross receipts. are "normally" more than $25,.000, see the instructions for Form 990.

If a return is required, it must be filed by the 15th day of the fifth month after the end of your annual accounting period. A penalty of $1:0 a day is charged when a return is filed late, unless there is reasonable cause for the delay.. However, tha maximum penalty charged cannot exceed $5,000 or 5 percent of your gross receipts for the year, whichever is less-. This penalty may also be, charged if a return is not complete, so please be sure your return is complete before you file it.

If we have indicated in the heading of this letter that an addendum aV41A64, uhe adderlAunr rnasd.dmad it and &numeral pawb aff aril■ lmhtLer. .

Letter 1050 (DOICO)

-2-

INTERNATIONAL CHRISTIAN ADOPTIONS
r
Because this letter could help resolve any questions about your private foundation status, please keep it in your permanent records. if you have any questions, please contact the person whose name and telephone number are shown above.
sincerely yours,
e P-44r�
Richard R. Orosco
District Director
Letter 1050 (DO/Cg)

FY 23/24 Community Service Funding (CSF) Grant
Application
22 JACOB'S HOUSE

Community Service Funding Application
a �
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
co„f1FM
Applicant Organization
Name:

Jacob's House
Mailing Address:*
31525 Jedediah Smith Road
* Year Organization Website:

Founded: jacobshousetemecula.org
-) 0 7
Number of Paid Staff:Number of Volunteers:*
7I
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Martin Barrera-Martinez [email protected] 9514522627 Executive Director
Does the nonprofit have a current City of Geographic Area(s) the Organization Serves:* Temecula Business License? Temecula
Business License No.*
054374
Copy of Business License*
JH City of Temecula Business License 2023.pdf
https://css.temeculaca,gov
563.54KB
Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:`
$5,000.00 Jacob's House "Open A Door For A Family"
MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program* 2023-10-01 2023-112-31 31525 Jedediah Smith Road Temecula, CA 92592 Preferred Payment Method:
(If grant is awarded.)
Check Mailed Check Picked Up
Dectronic File Transfer
Make Check Payable to:"
Jacob's House Inc.

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

Z6-1183832
To find IRS Deductibility Status,
click the link below:
https://a pps. irs.govla ppleosl
Date of Incorporation:
08/16/2007
Attach State of California Entity Status Letter:*
Certified 100,pd1'
Attach IRS Deductibility Status:*
Articles of Incorp, 501 c3 EIN #, etc,.pdf
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (link below) Attach First Page of Most Recent Form 990*
You might find IRS Form 990 scan_20230809-120421.pdf
on the link below: (990, 990-EZ, 990-PF, 990-T)
http s.//rct. d oj.ca.govNe ri fi cat i o n/ We b/Sea rc h. a s px? facility=Y
546.79KB

2.22 M B
1,86MB

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:' Jacob's House is a home of refuge Where families and loved ones of those in hospitalized traumatic medical need can find hope, comfort, ,peace, and inspiration. We are a community resource dedicated to serving families in crisis. We do this by providing a shelter for the physical, emotional and spiritual support.

UPON REQUEST, COPIES OF THE ORGANIZATION'S CURRENT BUDGET/FINANCIAL STATEMENTS {BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPAS AUDIT, MAY BE NEEDED TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. 1Jnderstand

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
NAME of PROGRAM/PROJECT

FUNDED BY THE CITY GRANT
OR SPONSORSHIP *
Jacob's House
Jacob's House
AM❑UNT,*
$25,000.00
$5,000.00
MONTH + YEAR FUNDING
RECEIVED*
April 2023
February 2022
NAME of CITY GRANT OR

SPONSORSHIP
CSF Grant
CSF Grant

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U+iderstand
ProjectfProgram Title. Jacob's House "Open A Door For A Family"

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT,* Jacob's House at 31525 Jedediah Smith Road, Temecula, Ca 92592 is part of a national model of healthcare hospitality homes whose goal is to provide free lodging and support for families whose loved one is admitted into the hospital for an unforeseen traumatic medical event. We do this by partnering with 8 hospitals in Riverside, San Diego and San Bernardino counties (including in the City of Temecula - Temecula Valley hospital) who identify and refer families who need emotional support. Doctors, nurses, case managers, social workers and even security units can make a referral to jacob's House for a family who had to drive, fly or otherwise make arrangements to be bedside of their loved one.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.* ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

All CSF grant funds are used to provide free lodging to families experiencing a traumatic medical event, resulting in their loved one being admitted into the hospital. A grant of $SOOO will provide free lodging to families in need for 3S nights. This will include lodging, meals, ancillary resources, laundry, and emotional support.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

Jacob's House continues to meet the needs of the local community is by providing the citizenry of Temecula an opportunity to give back since our opening in December 2012. Be it sweat equity, development, fundraising, maintenance, guest family services, service projects and/or outreach, Jacob's House has become that vehicle for businesses, community based organizations, students, retirees, faith -based communities, and area stakeholders to utilize their experience, learn new skills, make a connection, develop new bonds, and profoundly make a difference in the lives of their brethren through community volunteerism. Temecula volunteers' role in the community is a unique one, where they can measure their resolve by their commitment to helping others This includes but is not limited to, helping reduces stress and financial burdens for families when they must travel far from home when their loved has a health care emergency, intern allowing families the ability to stay together when there loved one is sick or injured. Another benefit to community is a when a area's citizenry is engaged in the welfare of others in the community, the community itself begins to thrive. With Jacob's House's size, mission, and scale of volunteer service opportunities, we're uniquely positioned so Temecula residents can give back in meaningful ways. We believe that significant changes can and does occur with individuals, cities and communities when the adage of "being of service" is realized through a stable, respected and valued entity. Throughout it all, we've been able to serve as a critical Temecula resource, showing up during times of need and helping families, be they Temecula residents or Temecula visitors, with the support during their most vulnerable times. Jacob's House is proud to serve through a network of more than 70 Temecula volunteers, 100's

of businesses, CBO's, houses of worship, school districts students and countless service groups, such as National Charity League, Boys/Girl Scouts..etc. in benefiting both volunteers and recipients of that kindness.
3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
75 3c. ESTIMATED NUMBER OF VOLUNTEERS
INVOLVED IN THIS PROJECT/PROGRAM:

4. SUMMARY STATEMENT— SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.' With the City of Temecula 2023-24 grant, Jacobs House will provide 700+ nights of emergency lodging for family members enduring a traumatic medical crisis, preserving their physical, emotional, and financial stability. While simultaneously providing 70 residents, businesses, community based organizations, faith -based communities, and service groups the ability to connect to our community, make a difference in the lives of families experiencing a traumatic medical event, and prove that Temecula`s well earned reputation extends to both residents and visitors alike.

Project/Program Budget

LIST REVENUESIINCOME FOR PROJECT/PROGRAM
Amount requested from this City of Temecula Community Services Grant REVENUES* $5,000.00
Refer to Page 2
Amount contributed to the ProjectlProgram by the Applicant Organization $105,000.00
Other grants or funding already awarded for Project/Program, if any Sundt Foundation-$4500; City of Temecula-$25,000; Morongo-$5000; BOS $74,000.00 CID: $20,000; IRS/EITC/ERTC-$12,571; Legrand-$2500; Starbuck Foundation-$3000; North Coast Ch urch-$1 0,000; Edwards Lifesciences Foundation-$1010;
In -Kind match amount or volunteer credit hours estimated amount $2,S{I0.00

LIST OF EXPENSES FOR PROJECTIPROGRAM
Tool s/Equipment* EXPENSES`
Landscaping, hand -tools, and cleaning equipment... etc. $1,000.00 FacilitieslRent/lnsurance *
Maintenance, NIA Property Ins. and Various repair managment... etc. $2,500.00 Supplies'
Includes admin, janitorial, and ancillary resources... etc. $4,500.00 Marketing*
Brochures, Outreach Merch, Annual Reports..etc. $4,500.00 Services*
Lodging $0.00
Food*
Meals, snacks and event catering $1,500.00
Other*
Lltilities,Telephone, Telecommunications utilities Recognitions & Awards $17,500.00 Other Types of Expenses Advertising Expenses Interest Expense - General Merchant and Bank Fees Staff Development, Conferences & Meetings Staffing Expense
50,00
TOTAL REVENUE: TOTAL EXPENSES
S 186,500.00 S31. `_ 1L)0.0 0

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization:* Requested Amount:

Jacob's House $5,000.00
PresidenttAuthorized Officer:* E-mail:* Phone:*
Martin Barrera Martinez Executive martin@jacobshousetemecul(- 951-452-2627 Director
Name & Title
President/Authorized Officer Signature* Date Time
2023-08-09
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Name, Title, & Organization
If you have any questions, please contact:

[email protected] (951) 693-3959 or

MRINAL REVM,7UE SERVICE
P. 4 BOX 2508
CINC=:NNP6"T`I, QH 45201
Date
3ACOW S ROUSE, INC.

C/O IIARTIN A WEISS
ONE 13ETTBRWORLD CIRCLE,
T°EMRML,A. MCA 92590
Dear Applicant:

SUITE 300
DI3PARTMENT OF THE TREASURY
Employer identification Number:
25-1183832
DLN
17053106310008
Contact Person:

JOANNA YAWNEY ID# 95078
Contact Telephone Number:
(877) 829-5500
Accounting Period Ending-
December 31
Public Charity status:
170 (b) (1) (A) (vi)
Farm 990 Reauired:

Yes
Effective Date of Exemption:

August 16, 2007 -
Contribution Deductibility:

Yes
Addendum Applies:

Tio
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 -lax under section 501(c)(3) of the Internal Revenue: Cade. 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 ptblic charity under the Code section(s) listed in the heading of this letter.

Please see enclosed PubliCatlon 4221-PC, Compliance Guide fox 501(c)() Ilic Chaiities, for some helpful information about your responsibilities as ar_ exen.pt organ zat i, on _
Letter 947 (DD/CG;

JAC01. ` S HOUSE, INC.

Encl�)sures= Publication 4221-PC
Sincerely,
Robert Choi
Director, Exempt Organizations
Rulings and. Agreements
wetter 947 (DO/CG)

FY 23/24 Community Service Funding (CSF) Grant
Application
23 JDS CREATIVE ACADEMY

Community Service Funding Application
a �
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
co„ f1FM
Applicant Organization Year Organization Website:

Name: Founded: jdscreativeacademy.org
JDS Creative Academy ti a
Mailing Address:* Number of Paid Staff:* Number of Volunteers:* Temecula, CA 13 7
92591
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Diane Strand Executive Director [email protected] 9S'I-296-6715 Does the nonprofit have a current City of x Geographic Area(s) the Organization Serves:* Temecula Business License? Riverside County
Yes r�•
Business License No.*
042202
Copy of Business License*
JD5CA Business License.pdf
https://css.temeculaca,gov
951.45KB
*
Geographic Area(s) the ProjectlProgram
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
ss,000.00 DigiFest Temecula 2024
MAX: $5,000 PER DRG
Start date:* End Gate:* Physical Address of Project/Program* 2024-04-19 2024-04-21
Preferred Payment Method:
(If grant is awarded.)
Check Mailed Check Picked Up
Electronic File Transfer
28069 Diaz Rd. Suite D-G Temecula, CA 92s90
Make Check Payable to:*
JDS Creative Academy

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS Deductibility Status
State of California Entity 1D: *
3782660
To find CA Entity Status Letter,
click the link below:
https://www.ftb.ca.gov/help/b usinesslentity-
status-letter.asp?wT.mc_id=a kBEStatus
IRS Employer Identification Number (ElN):
45-5293183
To find IRS Deductibility Status,
click the link below:
https://apps.irs.gov/app/eos/
Date of Incorporation:
05105/2015
Attach State of California Entity Status Letter:'
JDSCA Entity Status.pdf
Attach IRS Deductibility Status:*
JDSCA IRS 501c3 determination approval letter.pdf
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (link below) You might find IRS Form 990
on the link below:
http5.//rct.doj.ca.govNeriflcation/Web/Search.aspx?
facility,=Y
State Registry Search Tool:

Attach First Page of Most Recent Form 990"
2022 JDSCA 990 (First Page).pdf
(990, 990-E2, 990-PF, 990 T)
Attach State Registry Documentlinfo'
370.06KB
343.02KB

33.59KB
https:al}rct.do}.ca,goyNerifkMion/Web/Search.aspx? IDSCA 00) RCi_pdf 243.8FKB farill try

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* Nonprofit JDS Creative Academy opened in 2014 facilitating local demand for advanced education in the arts. The mission of JDSCA is to advance education, training, and opportunities in visual, performing, and digital arts. JDSCA classes and programs fulfill VAPA requirements, per California Education Standards, and Title-17 guidelines provide training for Inland Regional consumers; adults with developmental disabilities. JDSCA provides opportunities to gain creative enrichment, self-confidence, leadership, technical and collaborative shills so program participants can obtain the experience needed to prosper in a competitive marketplace or advance to higher- arts education. The founders of JDSCA have an extensive history in the entertainment industry and have developed programs for anyone who seeks higher arts education.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
Yp.'. ;,,
NAME OF PROGRAM/PROJECT MONTH + YEAR FUNDING NAME OF CITY GRANT OR FUNDED BY THE CITY GRANT AMOUNT;* RECEIVED* SPONSORSHIP OR SPONSORSHIP"
DigiFest Temecula $30,000.00 5/23 Community Service
2020 - 2023 Funding
DigiFest Temecula $0.00 23-24 In -kind $5,000
2023 marketing: Economic
Development Funding
Program for Special
Events
Spirit of Innovation $0.00 23-24 In -kind $5,000
marketing: Economic
Development Funding
Program for
Professional
Organizations
DigiFest Temecula $0.00 2022 In -kind $5,000
2022 marketing: Economic
Development Funding
Program for Special
Events

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. UodeFstand
ProjectrPrograrn Tittle: DigiFest Temecula 2024

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.* JDS Creative Academy (JDSCA) will use the Temecula grant to enhance DigiFest ff) Temecula, which is now in its eighth year. DigiFestiR? Temecula is a digital -media competition, festival, and conference that is a place for students, amateurs, professionals, and community residents to network, appreciate, and recognize digital -media work and artists. DigiFest®R Temecula has been a staple in the Temecula Valley region for 7 years and strives to bring opportunities in the digital -media industry to all, The festival has welcomed Emmy winners, studio executives, directors, live entertainment, producers, influencers, gamers, and all types of digital -media industry professionals.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.

ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

JDS Creative Academy will spend the grant funding on supporting the procurement of high-level speakers. The organization will use the funds to support DigiFest«7 Temecula which typically shoulders the cost of speaker honorariums, travel, and hotel accommodations. DigiFestlr Temecula has historically brought in high-level speakers, which draws attendees from the city, region, SoCal, the State, the U.S. and even the world to the City of Temecula to participate in the event.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS." TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING. 2024 marks the 8th year of JDS Creative Academy's three-day digital arts festival, DigiFestT:) Temecula, bringing together local communities to experience digital art in many mediums. DigiFest(R) Temecula is a place for local emerging content creators to learn about digital media industry advancements, how to pursue a career in the entertainment or digital media industry, and how to advance digital arts into the economic culture. Furthermore, the Temecula community gets a festival that brings entertainment, excitement and joy while providing collaboration, networking access, and pathways to an industry with subjective barriers.
3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
375
3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECT/PROGRAM:
40 4. SUMMARY STATEMENT- SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS.* Grant funds will elevate ❑igiFest,,1 Temecula, the annual digital arts festival that brings local creatives together with a world-wide audience and industry professionals. Funds will be used to ensure the procurement of high-level, celebrity talent to speak at DigiFestO Temecula. The impact is expected to be above 375 local Temecula and regional residents, and put on With the support of our staff and 40 volunteers,

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment* EXPENSES*
NIA $0.00
Facilities/Rentlinsurance*
Renting theater big screen $2,5OO.00
Supplies*
Food serving stations/trays, award trophies, lanyards $3,050.00 Marketing*
Swag, printed flyers/posters, website, advertising $8,900.00 Services*
Entertainment, speakers $10,875.00
Food*
Opening night and Awards Banquet catering and beverage. $6,2SO.00 Other*
Misc. expenses, Table linens, Scholarships given $3,249.00 Staffing Expense
$2,OOO.00
TOTAL REVENUE: TOTAL EXPENSES
$34,824.00 $34,824.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization:* Requested Amount:

JDS Creative Academy $5,000.00
PresidentfAuthorized Officer:* E-mail:* Phone:*
Diane Strand [email protected] 951-296-671 S
Name & Title
President/Authorized Officer Signature* Date Time
0/-,?fw 0,5r t eme
2023-08-07
IF DIFFERENT THAN ABOVE, APPICATION PREPARE❑ BY:

Name, Title, & Organization
If you have any questions, please contact:

Betsy.Lowrey@Ternecu[aCA.gov (951) 69 3-395 9 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 8/3/2023
ESL ID: 5048732610
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: 3782660
Entity Name; JDS CREATIVE ACADEMY

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 abort the entity.

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

State of California
Department of -Justice
Office of the
Attorney General
Registrant
Details
Entity type: Corporate Class as registered with the
Secretary of • or based on • r r & registrationdocuments.

Organization -'Name: JDS CREATIVE ACADEMY
IRS FEIN:
4652.93193
Entity Type: Public Benefit
SOSIFTB Corporate/Organization Number:
3782660
Registry Status: Current
Renewal Due/Exp. Date:
5/15/2O23
RCT Registration Number: CT0285040
Issue Date:
4/7/2023
Record TAW: Charity Registration
Effective Date:
41712023
Date of Last Renewal:

DBA:

Mailing
Street:

Street Line 2:

City, State Zip: TE'MECUL.A CA 92591
Filings &
Correspondence
Form RRF-1
2021
Renewal Filing
2021
Miscellaneous Documents
2020
Renewal Filing
2020
Miscellaneous Documents
2019
Rene-,val Filing
2019
Miscellaneous Documents
2018
Renewal Filing
2018
Miscellaneous Documents
2017
Renewal Filing
2017
CT-400 First Notice To Register
Click on Document Type at the left to open PDF
CT-451C 1st Delinquency Notice
Click on Document Type at the left to open PDF
Founding Documents
Click on Document Type at the left to open PDF
CT-550C Form RRF-1 Incomplete
Click on Document Type at the left to open PDF
r
Annual
Renewal Data
Status of Filing:

Accepted
Accounting Period Begin Date:
1!1i2017
Accounting Period End Date:
1213112017
Filing Received Date:
5r1812023
Form RRF-1 Reject/lucomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Mates From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
1/1/2019

Accounting Period End Date:
12/31/2018
Filing Received Date:
5/8/2023
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 RejectiIncomplete Reason:

Notes From Registry Staff.

Status of Filing:

Accepted
Accounting Period Begin Date:
1/1,12019
Accounting Period End Date:
12/31/2019
Filing Received Date:
518/2023
Form RRF-1 RejectAncomplete 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 '2020
Accounting Period End Date:
12 31 2020
Filing Received Date:
_5 8 2023
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:
1i1r2021
Accounting Period End Date:
1 W31/2021
Filing Received Date:
5/8/2023
Form RRF-1 Rejectflneomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Status of Filing:

Not Submitted
Accounting Period Begin Date:
1/1/2022
Accounting Period End Date:
12/31/2022
Filing Received Date:

Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Related Registrations
.

Event Reports
related
The records
Charity Registrations relate to Professional
shown below r-■- ■ on the record type beingviewed:

Fundr-aising Events which relate to Professional Fundraiser Registrations - Registrations to Raffle
Click on the RCT Registration No to
•ee
e. • to the related record.

No Related Records

INTERNAL REVENUE SERVICE
P. O. BOX 2508
CINCINNATI, OH 45201
Fate : k�0 74

JDS CREATIVE ACADEMY
TEMECULA, CA 92591
Dear Applicant:

DEPARTMENT OF THE TREASURY
Employer Identification Number:
46-5293123
DLN:
17053122345034
Contact Person:

J'ASON T SAMMONS IU# 31616
Contact Telephone number:
(877) 829-5500
Accounting Period Ending:

December 31
Public Charity Status:
509(a)(2)
Form 990 Required_
Yes
Effective Date of Exemption:

April 11, 2014
Contribution Deductibility:

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.

Sincerely,
Director, Exempt organizations
Letter 947

FY 23/24 Community Service Funding (CSF) Grant
Application
24 KENAI'S HOUSE, INC

Community Service Funding Application
(:7" di:Q�
Organization
https://temeculaca.gov/grants
CHECK THE BOX TO CONFIRM YOU HAVE REA❑ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
COnf[rm
Applicant Organization
Name:

Kenai's House, Inc
Mailing Address: *
31165 Temecula Pkwy #3SO
* Year Organization
Founders:
2022
Website:
www.kenaishouse.org
Number of Paid Staff:' Number of Volunteers:*
0 a
Contact Name &Title: * Contact's Email: Contact's Phone Number:* Shareen Harding, CEO
Does the nonprofit have a current City of * Geographic Area(s) the Organization Serves:* Temecula Business License? Riverside, Sate Diego adn LA Counties Yes Na
Business License No.*
055727
Copy ❑f Business License*
Business Jpeg
https://css.temeculaca.gov

50.431K$
Geographic Area(s) the Project/Program
Serves:

Riverside County- Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
ss,000.00 Project Saving the Voiceless
MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program 2023-09-11 2024-09-11 31165 Temecula Pkwy #350
Preferred Payment Method:
(If grant is awarded.)
Check Mailed Check Picked Up
Electronic File Transfer
Make Check Payable to:'
Kenai's House, Inc.

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
-State of CaI110Fnia Entity Status Letter
IRS Deductibility Status
State of California Entity ID:*
S097082
To find CA Entity Status Letter,
click the link below:
h ttps:// www.ftb . ca.gov/help/b usi nesslentity-
statu s-letter.asp?1NT.mc_i d=a kB EStatus
IRS Employer Identification Number (EIN):
88-3998252
To find IRS Deductibility Status,
click the link below:
https://a pps. irs.govla ppleosl
Date of Incorporation:
06/06/2022
Attach State of California Entity Status Letter:*
State Entity Letrer,pdf
Attach IRS Deductibility Status:*
EIN.pdf
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (link below) Attach First Page of Most Recent Form 990*
You might find IRS Form 990 Form 990 (2022).pdf
on the link below: (990, 990-EZ, 990-PF, 990-T)
http s.//rct. d oj.ca.govNe ri fi cat i o n /web/Sea rc h. a s px? facility=Y
370.24KB

13.99KB

2.66MB

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives: * Kenai's House Will provide a safe and healthy environment for abandoned and neglected animals to thrive and have a second chance at life until responsible and loving homes can be found. We focus on the 4 R's at Keani's House....

RESCUE - we partner with local shelters to pull "rescue only" pups that require a little more TLC before they are ready to be adopted to public. This is something the shelters are not able to offer so, rescues like us, step in to help.

REHAB- we work on some basic training and socialization in order to get a good read on the right fit for the pup to be adopted. We not only offer dog training while in our care, but after.

REHOME- this is where we search for the right fit for the pup RETENTION- We are here for the lifetime of the pet. We offer a FREE in home training consults and then the first (3) training sessions are 50% off. We also, offer boarding to all our adoptees for When their humans need a little vacation. We are also, available as a resource. We want to help our ,pups and families be successful.

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
,e

NAME OF PROGRAM/PROJECT

FUNDED BY THE CITY GRANT
OR SPONSORSHIP *
AMOUNT:*
MONTH + YEAR FUNDING
RECEIVED*
Project Second Chance $2,500.00 July 2023

NAME OF CITY GRANT OR

SPONSORSHIP

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
Project]Program Title; Project Saving the Voiceless

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT,* This grant will support our continued efforts to rescue dogs that would otherwise be euthanize without us stepping in. Along, with rescuing euth list dogs we are looking to do a pop up low cost vaccination clinic and to start offering spay/ neuter to a few families a year that cannot afford the procedure.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.* ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

Equipment:

Food
Crates
Medical care
Vaccinations
Spay/ Neuter
This grant would also help cis to be able to help at least (1) low income family get their dog spayed/ neutered as well, be able to offer some low cost vaccinations. (looking into a vet clinic that would be willing to help with this)

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

The benefit in the Temecula area is going to be decrease in unwanted pregnancies, so we are not having boxes of puppies left at AFV, out in the middle of Anza or puppies being abused/ neglected because the family is just overwhelmed and cant afford it. Vaccinations are key to health canine population, but it will reduce vet costs. A puppy that gets Parvo may not survive and if the family decides to get medical treatment it can cost a good $5,000 + in vet bills.
3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
100
3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECT/PROGRAM:

4. SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS.* This grant will allow Kenai`s House not only to support local rescues be pulling dogs that need support and rehab, but an opportunity to get out in the community and offer affordable vaccinations and help a family get their dog spayed/ neutered. This not only helps to decrease the population of unwanted dogs but gives us the opportunity to educate the community of vaccinating and spay/neutering their pets.

The change has to start somewhere, and we want to start that change.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment* EXPENSES'
Impact crates $2,000.00
Facilities/Rentll nsurance *
nonprofit animal rescue insurance $1,OOO,OO
Supplies*
bowls, leashes, cones, toys $500.00
Marketing*
social media, flyers, g❑ home resources $200.00
Services*
Spay/ neuter, medical care, vaccinations $1,400.00
Food*
dog food, treats $600.00
Other*
transportation appointments and rescuing dogs from shelters $300.00 Staffing Expense
$0.00

TOTAL REVENUE;

TOTAL EXPENSES
$6,000.00 $6,000.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization:*
Kenai's House, Inc
PresidentlAuthorized Officer:* E-mail:*
Shareen Harding, CEO _
Name & Title
PresidentlAuthorized Officer Signature*
Requested Amount:
$5,000.00
Date
2023-09-12
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Name, Title, & Organization
Phone:*
If you have any questions, please contact. [email protected] (951) 693-3959 or [email protected] (951) 694-6413

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/11/2023
ESL ID: 6439845419
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: 5097082
Entity Name; KENAVS HOUSE. INC

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) Secuon 23701 . 11 4.

We do not have current information abort the entity.

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

DEPARTMENT OF THE TREASURY
INTERNAL REVENUE: SERVICE
CINCINNATI OH 45999-0023

KENAIS HOUSE INC
31165 TEMECULA PKWY STE 350
TEMECULA, CA 9259.2
Date of this notice: 09-01-2022
Employer Identification N-Lunber:
88-3998252
Form: SS-4
Number of this notice: CP 5T75 E
For assistance you may call us at:
1-800-829-4933

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

WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER
Thank you for applying for an Employer Identification Number (EIN). We assigned you EIN 88-3998252. This EIN will identify your entity, accounts, tax returns, tax returns, and documents, even if you have no employees. Please }peep this notice in your permanent records..

Taxpayers request an EIN for business and tax purposes. Score taxpayers receive CF575 notices when another person has stolen their identity and are operating using their information. If you did not apply for this EIN, please contact us at the phone number or address listed on the top of this notice.

When filing tax documents, making payments, or replying to any related correspondence, it is very important that you use your EIN and complete name and address exactly as shown above. Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the information is not correct as shown above, please make the correction using the attached tear -off stub and return it to us.

When you submitted your application for an EIN, you checked the box indicating you are a non-profit organization. Assigning an EIN does not grant tax-exempt status to non-profit organizations. Publication 557, Tax. -Exempt Status for Your or_anization, has details -,n the application process, as well as information on re--,rns you may need to file. To apply for recognition of tax-exempt status, o _7_nization ~.:.-t complete an application on one of the following forms: Form 1023, A1i_'ication fiv =ecognition of Exemption Under Section 501(c)(3) of the Internal Revenue C;_._; Form 1,___31-EZ, Streamlined Application for Recognition of Exemption Under Section 501(c)(3) - -t-Le Internal Revenue Code; Form 10-24, Application for Recognition Under Section 56_1.=:.1; or Force. 1024-A, Application for Recognition of Exemption tinder Section 501(c)(4) -.he Internal Revenue Code.

Nearly all organizations claiming tax-exempt status must file a Form 990-series annual information return (Form 990, 990-EZ, or 990-PF) or notice (Fo= 590-N) beginning with the year they legally form, even if they have not yet applied for or received recognition of tax-exempt status.

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

(IRS USE ONLY) 575E 09-01-2022 KENA O 9999999999 SS-4
IMPORTANT REMINDERS:
* Keep a copy of this notice in your permanent records. This notice is issued only one time and the IRS will not be able to generate a duplicate copy for you. You may give a copy of this document to anyone asking for proof of your EIN. * Use this EIN and your name exactly as they appear at the top of this notice on all your federal tax forms.
* Refer to this EIN on your tax -related correspondence and documents. * Provide future officers of your organization with a copy of this notice.

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

Safeguard your EIN by referring to Publication 4557, Safeguarding Taxpayer Data: A Guide for Your Business.

You can get any of the forms or publications mentioned in this letter by visiting our website at www.irs.gov/forms-pubs or by calling 800-TAX-FORM (800-829-3676).

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

Thank you for your cooperation.

Keep this part for your records. CP 575 E (Rev. 7-2007) Return this part with any correspondence
so we may identify your account. Please CP 575 E
correct any errors in your name or address.
9999999999
Your Telephone Number Best Time to Call DATE OF THIS NOTICE: 09-01-2022 { } - EMPLOYER IDENTIFICATION NUMBER: 88-3998252
FORM: SS-4 NOBOD

INTERNAL REVENUE SERVICE KENAIS HOUSE INC
CINCINNATI OH 45999-0023 31165 TEMECULA PKWY STE 350
TEMECULA, CA 92592

FY 23/24 Community Service Funding (CSF) Grant
Application
25 MICHELLE'S PLACE

CANCER RESOURCE CENTER

Community Service Funding Application
a �
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
conform
Applicant Organization
Name:

Michelle's Place Cancer
Resource Center
Mailing Address:*
41669 Wjnchester Rd 101
* Year Organization Website:

Founded: www.michellesplace.org
2001
Number of Paid Staff:* Number of Volunteers:*
10 175
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Kim Gerrish [email protected] 9SI69954SS
Does the nonprofit have a current City of x Geographic Area(s) the Organization Serves:* Temecula Business License? Riverside County
Yes [,:-
Business License No.*
036098
Copy of Business License*
2023 License - Michelle's Place (1).pdf
https://css.temeculaca,gov

95.45KB
Geographic Area(s) the ProjectlProgram
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 Purple Ribbon Assistance
MAX: $S,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program* 2023-08-01 2024-06-30 41669 Winchester Rd Suite 101 Temecula, CA 92S90 Preferred Payment Method: Make Check Payable to:*
(if grant is awarded.) Michelle's Place Cancer Resource Center Check Mailed Check Picked Up
Dectrome Fife Transfer

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS Deductibility Status
State of California Entity ID:*
2267780
To find CA Entity Status Letter.
click the link below:
h ttps:// www.ftb . ca.gov/help/business/entity-
statu s-letter.asp?wT.mc_i d=a kB EStatus
IRS Employer Identification Number (EIN):
33-0951216
To find IRS Deductibility Status,
click the link below:
https:/Ia pps. irs.govla pp/eosl
Date of Incorporation:"
11/01/2001
Attach State of California Entity Status Letter:"
Michelle's Place Entity Letter 2023.pdf
Attach IRS Deductibility Status:*
IRS Letter EIN MP.pdf
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (fink below) State Registry Search Tool: Attach State Registry Docurnentlinfo* 370.12KB

11.91 KB
https://rct.doj.ca.govNerification/web/Search.aspx ? State Registry Tool info MP.pdf 101.77K9 facility=Y

Mission Statement
Briefly describe the nonprofit organization°s missionlgoaIs and objectives: * Empowering individuals and families impacted by cancer through education and support services.

Michelle's Place is a full service cancer resource center providing no cost assistance and support to families impacted by a cancer diagnosis.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
YP.. ;,.,

NAME OF PROGRAM/PROJECT
FUNDED BY THE CITY GRANT AMOUNT** MONTH YEAR FUNDING
OR SPONSORSHIP" RECEIVED*
Cancer Support $50,000.00 2022
Services
Cancer Support $S,000.00 2021
Services
Cancer Support $5,000.00 2022
Services
Purple Ribbon $1,000.00 2022
Assistance
Purple Ribbon $1,000.00 2022
Assistance

NAME OF CITY GRANT OR

SPONSORSHIP
CSF Reinvestment
CSF Grant
CDF grant
CM-MAE
►xLy, UL A17

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
ProjectlProgram Title; purple Ribbon Assistance

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT' The Purple Ribbon Assistance program provides Temecula residents and their families that are impacted by cancer immediate assistance through providing grocery gift cards. A simple application is flied with a Community Health Worker to evaluate the financial barriers that prohibit a cancer patient frim accessing food for the household.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.' ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

Funding will be used to provide cancer patients and their families with food. Through the Purple Ribbon Assistance program Michelle's Place will provide 100 residents with a max of $500 in grocery gift cards.

Amount is determined by family size. if the max is not met, more residents will be served. This program provides support for 12 months once they are accepted into the program. If they have children under the age of 18, they are provided Back to School supplies. At Thanksgiving they receive all the fixings to make a Thanksgiving meal and at Christmas they receive food and holiday gifts for their children.

Cancer patients should not have to worry about how to feed their families and provide basic needs items. Through the Purple Ribbon Assistance program, they are not alone.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.F TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

Temecula residents that are impacted by cancer and currently in treatment will be invited to apply for the Purple Ribbon Assistance Program . This program is designed to provide immediate relief to families who are financially disabled during cancer treatment. The gift cards will be awarded to Temecula residents and their families to prevent food insecurity. 3b. ESTIMATE❑ NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
100
3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECTIPROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS." Michelle's Place offers immediate support to Temecula residents impacted by cancer and in treatment.

The Purple Ribbon Assistance provides financial support to those in need of food in the form of grocery gift cards to promote the wellbeing of the citizens of Temecula. "No one should face cancer alone."

Project/Program Budget

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount requested from this City of Temecula Community Services Grant REVENUES* $5,000.00
Refer to Page Z
Amount contributed to the Project/Program by the Applicant Organization $1,800.00
Other grants or funding already awarded for Project/Program, if any 3rd District Supervisor CID, HWD, Stater Bros. Charities, Albertsons $105,000.00 In -Kind match amount or volunteer credit hours estimated amount $1,100.00

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment* EXPENSES*
NIA $0.00
Facilities/Rentlinsurance *
N/A $0.00
Supplies*
Office supplies, postage $1,800.00
Marketing*
copies, ads, emails and texts $1,600.00
Services*
Transportation 1 Treatment assist 1 $23,000.00
Food*
Meals, drinks, snacks at Back to School and Holiday event $5,500.00 Other*
Grocery Gift Cards, food boxes, Holiday food program $81,000.00 Staffing Expense
$54,000.00
TOTAL REVENUE.- TOTAL EXPENSES
$1 '12,'90t -00 $112, 900M 00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: * Requested Amount:

Michelle's Place Cancer Resource Center $5,000.00
PresidentlAuthorized Officer:* E-mail:* Phone:

Kim Gerrish [email protected] 951.699.5455
fame & Title
PresidentlAuthorized Officer Signature* Date Time
2023-09-06
XILM geeeish
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Name, Title, & Organization
If you have any questions, please contact:

[email protected] (951) 593-3959 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/4/2023
ESL ID: 8453801277
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: 2267780
Entity Name; MICHELLE`S PLACE CANCER RESOURCE CENTER

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.

9IM3, 7:37 AM
Details
k....-__.-._....._-............._...__.,........-....,.-....n,«..-.......w.«.........�....,.:..._....-..._...�.�.._-.._..._.._.-�,.......�--,.._,.-...-...«.d...,..n......-.....................�..:-..:..��,...........:._:......�:.�.7=.-..-y:;::a:.�.-_,:+-raw.:w..._«..ww»v...w:...�.....«...�..Y.-.�.._�,.:.,�.w Orgatllzation Name: M 1011-1,LF'S PLACE. CANCER R "SCIURC'F CENTi :R IRS FFTN- 331I95121ti i t•'ntity Type: I'Liblic Benefit SOSIl 1 f3 C.I)E'1311rf1tCIC]r�+±fE[ll'J,a;i[}n Number: 22rti77NO Registry Status:

RC"T Registralion Number:

Record Type:

Mato of Last Renewal;
i Street;.'-._, ..---
E
i Street Line 2:

Cite. State Zip:

C urrelit
13i;i91
('11.111t} Rcr1stra6on
10 6!2022
Renewal .Duel.l xp. Date. 5/1512023 r.

Issue i)ate: 1-17-2008
Effective Bate: 1: 1 T ]I IS
DBA.
41m-0.` I N C I I F ST 1,R Itl.].. l(.l.lr.........

TEN F'ClJl_,A CA 92590
Retilrn C heck. Notice 2010
Romr) Check Not w 201 r!
-i pondence €rom Registry_
Rc1:01-15 t_ct,er
=Renewal Filing
2421
Rcnewal F icing
2020 -- --
- _...- ......... ...... _...
- ----- ----- _----.... __. _..-.._._.._.._ . .... - ......... .. ...... - -- -
'Renewal Filing
2(11(J
CT-5 0 Fori22 RRF-1 Incomplete
20114
I16 Form 990 Series
,Form RRF-1
2111
Form RIZF-1
2018
Rela� N+ al 1= i lilg
sty 17
1Fc)rm RRF'-1
2t1ih
'IRS Form 990 Series
2016
12015 RRF-1
2015 RRF-I
SIRS Forn1 990 Series
2015 IRS Form 990
rt f
€2014 RRF-1
2014 RRF-1
=2014 IRS %ot•ln 990 ....�...._.,.
.. .. 2014,
1r1 Y [its F nnn 900 ...... ....... _ .. _.___ __....... __W � .. s
RRF-I 2013
2013 RRF-I
SIRS Form 990 201 J
,IRS
. _ .... .. ...... _.__.. ___.._..... ___.... .......... 20B 1R5 Form 990
..2
�
RRF-1 201')
701? 11R17-1
_ ..� ...._._......................
lRS Fern, cf 2() 12
...._..._.. -.._ ..
'-1112 IRS Form 990
UU-1 201.1_
2011 RRF_ I
11 RS Form 990 2011
201 1 IRS Form 990
1 1RRF- 1 201(1
2010 RRF-1
1 . . .....
............_....---__.._._..._..._....._..--------------------- .._ ...................._
'
SF-1 2010
,RP
^.__......................__ . _ ._...__.... _.._...__.. _._____...._.... _()1[l1{R -1
_ ._ .
https:llrct.doj.ce.govNerii5cationfWeblDetails.aspx?result=Scc6c l 6f-cac3-4779-bDc6-37334acf3ab2 114

9/5123, 7:37 AM Details
1IRS Form 990 7(} 1 i} ?c:lt? [ItS Fi=rat 990
iStmus of Filinty:

Accounting Period Begin Date:

Accounting Period land Date:
[,flint; Rceeh•cd Datc:
t
Form RRF-1 Reject/[iicomplele Reason:
2 Foriti C-T- TR-1 Reject, liiconipletc Rcassiet:
lIRS Form 9911 Ile ,ject.=lncomplete Reason:

Notes Frain lRegistr,, Staff:

Status of filing:
iAccounting Period Begin Bate:

Accounting! Period End Date:

Filing„ Received Date:

Form IZRF-1 IZejcctAneomplele Rctison:

Furitt C'[ 'rR-1 Rtject[IitCnntl)1ele Reasoit;
IRti l'urni 990 Re] Cetri]itcompletc Reason:
;Notes Frain Registry Staff:
5[:itnS of Fi ing.
lAccounting; Period Begin Date:

Acconntinl; Period End Date:

F'ilinn Reech,ed Date:
pFuriit RIZF-1 Rejc.ctl[itcoinpIcte Reason-
Forni CT-TIt-I Rejcct[Ineotnl)lete Reason:
j [11S Forin 990 Reject[lncomplete Reason:

Notes From RcgisI1,v S1off:
j 5t:lttis of Filing_--��
I Accounting Period Begin Date:

Accoon[inr Period End Date:

Filing Rectived Datc:

Forst RRF-1 Reject/[ncomplete Reason;
xFornt C"1-1 It-1 IZeject Iitc(fmplefe Rea son:
f1fIRS Form 490 Rejeetilncomplete Reason:
kotes Front Rcglslry Staff:
.status of Filing;:

Accounting Period Begin Bate:
pAccounting Period EAid hate:
ll iling 13ecei=ed DRIC:

Worm RRF-1 RejecUlincomplete Reason -
Form (T-TR-I IRejeclllitcosuplete Reasott:

ARS Form 990 Reject/Incomplete Reason:
`Notes From Registl"t Staff:
istait[s of I,mng:
,Accounting Period Begin (late:
iAccouitting; Period End Date:
(Filing Recek ed Date:
'Form RRF-I lReject/IncomI)lete Reason:
jFurin CT-TR-I Reject/Incnntplete Reason;
IRS Morin 9911 Rcjcrt!luconiplete Reason:
'totes Front Registry Staff-.

Afxopuxl
I F2011)
12/31i'201�]
Q. 7; 201 1
Accepted
Ix1z2Q11
11`31'2011
9;," 13!2012
:'accepted ¢�
3'27�2[i l .i
Accepted
1r 1, 2013
12:31:2013

5. 11J'2014
Accepted
I:I220l l
12 31=2014
h: 5, 2t115
,lecvlticCl
I 1 21ol5
I2.31 _"1015
5;16: 201 {,
s
F
6 r
3 s
aStxftls (if Filing: Ac�xptcd '
f
https-ilrct.doi.ca.gov/Varification[WebiDetails.aspx?result=6cc6cl6f-cac3-477&b4c6-37334acf3ab2 214

915123, 7:37 AM
Details
il ;+.ccuuitting Period Begin Dine:

I
:

Accountitig Perlind End Date.
iFiling Received Date:
gFm-ni RRF-f Rejectllucompletc Reason;
!Form C'T--TR-1 Rejectlineomptefe Reason:
1RS Forin 9911 Reject/€licomplete Ruson:

Notts Fronk Ite;istry StaIT:
5t.tttls of Filing:

I.Aecoun[itig Period Begin Dmie;
'Accounting Period End Date:
"IIing Ile. Ce1\elf Dafc:
jFnrm RRF-1 Reject/litcamplete Reams:
€Form C 1_TR-I Rtjectilmum plet.e Reason:

FIRS l or n 9911 Reject/Incomplete Reason:

Notes Fmin Registry Stnff-
�Si.ilus of filing:
�:1eeclunting Period 13cgin Date:

Accounting Period End [)site:

Filing; Receh ed Bate:
'Form RRF-I Rr:jcet/lncumplete Rcasott:
tl=orm CT-TRA Reject!]ttcomplete Reason:

IRS Fr; rm 990 Reject/Incomplete Reason:
?lutes from Re-Istry Staff:
xs[atus of F iling:
yAccounting Period Begin Date:

Accounting Period EIts/ Date:

I.ilin" Rccei%Cd Date:
' omn RR.F-1 RejectlFncnnipletc Reason:
3Form C" -TR-1 RejeclAncomplete Reason:
=IRS morn[ 990 Reject/Incompletc Rcusun:
;Notes From RegistryStatf:

StAllis of Filing:
�Acvilmiting Pet-iod Begin Date:
•`Aecouuting Period End late:

J-Him, Rteei+ed [late:

Toros 11RF-1 Rejectllncomplete [Zellsilll:
lForrn UY- R-1 ltcjectilucomplefe Rva%on:
1RS l'ai•in W RirjuctlluconipletE Reason;
'notch from Re hiry S(al'f:
:Sliitus ttf I•iling:
j:%cCOtill tin;,f Period Begin Date:

Accounting Period I:tid Date:
1€,iling Rec:chcd Uaft:
(Forst RRF-1 RejcctilllConlplete Reason:

Form CT-TR-I Rejectllitcomplete Re.isoit:
i IRS Form 990 Reject/Inewnpill etc Reason:

Notes Fralln Registry Staff:
1 1:201 i
..._......._ .._.__........_..._......

Acceptoil
11'?t117
1')31 2_017
k)..1 (, I (M 8
Accepted
li[!2oI
fir 12 201 l}
.._.... .........
..... .._. ...............

Acceptcd
1:`1 1019
12:31 20t9
H:ICi.�{1_I1
_..__..._.._.............. _.... __ _.... _._ .....
:Accepted

1. 1 ?02o
5-26:20,1
Acceptcd
I 1 2021
12 31.2t.I'_1

7.',)' ' 2
11'rerrq T pe;
PI-crequisitc Relationship -
Charity
Re-istranl:

IZITEWAY CII,-ARITY S1:RVICES, ITC.

Registration No:

F..002S91 I RegistrationType-
I=undraltim, 1.1011
Hate Esublished:

I111'2017 Association Date:
1 1�2017
h tt ps:llrct. doj .ca.govNerifccati on/We hlDetail s.a sp x? res u l t� 6 c c6c 15f-c a c3-47 7 8- b O c6-37 3 3 4 a c €3a b 2 Re;istration Status: C'omplele
Expiration lhte: 12:3 V2W
.. _.-_............ .......
314

915123, 7:37 AM
Details
Prrreq "Bpi .
111,L1,CquiSltc
Relationship:

Charity
Registrant:

RITE AY CHARITY SF-RV1CPS, INC.

Re�-vistr'atIon Ni):

E0030137
Re;;istratiolr Type:

Fundraisin,w 1:Vem
Regiktrntiou Status;
(.'ompicle
Date F_stahlishcd:

Y 1 T201 7
;association late:
1 1/2016
Expiration Date.

I1:2016
Prereq Type:
f11v1vqk1i"ilC
R0210onship;
C.ilii[ity
t Re;islraril:

I
RI f I�: k A Y CI1.NItITY
:i1,RNl I(TS. IN .

Rel;istratiun No:
1 0032 3[)3
Rel;istration `Ape:

FuIIkfnIisinI:.ent
Regisirmion Status:

Comizlele
Daie Established;
..
2:•7r�i}1iI
_. _...—.._..------------_.-----._
Association Date:
.............---...__...._._._rr....._.._................_..._..._._,...._..._............._._u._..._............__._._._................_..........__......._........_........... 1:1..;2018
Expiration Date.
1�:?1:� 01iI
I Prervq Type:•_._........
pi-el-equishe
Relationship:
`.�1ei1Ily
Registrant:

RITEWAY C.'H.ARITY
SERVICES. INC.
12et;istr:etin►t tin:

I...f][1;S?5[3
Registration Type:

Fu11draisi11L I:1enr
Registration Status
C'umplele
DaleFstalilished:
_....
? � 2019
association D:tte:
1 1-:2019
Expiration Date:

12.31 2t)19
Prereil Type-
Pi-cwqukite
Relationship:
.. ....

C 17aI'il}'
. ....... ._ ...

Registrant:

R11 FW',,1Y C11ARI
I Y SI-R1 R.EX INIC.

Registration No:

E-0041 W9
Fundraising h cnt
Re-isi r'fttion 5tattis:

Complete
x Date 1_• SULUSlll'.tl:
1 (Qi7.: „i)2(f
rI5SOC1ation Daty'
1 1.2020
Lxplration Date:
1213 1.20'10
IPrereq Type:
l'rerei]uisite
Rciatioitship:

Charily
,. Registrant:

I
RITEW.- Y (A IARITY
SEW1CFS. INC.

Reg istration No:
l-00421295
Registr•ation'l'�pe:
l'undi•,tisinyg I-ve i
Registralion Slulus:

C•c1111plcle
Date i.'.stahlished:
1 i21 2021
:Association D:tte:
t/1 2021
1Sxpiratiun Date.
12:'11.2021
ttttpsPret-doj. ca. govNedfiradonNVeblDeta ils.aspx?result=6cc6c 16i- cac3-4 778-bOW-37334act3ab2 414

915123, 7:39 AM
Tax Exempt Organization search Details I Internal Revenue Service Michelles Place
EIN: 33-0951216 1 Temecula, California, United States
Other Names

MICHELLES PLACE CANCER RESOURCE CENTER

MICHELLES PLACE BREAST CANCER RESOURCE CENTER
Publication 78 Data
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 Cade: PC Q
Copies of Returns (990, 990-EZ, 990-PF,
990 -T)
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 2020 Form 990
\/ Tax Year 2019 Form 990
\/ Tax Year 2018 Form 990
Tax Year 2016 Form 990
https:llapps.irs.govtappleosldetaits! 1 J2

FY 23/24 Community Service Funding (CSF) Grant
Application
26 NATIONAL CHARITY LEAGUE INC

MURRIETA-TEMECULA CHAPTER

�� Community Service Funding Application
C,,
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Confirm
Applicant Organization Year Organization Website:

Name: Founded: https:llnationalcharityleague.org/chap
National Chartity League 2016
Murrieta Temecula Chapter
Mailing Address:*
PO Box 1562
Number of Paid Staff:* Number of Volunteers:*
fj r9
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Karen Quinlan- Chapter
President
Does the nonprofit have a current City of F Geographic Area(s) the Organization Serves:* Temecula Business License? Murrieta and Temecula
r..

A current City of Temecula Business
License may be required to submit prior to
fund disbursement.

Undemland
Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 Philanthropy Support
MAX: $S,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program' 2023-09-15 2024-06-30
Preferred Payment Method:
(if grant is awarded.)
Crieck Mailed Check Picked Up
Electronic File Transfer
National Charity League Inc., Murrieta-Temecula Chapter PCB Box 1562; Temecula, Ca 92593
Make Check Payable to:*
National Charity League Inc., Murrieta Temecula Chapter

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
-State of GaI110Fnia Entity Status Letter
IRS Deductibility Status
State of California Entity 1D: *
3963330
To find CA Entity Status Letter,
click the link below:
h ttps:// www.ftb . ca.gov/help/business/entity-
statu s-letter.asp?wT.mc_i d=a kB EStatus
IRS Employer Identification Number (ElN):

S 1-4031603
To find IRS Deductibility Status,
click the link below:
https:/Ia pps. irs.govl'a ppleosl
Date of Incorporation:"
11 /14/2016
Attach State of California Entity Status Letter:"
EST leteer.pd
Attach IRS Deductibility Status:*
FinaILetter_81-4031603_NATIONALCHARITYLEAGUEINCINUR
RIETA-TEMECULACHAPTER 12052016,tif
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (link below) State Registry Search Tool: Attach State Registry Document/Info* 370.17KB

58.4KB
https://rct.doj.ca.govNerification/web/Search.aspx ? registry details.pdf 213.03KB facility=Y

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* Fostering the mother -daughter relationship through an ongoing commitment to philanthropy, culture, and leadership.

NCl_ Inc. Murrieta-Temecula Chapter is part of a larger national organization that was started in 1925.

The national organization offers us mentoring and close monitoring of items such as our governing board, program structure, and financial management. Locally, members of the Murrieta-Temecula chapters members have served over 44,000 hours since our inception in 2016. The hours were served in over 30 different, locally -based, non-profit organizations directly impacting the residents of the City of Temecula and the surrounding areas.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
yC ,j

NAME OF PROGRAM/PROJECT

FUNDED BY THE CITY GRANT
OR SPONSORSHIP *
Philanthropy Support
AMOUNT,*
$3,S00.00
MONTH + YEAR FUNDING
RECEIVED*
November 2021

NAME OF CITY GRANT OR

SPONSORSHIP
Community Service
Funding

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
ProjectfProgram Title; Philanthropy Support

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT' JACOBS HOUSE: Our Grade Level classes (Grade 7-12) will each provide a month (for a total of 6 months) of homemade breakfast or lunch options for the temporary residents of Jacob's house. NCL will be able to create the menu, purchase, cook, package, and deliver the ideals to Jacob's House. This will give the temporary residents at Jacob's House the opportunity to feel the love of a home -cooked meal while focusing their time and energy on their loved ones in the hospital in Temecula. BACKPACKS FOR CHANGE: We will provide comfort care backpacks to Backpacks for Change a non-profit organization that provides backpacks to law enforcement to give to children and teens rescued from trafficking. Our volunteers will create the bags for various ages/ genders so they are provided with comfort and immediate necessities and toiletries once rescued in the Temecula area. ROTARY/ PROJECT TOUCH: Our members Will be making blankets for Rotary to give to the elderly/ families in need at their Christmas Dinner. We will also make blankets for Project Touch for the homeless who need warmth during the winter.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED." ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED .AND WHY_ JACOBS HOUSE: Funding provided will be used to give each class 5200 toward the purchase of food and packaging supplies to make homemade meals for Jacob's House. Additional funding will allow us to provide a rental space with a kitchen to create these meals and package them for delivery. BACKPACKS FOR CHANGE: We will use the funds to purchase bags/ backpacks, basic clothing items, blankets, toiletries, and small comfort items like toys or games. These funds will allow us to complete approximately 50-100 bags to assist this organization. ROTARY/ PROJECT TOUCH: The funds provided would allow us to buy material/blanket-making kits and fabric scissors for us to create these blankets for the elderly, needy families, and the homeless in the Temecula area.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.' TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

JACOBS HOUSE: Jacob's House provides its services to residents who need to be closer to the hospital to provide better care for loved ones while they are in Temecula hospitals. 30- 50 meals per month for 6 months. BACKPACKS FOR CHANGE: This organization will provide these backpacks to local law enforcement agencies who will in turn provide these bags to those who are identified as in need of these essentials. 50-100 bags ROTARY/PROJECT TOUCH: These blankets will be distributed to those within our community who are in need of blankets for the winter months. This will be done through the Rotary Christmas dinner and the ongoing outreach for Project Touch. Goal 50-100 blankets made.

3b. ESTIMATED NUMBER OF PEOPLE FROM
TEMECtJLA EXPECTEE) TO BENEFIT FROM
THIS PROJECT/PROGRAM;
400
3c. ESTIMATED NUMBER OF VOLUNTEERS
INVOLVED IN THIS PROJECTIPROGRAM:
1 tC:

4. SUMMARY STATEMENT —SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS." JACOB'S HOUSE (food & meal preparation, preparation space rental, packaging materials) Monthly class project to make homemade meals for temporary residents while family members are in Temecula hospitals.; BACKPACKS FOR CHANGE (toiletry items, small games/ toys, blankets, clothing, and 'bags) To provide law enforcement essential bags to give to children rescued from trafficking in the Temecula area.; ROTARY/ PROJECT TOUCH (blankets) To make blankets for the elderly, needy families, and the homeless of Temecula.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment* EXPENSES*
scissors $2.00.00
Facilities/Re ntli ns u ra nce *
kitchen space rental $600.00
Supplies*
bags, toiletries, clothing items, small games/toys, blankets,packaging $3,000.00 materials for the meals
Marketing*
n/a $0.00
Services*
n/a $0.00
Food*
breakfast and lunch items to create meals $1,200.00
Other*
n/a $0.00
Staffing Expense
$0.00
TOTAL REVENUE: TOTAL EXPENSES
$ 5,000.Do !65,000.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: *
National Chartity League Murrieta Temecula
Chapter
PresidentfAuthorized Officer:* E-mail:*
Karen Quinlan _
Name & Title
President/Authorized Officer Signature*
Requested Amount:
$5,000.00
Date Time
2023-09-11
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Name, Title, & Organization
If you have any questions, please contacr_:

Phone:*
Betsy.Lowrey@Temecu[aCA.gov (951) 593-3959 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9l812023
ESL ID: 8024965474
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: 3963330
Entity Name; NATIONAL CHARITY LEAGUE, INC., NIURRIETA-TENIECULA CHAPTER

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) Secuon 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.

HOME_ A-euLIT MFLJ[ri =.V!E= F!FGUI A -{IONS RESOURCES f,ROGRAMS, .04TA+=,r Registrant Details
Entity type: �.t-�rporate �_ - -. _ <-t y,,�r�.
- - - q
_' r� �stration documents.

Organization Name: NATIONAL CFLU T1'Y LE.-',GLE, L C., M IRRIET4-TEMECT LA 01AAPTERIRS FEINT 814031603 Entity Type: Public Benefit
SOSIFTB Corporate/Organization Number: 3963330
Registry Status: CwTent
Renewal Due/Exp. Date: 10/ 15122a23
RCT Registration Number: CT0262014
Issue Date: 1/23/2019
Record Type: Charity Registration
Effective Date: 1/23/2019
Date of Last Renewal: 4/24/2023
DBA:

Mailing Address
Street: PO BOX 1562
Street Line 2:

City, State Zip: TEMECULA CA 92593
Filings &.
correspondence
CT-551D Foim RRF-1 Refiind
Return Check Letter
Renewal Filing
2022
IRS Forth 990 Series
2021.

Fonn RRF-1
2021
Renewal Filing
2020
Renewal Filing
2019
Renewal Filing
2018
Form RRF-1
2017
CT-400 First Notice To Register
Click on Document Type at the left to open PDF
CT-402 Final Notice to Register
Click on Document Type at the left to open PDF
CT-470A Confirmation of Registration
Click on Document Type at the left to open PDF
CT-45IC Ist Delin-iieney Notice
Click on Document Type at the left to open PDF
Founding Documents
Click on Document Type at the left to open PDF
CT-550C Form RRF- I IIIeornglete
Click on Document Type at the left to open PDF
Annual
Renewal Data
Status of Filing:

Accepted
Accounting Period Begin Date:
6/1/2016
Accounting Period End Date:
5/31/2017
Filing Received Date:
3I112019
Form RRF-1 Rejeetllucomplete Reason:

Form CT-111-1 RejectlIneomplete Reason:

IRS Form 990 Reject/Incomplete Reason:
_Votes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
6J112017
Accounting Period End Date:
5/31/2018
Filing Received Date:
3/1/2019
Form RRF-1 Rejeetllncomplete Reason:

Form CT-TR-1 RejectlIncomplete Reason:

IRS Form 990 Reject/Incomplete Reason:.

Notes From Registry Staff:

Status of Filing:

Accepted

Accounting Period Begin Date:
6/1/2018
Accounting Period End Date:
5/31/2019
Filing Received Date:
10/1/2019
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:
6/1f2019
Accounting Period End Date:
5/31/2020
Filing Received Date:
10/24/2022
Form RRF-1 Rejeet/Incomplete Reason:

Form CT-111-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Ineumplete Reason:
:Votes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
6f 1/2020
Accounting Period End Date:
5/31/2021
Filing Received Date:
4/19/2022
Form RRF-1 Rejeet/Incomplete Reason:

Resubmission/CorreetionAccepted
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:
611f2021
Accounting Period End Date:
5131/2022
Filing Received Date:
4/7f2023
Form RRF-1 Reject/Ineomplete Reason:

Form CT-TR-1 RejectAncomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Related
Registrations & Event Reports
The related records Ebown below depend on the recwd type being viewed • Charity Registrations relate to Professional Fundraising Events which relate to Professional Fundraiser Registrations. • Raffle Registrations relate to Raffle Repo-ts.
• Click on the RCT Registration No to navigates to the related record.

No Related Records

Search in document
Temecula ... IRS Determination Letter � I
1 / 2 Fit winds v View plain text
I RL7faRL WWV SIRYWE
Ii FAWnl r OF -AM TRrh99RT
Y. O. ROIL M"
-1x4ar.wrr, w>ff +sa4i
DECr�L��
D
Jp�leyer L9�nr-f ELertim HUMbETi
Pate: 12 F016
11-J8YSi7l
ULM;
7[d517iAOeA54fi
11ATI4NhL CILhl.1rY LJlkW5 JWC
r SA "O'm PbY[tr4
KW.rTET A TEMLlr.A IAF.PW
MaTo6R 2MVICR 71k 31954
17713 raR— cau 7dlatlA kb AEd-17S
Qx[ret. 7.1.pbon. N�.—
TFI+ MU. CA 4d591-9094
49,71 82!-550-
A--ti.R 1'—d Lawny:
d.a.rLl7oi 3d
P.2ai, t'halitY st.t-
54i{}7 lsi
P4r. 1p9/p!9-LLf4l4-R #lwo—di
Yae
Rl:OMI" Mar's p[ [Lr.p[1001
7PPr.W— 14, a91i
_
C—L.0 jLi— b d-hihi LktY_
Yet
Add—t— Jppli..,
M.
00" aprai—it
W'r* pleiwd [0 Ybll you w Osg—inld yaw°rl ..r'qt [TO. [.oral i.— tax .od.r I.t—.L Rv— cod. 43NO LeGRlwr 5414001 . Pi-- son A.*-6 CORLrl Wr%4bF [by kW to V— Linfte 1W 2—t-1an 17E. 1!--- ally gL.LLift d w -- L— d.d—Libl. bglPert.. .l... Cr.nlr.rl Cr girt* YndeT ..eeim 26SS, I1d1, er 15A1. Tbil l.tt.[ e.uld h.11r. —.I— q.l.tion. on.. .eaaYJ. Ale} x ep LL rcr your r*c*rds.

OEgarLLthe ielu I —.pL —&— LH J. l— 3.11e191L aea Fag re.ae Clu.l [Lid a. either Puzil, tM GLea .r pri WLe Loanda'i'mo. .e d*[emhrAA Y—r• a pugllC ~$tv ripe rh. T.a£ 5.ctirlr Lizt.d at thr t y of thi. i.tter- I[ ]re i.dir-at ad at the tM .9 ULL. lerttar LhAt }Yw'rti YiO.ir" [0 1114 ►ak% }lPl l46-FyJAAP-R, My 6'[40r0R -ft— lrm'T. r.qul=.d to ril. a. aonwi kntuAUC1a1 17•CCurn [iVrs 449 .T r.— 749-1$] ®r wllctranic neTieF rp-M [len e. leateaYN1- di l"� dem't Ii1e e a ]uireQ [etrrn oa nntlCe 1x lriA yo v *vmpt Ltattrs Lill be iO[ar.1[1£ally rW Od- I:[ +.e LLidlUt" ad %h* [op o! 'AL+ 1.}tur Lb - as addmdlm rg1Llu. U. emi—id sddand= iJ an integral Bart of tbi. Letter.
rnr inp—t—t l.lern.LIt- Abut ywr yy.[p®q}lEilitL.. i. a tu• .p. 0t511.161}[ 10a, go z `ror. 1" qu CMritke.. M[trr '1321-PC' in the d AVO Wr to V1eM P9bliF ti— 4P2:-Pt, £beryl aillC�' diktl� Epr 591 [n1131 R[bL lc CMri tier, ditLan U5Crlbel YQUE ICCOTEIA 9PIFA, LYppT[kaJ'. }RR 9U wianfea r.qulne..Ltt..

NATLOML CWMITY 1LWM I1tC
irrtt.3 }+A
Sidtelely-
�Wlz-
detlt" I. £-per
OLMMay, Unyc Oryan 9.ti—

INTERNAL REVENUE SERVICE
P. O. BOX 2508
CINCINNATI, OH 45201
Date: D E C 12 2016

NATIONAL CHARITY LEAGUE INC

MURRIET A-TEMECULA CHAPTER
31915 RANCHO CALIFORNIA RD 200-375
TEMECULA, CA 92591-0000
Dear Applicant:

DEPARTMENT OF THE TREASURY
Employer Identification Number:

81.-4031603
DLN:
26053742002966
Contact Person:

CUSTOMER SERVICE ID# 31954
Contact Telephone Number:
(877) 829-5500
Accounting Period Ending:

December 31
Public Charity Status:
509(a) (2)
Form 990/990-EZ/990-N Required:

Yes
Effective Date of Exemption:

November 14, 2016
Contribution Deductibility:

Yes
Addendum Applies:

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

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

For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities . Enter "4221-PC" in the search bar to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, which describes your recordkeeping, reporting, and disclosure requirements.

Letter 947

FY 23/24 Community Service Funding (CSF) Grant
Application
27 NATIONAL CHARITY LEAGUE INC

TEMECULA CHAPTER

Community Service Funding Application
T1, I.,,,, ,
Organization
https://temeculaca.gov/grants

CHECK THE BOAC TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Conferm
Applicant Organization Year Organization Website:

Name: Founded: www.temeculavailey.nationalcharityleE
National Charity League, Inc., 2013
Temecula Valley Chapter
Mailing Address:* Number of Paid Staff:* Number of Volunteers:* PO Box 891381 Temecula, CA 92589 0 204
Contact Name & Title:* Contact's Email:" Contact's Phone Number:* Danielle Jacques -Senior Project
Coordinator
Does the nonprofit have a current City of F
Temecula Business License?
Yes
Business License No.*
055437
Copy of Business License*
Business license exp 1-31-2024.pdf 389.77KB
https: //css.temeculaca.gov
Geographic Area(s) the Organization Serves:*
Temecula Valley
Geographic Area(s) the Project/Program
Serves:.

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 Healing Heart Tote Bags
MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program* 2023-06-01 2024-05-31 31938 Temecula Pkwy, Ste A #385 Temecula, CA 92592 Preferred Payment Method: Make Check Payable to:*
(if grant is awarded.) National Charity League, Inc., Temecula Valley Chapter Check Mailed Check Picked Up
Electronic File Transfer

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No
IF NO, THEN INELIGIBLET© RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS deductibility Status
State of California Entity 1D: *
3577161
To find CA Entity Status Letter,
click the link below:
h ttps:// www.ftb . ca.gov/help/business/entity-
status-letter.asp?WT.mc_id=akBEStatus
IRS Employer Identification Number (EIN):*
46-2834204
To find IRS Deductibility Status,
click the link below:
https://apps.irs.gov/app/eos/
Date of Incorporation:"
02/02/2015
Attach State of California Entity Status Letter: *
Scan_20230912.jpg
Attach IRS Deductibility Status:*
Tax Exempt Organization Search Details _ Internal Revenue Service.html
Provide further verification as follows —
(one required, both preferred)
First Page of most recent IRS Farm 990
Detailed info about your chanty found on the State Registry Search Tool (link below) You might find IRS Form 990
Attach First Page of Most Recent Form 990*
99€3 EZ 6-1-21 - 5-31-22.pdf
990.82KB
135A8KB
859.01 K8
on the link below: (990, 990-EZ, 990-PF, 990-T)

https.//rct.doj .ca.govNe ri f icat i o n / W eb/Sear c h . a s px? facility Y
State Registry search Tool. Attach State Registry Document/Info* https.//rct.doj.ca.gov/Verification/Web/Search.aspx? ❑etails.html 41.79KO facility=Y

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* Our mission is to foster the mother -daughter relationship through an ongoing commitment to philanthropy, cuiture and leadership. Temecula Valley Chapter is a local chapter of a very distinguished national organization. We have served over SQ,000 volunteer hours since 2013 with 23 local non-profit organizations that directly serve the residents of Temecula.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?

NAME OF PROGRAM/PROJECT
FUNDED 6Y THE CITY GRANT
OR SPONSORSHIP *
Warrior Bags
AMOUNT:*
$5,000.00
MONTH + YEAR FUNDING
RECEIVED*
12/2022

NAME OF CITY GRANT OR

SPONSORSHIP
Community Service
Funding Program

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
Project/Program Title: Healing Heart Tote Bags

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT' This year our senior project objective is to support our philanthropy partner, Empty Cradle. Empty Cradle supports women who have experienced the loss of their baby due to miscarriage, stillbirth, TFMR, infant death, SIDS, or SUID. The death of a baby is one of life's most devastating experiences. With these tote bags, we want to offer some hope and comfort to their aching heart.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.+ ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

Along with the purchase of the tote bags we will be personalizing, inside we will purchase, make and include: a candle, boo"ournai & pen, handmade tied, no sew lap throw, bracelet with heart charm, handmade no -sew rice heating wrap, homemade scented soap bar, lip balm, foot and hand cream, flower seeds, and a white clay pot with cricut vinyl inspirational words placed on them. We will be ordering most materials supporting local businesses and doing the work ourselves.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

We hope to make a difference by providing some comfort to these women in their grieving process with handmade heartfelt tote bags. Empty Cradle will distribute these tote bags to the local hospitals, We are a class of 10 Nigh school senior girls and our goal is to mare 100+ bags 3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
100
3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECT/PROGRAM:

4. SUMMARY STATEMENT - SUMMARIZE ANSWERS 1 - 3 ABOVE IN 50 WORDS OR LESS.* Healing Heart Tote gags
....to comfort the grief of an aching heart and ease the pain of an empty cradle The senior class of 2024 is pleased to work with the National Charity League Executive Board and its Philanthropy Partners in an effort to help improve our community. As high school seniors we are required to complete a Community Service Leadership Project. The purpose of this project is to utilize our skills attained over the past 5 years of NCL and design a project that allows us to research, develop, and present for the chapter and community to participate in. This year we would like to support and work with Empty Cradle

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
ToolslEquipment* EXPENSES"
crlcut machine $500.00
Facilities/Re ntli ns u ra nce *
N/A $0.00
Supplies`
reusable tote bags, candles, soap kits, fleece material, journals, vinyl, $3,000.00 socks, rice, ribbon, bracelets, flower seeds, clay pots, embellishments, hand and foot creams
Marketing
N/A $0.00
Services' kk
Local Temecula Candle Co $1,250.OD
Food*
NIA $0.00
Other'
Misi 5500.00
Staffing Expense
$0.00
TOTAL REVENUE: TOTAL EXPENSE►
s5,250.00 $5,250.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: *
National Charity League, Inc., Temecula Valley
Chapter
PresidentfAuthorized Officer:* E-mail:*
Requested Amount:

Leah Finn president@ncitv,org
Name & Title
President/Authorized Officer Signature* Date Time
e7l, C,t "fr
2023-09- i 2
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Danielle Jacques -Senior Project Coordinator
Name, Title, & Organization
Phone:*
If you have any questions, please contact:

Search in document
Temecula ... CA FTB Entity Status Letter � I
/ 1 Fit winds v View plain text
nr�awEr■�r�elwo
rar�wrri ■�>r.lo
Omb 4131231%
EEL ID 3K7 -(84
9!a c>++-rwe4r. an w1oM--s ■ml/' Nwm■IYn ■e YYr sW ■■w1w r d qe■ Prw Pt II4■ rmr EM%4 3srTlal
EP■■yhwst J"-KftM 04AMTV .E qVe W- TONCULAWY LEWOMITEq
' rgFrMY�F ■. ,.T M■gF111 r-R�lsFtRr+rr 7s �4.
i. T1f�.Y■+yl.-iPd'■f■■ie��lh�f+IsaF■F rP iyOy
Y fieFv911Yi �-rrllyr�yr�.l■t-now N.�-iWr r--Fra+ti■r-CPtlP 1�1YCy 5■wsr.-33Tstt 1, 1YFY ngl�r-. �w�rwP.iwIII�AR+-�ir�1Y
Ttq �r Pb^•Wbl dr® nollw�l�r n■!�t
• rrg r'I�F rOWI. �- I-r 1�M ■�q �+w � sF CarlPns Pr id�r pr-w�r1y!•q �Lr'-gl. pwlw�.muw ,Wt .0 I.I ft ■ .,e who w M-irwo0- w Pw w ■rW wPW .0. r!ry rwww■"1Y [Sbr—~a H+-gWILe-,-A-*.@ -r1 Wr Warwn Q.Mb r.

T"s 4d. n.-Mi) d"■ 1.0.'. Cao—*ry rw wf A■—wt-rw■ot.wY
,. I-rT eaY1rt Pr.Fii vY� 141 C r+orrn �f�e: rlit �. Im16■r■-■ ar. wr wpt�r 4 i-rgna6 a fin hIa■nn-■ R-■- wl B. p•1wn.P wi ■r ■nOr
Crowd WM U.

W.b IIY�4
I',—�2E TPII Fwn 1■r-c6lmm.P■-.._P1—!d-.
na..sEm.■sc1 a-�wtr T.d� 3Piw,
nvrrplC; �0 @ 1f�4 pr-r■•� yMll IIM-1 PI Ppil-W MIf�MP
rn+ar�+wa IRe- er m-a

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 10/2/2023
ESL ID: 7336302338
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:

Entity Name: NATIONAL CHARITY LEAGUE, INC., TEMECULA VALLEY CHAPTER ✓❑

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.

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).

• HOME
• ABOUT
• MEDIA
• CAREERS
• REGULATIONS
• RESOURCES
• PROGRAMS
• CONTACT
Registrant Details
Entity type: Corporate Class as registered with the secretary of State or based on foundin & registration documents.

Organization Name: NATIONAL CHARITY LEAGUE, INC., TEMECULA VALLEY CHAPTER IRS FEIN:

Entity Type: Public Benefit SOS/FTB Corporate/Organizatio Registry Status: Current Renewal Due/Exp. Date: 10/15/2023 RCT Registration Number: CT0214184 Issue Date: 12/19/2014 Record Type: Charity Registration Effective Date: 12/19/2014 Date of Last Renewal: 11/15/2022 DBA:

Mailing Address
Street: PO BOX 891381
Street Line 2:

City, State Zip: TEMECULA CA 92589-1381
Filings & Correspondence
Founding Documents Founding Documents
Confirmation of Registration Confirmation of Registration Letter Letter
Renewal Filing 2022
Renewal Filing 2021
Renewal Filing 2020
Renewal Filing 2019
Renewal Filing 2018
Form RRF-1 2017
2016 RRF-1 2016 RRF-1
RRF-1 2015 2015 RRF-1
IRS Form 990-N 2015 2015 IRS Form 990-N
RRF-1 2014 2014 RRF-1
IRS Form 990-N 2014 2014 IRS Form 990-N
Annual Renewal Data
Status of Filing: Accepted
Accounting
Period Begin 6/1/2013
Date:

Accounting 5/31/2014
Period End Date:

Filing Received 1/12/2015
Date:

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

INTERNAL REVENUE SERVICE
P. D. SOX 2508
CINCINNATI, OH 45201
Date: DEC 09 ZU1j

NATIONAL CHARITY LEAGUE INC

TEMECULA VALLEY CHAPTER

C/O JULIET GROSSMAN
PO SOX 891300
TEMECULA, CA 92589-1300
Dear Applicant:

DEPARTMENT OF THE TREASURY
Employer Identification Number:
46-2834204
DLN:
17053235363013
Contact Person:

MS. GAISER ID#( 31609
Contact Telephone Number:
(877) 829-5500
Accounting Period Ending:

May 31
Public Charity Status:
509 (a) (2)
Form 990 Required:

Yes
Effective Date of Exemption:

June 3, 2013
Contribution Deductibility:

Yes
Addendum Applies:

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.

Please see enclosed Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, for some helpful information about your responsibilities as an exempt organization.

Letter 947 (DO/CG)

FY 23/24 Community Service Funding (CSF) Grant
Application

OAK GROVE CENTER

Community Service Funding Application
a �
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Conform
Applicant Organization Year Organization Website:

Name: Founded: culinarycreationsoakgrove.org
Oak Grove Center i Cj8
Mailing Address:* Number of Paid Staff:Number of Volunteers:* 24275jeffersrn Ave, Murrieta, CA 0 (31
92562
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Tammy Wilson, LMFT, CEO [email protected] 9SI677SS99 Does the nonprofit have a current City of x Geographic Area(s) the Organization Serves:* Temecula Business License"? Riverside County
Business License No.*
OS4387
Copy of Business License*
City of Temecula Business License 2023 exp 013
12024.pdf
https://css,temeculaca.gov
234.54KB
*
Geographic Area(s) the ProjectlProgram
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 Culinary Creations Program
MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program* 2023-07-01 2024-06-30 41923 2nd Street, Ste 104, Temecula, CA 92590 Preferred Payment Method:
(If grant is awarded.)
Check Mailed Check Picked Up
Dectronic File Transfer
Make Check Payable to:"
Oak Grove Center

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
-State of CaliYarnia Entity Status Letter
IRS Deductibility Status
State of California Entity 1D: *
1574925
To find CA Entity Status Letter,
click the link below:
https://www.ftb.ca.gov/help/business/entity-
statu s-letter.asp?wT.mc_i d=a kB EStatus
IRS Employer Identification Number (EIN): *
33-9479446
To find IRS Deductibility Status,
click the link below:
https://a pps. irs.govl'a ppleosl
Date of Incorporation:"
09/24/1992
Attach State of California Entity Status Letter: *
FTB Status Leiter.pdf
Attach IRS Deductibility Status:*
TAX ID Status Federal.pdf
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (link below) State Registry Search Tool: Attach State Registry Document/Info* 371.91 KB
257.39KB
https://rct.doj.ca.govNerification/web/Search.aspx ? Charity Registration.pdf 1,35MB facility=Y

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* he mission of Oak Grove Center is to rebuild the lives of at -risk children and their families through educating, healing, restoring relationships., building character and instilling hope.

Oak Grove Center specializes in serving California's most at -risk and vulnerable children and their families with the widest spectrum of services including residential, educational treatment, and day ,programming. In addition, we operate Oak Grove Center's Culinary Creations Bakery in Temecula, which provides our youth vocational training and hands-on programming as they actively participate in a working bakery. In addition, Oak Grove acts as a Workability site for students in high school programs in Temecula, Oak Grove is proud of preparing local youth for the world of work. Youth have gone on to become employed in the hospitality industry following graduation from the culinary training program, At Oak Grove Center our vision is to see broken lives healed and Dope restored. We are empowering success and transforming lives!
UPON REQUEST, COPIES OF THE ORGANIZATIONS CURRENT BUDGETiFINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT), AND IF AVAILABLE CPA'S AUDIT, MAY BE NEEDED TO ❑EMONSTRATE SOUN❑ FINANCIAL MANAGEMENT, DO NOT SUBMIT NOW, Understand

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
yC ,j

NAME OF PROGRAM/PROJECT
FUNDED 6Y THE CITY GRANT
OR SPONSORSHIP *
Community Service
Reinvestment Program
AMOUNT,*
MONTH + YEAR FUNDING
RECEIVED*
Aug 2023

NAME OF CITY GRANT OR

SPONSORSHIP
Reinvestment Program

Project/Program Description
RECEIPTSIINV©ICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
Project]Program Title: Culinary Creations Program

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT,* Culinary Creations is a unique vocational program designed to build vocational and culinary skills, as well as provided jobs for at -risk, vulnerable and/or special needs and disabled youth and TMI (Toward Maximum Independence) young adults through a retail store in Temecula. While core services seep to restore challenging circumstances and move youth frorn crisis to stability, Oak Grave Center's unique approach of supportive programs sets our agency apart. Culinary Creations provides hands-on vocational training to youth including customer service, culinary expertise, barista skills, inventory management, catering services and more.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.* ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND VVHY.

Funds will be spent on the operating costs of the Bakery, including rent, utilities, supplies (which includes food for baking, supplies for the kitchen as well a take out containers, bags and boxes, etc.) "Other expenses" include payroll taxes, workers comp insurance, medical benefits and credit card charges related to transactions on sales.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IFAWARDED CITY FUNDING.

While we expect to serve 70 youth through this program during the grant period, 4S will be Temecula residents. These Temecula youth will engage in hands-on vocational training at the Culinary Creations Bakery and/or on our main campus in Murrieta. Temecula youth may be either placed at Oak Grove, a Workability Student from local schools and or Young Adult Special Needs Students. 3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM;
1 C,
3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECT/PROGRAM:

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

At -risk, vulnerable Temecula youth and young adults participating in mental health services, local schools and colleges, the Toward Maximum Independence Program who will engage in hands-on vocational training programming in the Culinary Creations Program.

Project/Program Budget

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount requested from this City of Temecula Community Services Grant REVENUES* $5,000.00
Refer to Page 2
Amount contributed to the Project/Program by the Applicant Organization $100,000.00
Other grants or funding already awarded for ProjectlProgram.. if any CID grant, Founders Contribution, other fundraising and sales In -Kind match amount or volunteer credit hours estimated amount 11111116'111111141111a0�a010&1 =01:1i] a,:tilU:1411111111aloffiilel:41—AlA Tools/Equipment*
Industrial Mixer and cooking utensils, pans and spatulas -spoons Facilities/Rentllnsurance*
Rent and Utilities (electric, Internet) and shared utilities gas -water *
$159,430.00
*
$0.00
EXPENSES*
$750.00
*
$73,707.00
Supplies*
baking supplies, coffee, bags and boxes, fruit and chocolate, plate, napkins, $135,000.00 silverware, cups
Marketing*
although a cost, not inClUded on this grant NA
Services*
NA
Food*
NA
Other*
Payroll taxes, Worker's Comp, Medical Benefits, Credit Card Charges *
$0.00
*
$0.00
*
$0.00
$54,973.00

Staffing Expense
$287,331 M
TOTAL REVENUE;

TOTAL EXPENSES
$264,430.00 $264,430.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization:* Requested Amount:

Oak Grove Center $5,000.00
President/Authorized Officer:* E-mail:* Phone: "
Tammy Wilson CEO
Name & Title
[email protected] 951-677-5599
PresidentlAuthorized Officer Signature* Date
y Jr
2023-09-13
_' llittiil� e,I'�r /I't�i►"Cit, �_-��
IF DIFFERENT THAN ABOVE, APPIGATION PREPARED BY:

Name, Title, & Organization
If you have any questions, please contact. [email protected] (951) 693-3959 or [email protected] (951) 694-6413

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
FTB
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 918/2022
ESL ID: 7230475266
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: 1574925
Entity dame: OAK GROVE INSTITUTE FOUNDATION, INC.

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.

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 Lis
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)

State cif Californiai Office of the
Department of Justice Attortiey General

CAREERSHOME ABOUT MEDIA PROGRAMS CONTACT
■
Organization Name: OAK GROVE INSTITUTE FOUNDATION, INC. IRS FEIN: 330470446 Entity Type: Public Benefit SOSIFTB Corporate/Organization Number- 1574925 Registry Status: Current - Awaiting Reporting Renewal Due/Exp. Date: 5f 15/2022 RC,r Registration Number. 082134 Issue Date: 12/31/2005 Record'fype: Charity Registration Effective hate: 12/31/2005 Date of Last Renewal: 3/25/2022 DBA:

Mailing Address
Street: 24275 JEFFERSON AVE
Street Line 2:

City, State Lip: MURRIETA CA 92562
Filings & Correspondence
Ppinding�1 ntsnts Founding D(wuments
-1 20(
Form
-1 20
Fnrlrt '
-1 20(
2009 RRF-1
2008 IRS Farm 990
2007 RRF-I
2007 IRS Form 990
2006 RRF-1
2006 IRS Form 990
2005 RRF- I
2005 IRS Form 990
2004 RRF-1
2004 IRS Form 990
2003 RRF-1
2003 IRS Form 990
2002 RRF-1
2002 IRS Form 990
2001 RRF-1
2009 RRF-1 -
2009 IRS Form 990
2011 IRS Form 990
201 t RRF-I
2010 RRF-1
2010 IRS Form 990
2019
2019

RRF-1 2012
2012 RRF-1
116 form 990 2012
2012 IRS Form 990
RRF-1 2.01.3
2013 RRF-1
IRS Forlrt 92Q_2DII
2013 IRS Form 990 — — - -- — —
RRF-1 2014
2014 RRF-1
IRS Form 990 2014
2014 IRS Form 990
2015 RRF-1
2015 RR17-1
2015 IRS Form 990
2015 IRS Form 990 -- -
201$ Farm RRF-1
Click on Document Type at the left to open PDF
2 16 I S Form 990 Sefies
Click on Document Type at the left to open PDF
Renewal Filing
2017
Renewal Filijig
2020
Status of Filing: Acceptcd
Accounting Period Begin Plate: i/l/2010
Accounting Period End Date: 12/31 /2010
Filing Received Date: 11 / 14/201 1
Farm RRF-1 RejectfIncomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Rejectllneomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
1 /l /2011
Accounting Period End Date:
12/31/2011
Filing Received Date:
9/20/2012
Form RRF-I Rejectllneomplete Reason:

Form CT-TR-I Rejject/[neomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Status of Filing:
,accepted
Accounting Period Begin Date:

I/112012
Accounting Period End Date:
12/3100 12
Filing Received Date:
11/18/2013
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Reject/incomplete Reason:

IRS Form 990 Rejeet/Incontplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
1/1/2013
Accounting; Period End Date:
12/31/2013
Filing Received Date:
9/3/2014
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 slate:
1/1/2014
Accounting Period End (late:
12/31/2014
Filing Received Date:
10/19/2015
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-I Reject/Incomplete Reason:

IRS Form 990 RejectfIncomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
1/112015
Accounting Period End Date:
12/31/2015
Filing Received Date:
7/26/2016
Form RRF-i Reject/Incomplete Reason:

Form CT TR-1 Reject/Incomplete Reason:

IRS Form 990 Rejectllncomplete Reason:

Notes From. Registry Staff_
Status or Filing: — - - --
Accepwd
Accounting Period Begirt Date:

Illl2016
Accounting Period End Date:
12/31/2016
Filing Received Date:
9/7/2017
Form RRF-1 Reject/incomplete Reason:

Form CT-TR-1 Rejectllncomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Dotes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Irate:
11112017
Accounting Period End Irate:
12/31/2017
Filing Received Date:
9/18/2018
Form RRF-1 Rejectllncomplete Reason:

Form CT-TR-1 Rejectllncomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
1 J11201 i;
Accounting Period End Date:
12/31/2018
Filing Received Date:
1 1l18/2019
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: ill/2019
Accounting Period End Date: 12/31/2019
Filing Received Date: 1/15/2021
Form RRF-I Reject/Incomplete Reason:

Form CT-TR-I Rejectllncomplete Reason:

IRS Form 990 Rejectllncomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accounting Period Begin Date:

Accounting Period F;nd Date:

Filing Received Date:

Form RRF-1 Reject/Incomplete Reason:

Form C -,rR-1 Rejectllncomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Accepted
11112020
12/31 /2020
11 /23/2021
No Related Records

internal Revenue Service
Date: March 23. 2005

OAK GROVE INSTITUTE FOUNDATION INC
% THOMAS LESTER
24275 JEFFERSON
MURRIETA CA 92562-7285
Dear Sir or Madam:

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

Ms. Regina Parker 31-07403
Customer Service Specialist
Toll Free Telephone Number:
8:30 a.m. to 5:30 p.m. ET
877-829-5600
Fax Number.
513-263-3756
Federal Identification Number:
33-0470446
This is in response to your request of March 23, 2005, regarding your organization's tax- exempt status.

In September 1992 we issued a determination letter that recognized your organization as exempt from federal Income tax. Our records indicate that your organization is currently exempt under section 501(c)(3) of the Internal Revenue Code.

Our records indicate that your organization is also classified as a public charity under section 509(a)(2) of the Internal Revenue Code.

Our records indicate that contributions to your organization are deductible under section 170 of the Code, and that you are qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Internal Revenue Code, If you have any questions, please call us at the telephone number shown in the heading of this letter.

Sincerely,
A4mw,WA,�&o
Janna K. Skufca, Director, TEIGE
Customer Account Services

FY 23/24 Community Service Funding (CSF) Grant
Application
29 ROCK YOUR RED

Community Service Funding Application
a �
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Conform
Applicant Organization
Name:

Rock Your Red for Heart and
Stroke Awareness
Mailing Address:*
* Year Organization
Founded:
2015
* Website:
www.rockyourred.org
Number of Paid Staff:* Number of Volunteers:*
0 14
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Denyse Wilson, CEO
Does the nonprofit have a current City of x Geographic Area(s) the Organization Serves:* Temecula Business License? Temecula, Murrieta, Lake Elsinore, Menifee Business License No.*
OS4184
Copy of Business License*
RYRBusi n essLocense.pdf
https://css.temeculaca,gov

94.18KB
Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:*
$5,000.00
MAX: $5,000 PER ORC
Start Date:*
2024-02-23
Project/Program Title:*
Rock Your Red for Heart and Stroke Awareness Annuai Event End Date:*
2024-02-23
Preferred Payment Method:
(if grant is awarded.)
Check Mailed Check Picked Up
Electronic File Transfer
Physical Address of Project/Program*
Pechanga Casing, Resort and Spa, 4500 Pechanga
Parkway, Temecula, CA 92592
Make Check Payable to:`
Rock Your Red

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Provide nonprofit status verification as follows:*
(one required, bath preferred)
State of California Entity Status Letter
IRS Deductibility Status
State of California Entity ID:*
4590840
To find CA Entity Status Letter,
click the link below:
h ttps:// www.ftb.ca.gov/help/business/entity-
status-letter.asp?WT.mc_id=akBEStatus
IRS Employer Identification Number (ElN):
85-2536062
To find IRS Deductibility Status,
click the link below:
https:"apps.irs.gov/app/eos/
Date of Incorporation:
05/01 /2020
Attach State of California Entity Status Letter:*
EntityStatusStateofCalifo mia. pdf
Attach IRS Deductibility Status:*
20230816_045325.PDF
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (link below) You might find IRS Form 990
on the link below:
http s:Jf rct. d of .ca.govNe ri f Ecat i o n /web/Sea rc h. a s px? facility=Y
Attach First Page of Most Recent Form 990*
20230816_045339.PDF
(990, 990-EZ, 990-PF, 990-T)
370.23KB

32.33KB

37.04KB
State Registry search Toole Attach State Registry Documentnnfo" https llrrrt.dcP].ca.gOVNerlfcatipnlWeb/searth.aspk? DU].html facility=Y

11.8EKB

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:

Mission: Is to significantly improve the cardiovascular health and Wellbeing of the members of our community through education awareness, training, support, and services to reduce the lives lost to cardiovascular diseases.

Goal: To provide free/reduced preventable education & services to our Heart community to reduce the overall death rate by 10%.

Objective: Promote a healthy way of living free of heart and stroke diseases where each person has a chance to make a healthy choice,

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?

NAME OF PROGRAM/PROJECT
MONTH i YEAR FUNDING
FUNDED BY THE CITY GRANT AMOUNT;*

RECEIVED
OR SPONSORSHIP *
Rack Your fled event $5,000.00 12/2023
NAME of CITY GRANT OR

SPONSORSHIP
Community Service
Funding Grant
Program
0 $0.00 0 0

Project/Program Description
RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE x

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. ide'Stencl
ProjectPrograrn Title: Rock Your Red for Heart and Stroke Awareness Annual Event

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.* - Organize and provide free hand -only CPR training, stop the bleed training, cardiac & stroke awareness, and provide free lunch for all attendees.
-Host free health fairs and expo events for our community providing resources and educational materials free.
- Coordinate and host heart walks in our communities. Last year AHA cancelled their annual walk and Rock Your Red held a community walk with over 60 attendees. We also provided goodies bags and morning snacks and drinks.
-Host annual Rock your Red community event at Pechanga with vendors, cardiac speakers, blood pressure checks, lunch and more.
- Outreach programs teaching warning signs of heart attacks and stroke. - Provide BP tool kits, pamphlets, health screening for underrepresented population and community.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.* ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY. (0) Host an annual fundraising event with lunch, health speakers, vendors, etc., at Pechanga Casino Resort for our community to educate and bring awareness about heart and stroke diseases. (1) Purchase portable AEDs and educational supplies for training (2) Purchase BP & Emergency medical kits. (For resident training) (3) Purchase marketing materials for Health & Wellness seminars, and pay monthly expenses for website, etc.
(4) Offer discount price to Temecula residents at events. (5) Provide meal gift cards to assist Temecula residents after cardiovascular surgeries (6) Free lunch/snacks for Temecula residents at health events hosted by Rock Your Red. (7) Host mini health fairs in Temecula with AHA, TVH, Wellness Coaches

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

Our programs, workshops, trainings, webinars and services will be customized to accommodate our diverse community by focusing on their needs, healthy, overall well-being, but not limited to our seniors, military, special needs, adults, school aged, homeless, etc. Our services will cover and consist of those who live in Temecula areas of 92590, 92591, 92592.. These services will be reduced or free to our Temecula residents.
3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
3c. ESTIMATED NUMBER OF VOLUNTEERS
x INVOLVED IN THIS PROJECT/PROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.* Cardiovascular disease is the leading cause of deaths in the United States, according to the Center for Disease Control and Prevention. The American Heart Association estimates that more than 90 million Americans are living with some form of heart disease or ,after-effect of stroke. These grant funds will he used for our Temecula residents to provide programs, health events, workshops, wehinars to educate, our Men, women, children, special needs, homeless, military, etc. on how to live a healthy life, free of cardiovascular diseases for all! This grant will allow us to provide services to our community while reducing the death rate of cardiovascular diseases. Thank you.

Project/Program Budget

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount requested from this City of Temecula Community Services Grant REVENUES` $5,000.00
Refer to Page 2
Amount contributed to the Project/Program by the Applicant Organization $1,800.00
Other grants or funding already awarded for Project/Program, if any $0.00
In -Kind match amount or volunteer credit hours estimated amount $600.00

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment* EXPENSES'
faxlscanner, shredder, credit card reader, ipad $1,675.00 Facilities/Rentllnsurance*
Bus. License, Tax insurance, incorporation insurance preparation $2,000.00 Supplies*
Ink, printer, paper, fax/scanner $1,841.00
Marketing*
FB marketing, uniforms, marketing materials for events $1,014.00 Services*
website management $828.00
Food*
expense for Pechanga event in February 2023 $2,658.00
Other*
Permits to city for events/health $211.00
Staffing Expense
$0.00
TOTAL REVENUE: MTAL EXPENSES
$7,400.00 $10,227.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization:*
Rock Your Red
PresidentiAuthorzed Officer:* E-mail:*
Denyse Wilson, CEO -
Name & Title
PresidentlAuthorized Officer Signature*
Requested Amount:
$5,000.00
Date Time
2023-08-25
IF DIFFERENT THAN ABOVE, APPICATION PREPARE❑ BY:

Name, Title, & Organization
If you have any questions, please contact:

Phone:*
Betsy.Lowrey@Ternecu[aCA.gov (951) 69 3-395 9 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 8/16/2023
ESL ID: 2632461350
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: 4590840
Entity !Name; ROCK YOUR RED

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 . 11 4.

We do not have current information abort the entity.

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

Department of the Treasury
Date:

Internal Revenue Service
09/02/2022
Tax Exempt and Government Entities
P.O. Box 250$
Employer ID number:

Cincinnati, OH 45201
85-2536062
Person to contact:

Name: Suzanne Richey
ID number: 50750
Telephone: 877-829-5500

ROCK YOUR RED
Accounting period ending:

CIO SHARON DENYSE WILSON
December31
Public charity status:

TEMECULA, CA 92592
509(a)(2)
Farm 9901990-EZ t 990-N required:

Yes
Effective date of exemption,
May 1, 2020
Contribution deductibility:

Yes
Addendum applies:

No
DLN:
26053603004162
Dear Applicant:

We're pleased to tell you we determined you're exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). Donors can deduct contributions they make to you under IRC Section 170. You're also qualified to receive tax deductible bequests, devises, transfers or gifts under Section 2055, 2106, or 2522. This letter could help resolve questions on your exempt status. Please keep it for your records.

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

If we indicated at the top of this letter that you're required to file Form 9901990-EZ1990-N, our records show you're required to file an annual information return (Form 990 or Form 990-EZ) or electronic notice (Form 990-N, the e-Postcard). If you don't file a required return or notice for three consecutive years, your exempt status will be automatically revoked.

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

For important information about your responsibilities as a tax-exempt organization, go to ww.irs.govlcharities.

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

Sincerely,
cx..

Stephen. A. Martin
Director, Exempt Organizations
Rulings and Agreements
Letter 947 (Rev. 2-2020)
Catalog Number 35152P

Rock Your Red
EIN: 85-2536062 I Temecula, California, United states
Publication 78 Data
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 Q
Determination Letter
I
Afavorable determination Letter is issued by the IRS if an organization meets the requirements for tax-exempt status under the Code section the organization applied.

Final Letter(s)
inaltetter 85-2536062_ROCKYOURRED 07202022^00.tif
[https: Capps.irs.ggvZpubepostcard/dllfinaiLetker 85-
2536062 ROCKYOURRED D7202 22 001if
Form 990-N (e-Postcard)
Organizations who have filed a 990-N (e-Postcard) annual electronic notioe.

Most small organizations that receive less than $50,000 fall into this category.

Tax Period:
2022 [01/01/2022-12/31/2022)
EIN:
85-2536062
Organization Name (Doing Business as):

ROCKYOUR RED i
Maiting Address:

Organization Warne (Doing Business as):

ROCKYOUR RED
Mailing Address:

Temecula, CA 92592
United States
Principal Officer's Name and Address:

Sharon Denyse Wilson
Temecula, CA 92592
United States
Gross receipts not greater than:
$50,000
Organization has terminated:

No
Website URL:
www.rockyourred.com

• HOME
• ABOUT
• MEDIA
• CAREERS
• REGULATIONS
• RESOURCES
• PROGRAMS
• CONTACT
Registrant Details
Enti e: Corporate Class as registered with the Secretaa of State or based on foundind & re istration documents.

Organization Name: ROCK YOUR RED IRS FEIN:

Entity Type: Public Benefit SOS/FTB Corporate/Organization Number: 4590840 Registry Status: Not Registered Renewal Due/Exp. Date:

RCT Registration Number: Issue Date:

Record Type: Charity Registration Effective Date:

Date of Last Renewal: DBA:

Mailing Address
Street:

Street Line 2:

City, State Zip: TEMECULA CA 92592
Filings & Correspondence
No Related Documents
Annual Renewal Data
No Annual Renewal Data
Related Registrations & Event Reports
The related records shown below depend on the record type being viewed:
• Charity Registrations relate to Professional Fundraising Events which relate to Professional Fundraiser Registrations. • Raffle Registrations relate to Raffle Reports.
• Click on the RCT Registration No to navigate to the related record.

No Related Records

FY 23/24 Community Service Funding (CSF) Grant
Application
30 ROTARY CLUB OF TEMECULA

�� Community Service Funding Application
C,
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Confirm
Applicant Organization * Year Organization Website:

Name: Founded: www.rotarycluboftemecula.com
Rotary Club of Temecula ° )75
Mailing Address:*
PCB Box 64
Number of Paid Staff:* Number of Volunteers:*
-1 11,E
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Susie Marshall
Does the nonprofit have a current City of * Geographic Area(s) the Organization Serves:* Temecula Business License? Temecula
Yes No
Business License No.*
054545
Copy of Business License"
Business License 021523.JPEG
i-
https://css.temeculaca.gov
502.3KB
*
Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 Food for TVUSD low income students and families during cold winter MAX: $5,000 PER ORG months
Start Date:* End Date:* Physical Address of Project/Program* 2023-07-01 2024-06-30 PO BOX 64 Temecula CA 92593
Preferred Payment Method:
(if grant is awarded.)
Check Mailed Check Picked Up
Dectronic Fife Transfer
Make Check Payable to:

Rotary Club of Temecula

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS Deductibility Status
State of California Entity ID:*
0776714
To find CA Entity Status Letter,
click the link below:
https://www.ftb.ca.gov/help/business/entity-
statu s-letter.asp?1NT.mc_i d=a kB EStatus
Provide further verification as follows:*
Date of Incorporation:*
05/04/1999
Attach State of California Entity Status Letter:*
RCDT Entity Letter.pdf
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry .Search Tool [link below] Attach First Page of Most Recent Form 990*
You might find IRS Form 990 990 first page.pdf
on the link below: (990, 990-EZ, 990-PF, 990 T)
https:/Irct.doj.ca.govNerif ication/web/Search.aspx?
facility=Y
370.08KB
124.03KB

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* Rotary Internationals mission is "We provide service to others, promote integrity, and advance world understanding, goodwill, and peace through our fellowship of business, professional, and community leaders."
Rotary Club of Temecula objective is to benefit the well-being of 200 or more low income students/families referred by Temecula Valley Unified School District (TVUSD) by providing food boxes Filled with staples, canned goods and proteins during the cold winter months.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
Ye' .,.:

NAME OF PROGRAM/PROJECT
MONTH +YEAR FUNDING
FUNDED BY THE CITY GRANT AMOUNT:*
RECEIVED*
OR SPONSORSHIP*
Food Boxes for Love `b30,000.00 January 2023
Income TVUSD
Students and their
families
Food Boxes for Low $5,000.00 January 2022
Income TVUSD
Students and their
families

NAME OF CITY GRANT OR

SPONSORSHIP
Reinvestment Grant
CSF Grant

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. nderstand
ProjectlProgram Title: Food for TVUSD low income students and families during cold winter months

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.* Temecula Valley Unified School district provides a list of low-income students and families needing supplemental food assistance in the cold Weather- months of November and December. Grant funding will assist RC Temecula in the purchase of proteins (turkey and hams) and grocery store cards with Rotarians providing canned vegetables and fruits and dry packaged staples to fill food boxes, averaging from 200 to 350 boxes a year, to promote the health and well-being of Temecula residents,

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.* ALSO, INCLUDE EQUIPMENT, SERViCES TO BE PURCHASED AND WHY.

A grant of $5,000 will be used to purchase proteins such as turkeys and hams to supplement the canned and dry packaged foods donated by the members of RC Temecula.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

More than 200 low income students/families determined by the Temecula Valley Unified School District will receive food boxes to promote the wellbeing of Temecula residents during cold winter months. 3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
500
3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECTIPROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.* The Rotary Club of Temecula is committed to providing food boxes benefiting over 200 Temecula Valley Unified School District low-income students/fa milies equivalent to 600 residents, Residents are supplied with canned goods, staples, and proteins to promote community members' wellbeing during the cold winter months. Thank you.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment* EXPENSES*
Tools $0.00
Facilities/Re ntli ns u ra nce *
Rent $0.00
Supplies*
Supplies
$0.00
Marketing*
Marketing
$0.00
Services*
Services
$0.00
Food*
Food that needs to be purchased (turkeys, hams, potatoes) $35,000.00 Other*
Volunteer hours $25,000.00
Staffing Expense
$0.00
TOTAL REVENUE: TOTAL EXPENSES
$60,0GO.00 $60,000.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: *
Rotary Club of Temecula
PresidentlAuthorized Officer:* E-mail:*
Shane Lesovsky _
Name & Title
PresidentlAuthorized Officer Signature*
Requested Amount:
$5,000.00
Date Time
2023-08-29
IF DIFFERENT THAN ABOVE, APPICATION PREPARE❑ BY:

Name, Title, & Organization
If you have any questions, please contact:

Phone:*
Betsy.Lowrey@Ternecu[aCA.gov (951) 69 3-395 9 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 8/22/2023
ESL ID: 6594743071
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: 0776714
Entity Name; ROTARY CLUB OF TEMECULA. INC.

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) Secuon 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.

FY 2023-24 Community Service Funding (CSF) Grant
Applications
31 SAFE FAMILY JUSTICE CENTERS

Community Service Funding Application
a �
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Conform
Applicant Organization Year Organization Website:

Name: Founded: www.safefjc.org
SAFE FamilyJustice Centers 1998
Mailing Address: * Number of Paid Staff:* Number of Volunteers:* 28910 Pujol St. Temecula CA 92S90 28 10
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Marshall Hamilton, Supervising marshal Ihamilton@safefamiliesca.

Family Specialist
Does the nonprofit have a current City of Geographic Area(s) the Organization Serves:* Temecula Business License? County of Riverside
(Temecula/Murrieta/Riverside/l ndio)
A current City of Temecula Business
License may be required to submit prior to
fund disbursement.

Understand
Geographic Area(s) the Project/Program
Serves:

City of Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:'
s5,000.00 Temecula SAFE Families
MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program * 2023-10-01 2024-09-30 28910 Pujol St. Temecula CA 92590 Preferred Payment Method:
(If grant is awarded.)
Check Mailed Check Picked Up
Electronic File Transfer
Make Check Payable to:*
SAFE Family Justice Centers

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS Deductibility Status
State of California Entity ID:*
2041277
To find CA Entity Status Letter,
click the link below:
https://www.ftb.ca.goWhelp/business/entity-
status-letter.asp?1NT.mc_id=akBEStatus
IRS Employer Identification Number (EIN):
19-9162947
To find IRS Deductibility Status,
click the link below:
https:t/apps.irs.gov/app/eos/
Date of Incorporation:
07/08/2024
Attach State of California Entity Status Letter:*
CA Business Entity.JPG
Attach IRS Deductibility Status:*
IRS Letter (2).pdf
Provide further verification as follows:
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (link below) Attach First Page of Most Recent Form 990*

90.75KB
587.54KB
You might find IRS Form 990 2022 990 (2).pdf 1.15MB

on the link below: (990, 990-EZ, 990-PF, 990 T)
https:llrct.doj.ca.govNerification/Web/Sea rch.aspx?
fadlity_Y
State Registry Search Tool: Attach State Registry Document/Info* https://rct.doj.ca.govNerification/Web/Search.aspx ? 5tate.pdf 322.94K8 facility=Y

Mission Statement
Briefly describe the nonprofit orga n ization's missionfgoaIs and objectives:' SAFE Familyjustice Centers provides services for children, youth, and families Who have experienced or are at -risk of abuse and violence. We provide emergency and case management assistance to the individuals that we serve to help them become safe, stable, and free from abuse.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
le I -

NAM E OF PROGRAM/PROJECT

FUNDED BY THE CITY GRANT
OR SPONSORSHIP *
CDBG Funding
AMOUNT:*
$7,000.00
MONTH + YEAR FUNDING
RECEIVED*
July 2023

NAME OF CITY GRANT OR

SPONSORSHIP
City of Temecula

Project/Program Description
RECEIPTSfINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE x

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. ldaIstand
ProjectProgram Tale: Temecula SAFE Families

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.* Temecula SAFE Families is a stability program for individuals who have experienced violence. SAFE FJC provides comprehensive services to adults and children following abuse, these individuals need help with counseling, orientation to county and criminal justice systems, housing, transportation, and access to basic needs. This grant will allow for us serve individuals who have experienced violence in Temecula.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED." ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

Emergency and basic needs items for clients experiencing abuse. Assistance will be provided to help adults and children with grocery, gas, hotel, and transportation assistance. Clients will be provided with gift cards from large retail companies (walmart, gas cards, lyft, etc.) to meet this need,

3.'EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

Following violence; adults and children who are often left displaced and without resources. SAFE FJC will be able to provide services for victims that reside in Temecula that are much needed such as food, clothing, gas, and other basic needs while receiving assistance with safety planning, education, case management, court accompaniment, therapy, and crisis intervention. SAFE FJC seeks to reduce the effects of trauma on our Temecula residents.
3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
75 3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECT/PROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.* Grant funds will assist SAFE FJC in providing comprehensive services to Temecula residents who experience abuse and are in need of help with basic needs, safety, and crisis services.

Project/Program Budget

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount requested from this City of Temecula Community Services Grant Amount contributed to the Project/Program by the Applicant Organization Other grants or funding already awarded for Project/Program, if any COBG Temecula
In -Kind match amount or volunteer credit hours estimated amount

LIST OF EXPENSES FOR PROJECT/PROGRAM
ToolslEquipment*
Company Owned Equipment
Fac Iities1Rent/Insurance*
City of Temecula sponsors building
Supplies*
Gift Cards for basic needs
Marketing
NIA
Services*
Services to victims are free
Food*
NIA
Other*
N/A..

Staffing Expense
TOTAL R��'yyEVEN UE;
say, 7i�{] OO

TOTAL EXPENSES
$10,00 o)a
REVENUES*
$5,000.00
Refer to Page 2
$7,000.00
$73,008.00
EXPENSES*
$0.00
*
$0.00
*
$10,000.00
*
$0.00
*
$0.00
*
$0.00
$0.00
*
$49,920.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: Requested Amount:

SAFE FamiiyJustice Centers $5,000.00
PresidentlAuthorized Officer:* E-mail:* Phone:*
Adriana Moreno, CEO adrianamoreno@safefamilies. _
Name & Title
PresidentlAuthorized Officer Signature* Date
2023-09-12
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Marshall Hamilton, Supervisor & SAFE Family Justice Centers Name, Title, & Organization
If you have any questions, please contact: [email protected] (951) 693-3959 or [email protected] (951) 694-6413

Search in document
Temecula
1 /1
SAFE Family Justice Centers CA FTB Entity Status Letter Rme's(
certificate
Fit windc v
intronl Fohng Cate
12/1W1998
Sratus
Active
Standing - SOS
Good
Standing - FTQ
Good
Standing - Agenr
Good
Standing -VCFCF
Good
Formed to

CALIFORNIA
Errrity Type
Nonprofit Corporauon - CA
Public Benefit
Prlmcrpa)Address
28910 PUJOL STREET
TEMECULA, CA9259D
Mailing
28910 PUJOL STREET
TE MEC U LA. CA92590
Storeme,nt of Info
12/31 /20,24
Due Dare
Ageor
Individual
Katie Gilbertson
28910 PLJOL STREET
TEMECULA, CA 9259`'
View plain text

STATE OF CALIFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 10/2/2023
ESL ID: 3759953994
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:

Entity Name: SAFE FAMILY JUSTICE CENTERS
✓❑

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.

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).

State of California
Department of Justice
Office of the
Attorney General
SERVICE DISRUPTION - Site will be unavailable intermittently from Wednesday September lath, 2023 6:15 PM to Thursday September 21 st. 6:00 AM
type:Registrant Details
Entity / // ' / ' / with the Secretary of State or based on founding & registrationdocuments- Organization Name: SAFE FAMILY JUSTICE CENTERS IRS FEIti: 911962947 Entity Type: Public Benefit SOS/FTB Corporate/Organization Number: 2041277 Registry Status: Current
RCT Registration Number: 111953
Record Type: Charity Registration
Date of Last Renewal: 81/10. 2023
■
Street:

Street Line 2:

City, State Zip:

Filings
Explanations For Yes Answers
Renewal Due/Exp. Date:

Issue Date:

Effective Date:

DBA:
! Address
28910 PUJOL STREET
TEMECULA CA 92590
Correspondence
2022
2/15/2024
9/30/2006
9/30/2006

SAFE FAMILY JUSTICE CENTERS
IRS Form 990 Series
2022
Online Renewal Submission
2022
Form RRF-1
2022
Renewal Filing
2021
Renewal Filing
2020
IRS Form 990 Series
2019
Renewal Filing
2019.

Form RRF-1
2019
Renewal Filing
2018
IRS Form 990 Series
2017
CT-550 Form RRF-1 Incomplete
2017
CT-550 Form RRF-1 Incomplete
2017
Renewal Filing
2017
2016 IRS Form 990 Series
2016 IRS Form 990 Series
2016 Form RRF-1
2016 Form RRF-1
2015 RRF-1
2015 RRF-1
2015 IRS Form 990
2015 IRS Form 990
RRF-1 2014
2014 RRF-1
IRS Form 990 2014
2014 IRS Form 990
RRF-1 2013
2013 RRF-1
IRS Form 990 2013
2013 IRS Form 990

RRF-1 2012
2012 RRF-1
IRS Form 990 2012
2012 IRS Farm 990
RRF-1 2011
2011 RRF-1
IRS Form 990 2011
2011 IRS Form 990
RRF-1 2010
2010 RRF-1
IRS Fomi 990 2010
2010 IRS Form 990
RRF-1 2009
2009 RRF-1
IRS Form 990-EZ 2009
2009 IRS Farm 990-EZ
Annual
Renewal
■ r
Status of Filing:

Accepted
Accounting Period Begin Date:
10/112009
Accounting Period End Date:
9/30/2010
Filing Received Date:
5/12/2011
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:
10/1/2010
Accounting Period End Date:
9/30/2011
Filing Received Date:
3130/2012
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:
101112011
Accounting Period End Date:
9/30/2012
Filing Received Date:
4/18/2013
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:
10l1/2012
Accounting Period End hate:
913012013
Filing Received Date:
5/19/2014
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Rejectllncomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
10/1/2013
Accounting Period End Date:
9 3012014
Filing Received Date:
5,18/2015
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:
101 2014
Accounting Period End Date:
9: 30 2015
Filing Received Date:
5r 16:2016
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Rejectllucomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

:NTERNAL REVENUE SERVICE

DISTRICT DIRECTOR
P. O. BOX 2508
CINCINNATI, OR 45201
Date:

SAFE ALTERNATIVES

C/O ALICEN WONG
PO BOX 1070
DEPARTMENT OF ': MR TREASURY
Employer Identification Number:
91-1962947
DLN ;
17053120023019
FOR EVERYONE INC Contact Person:

MURRIETA, CA 92564
Dear- Applicant:

REBECCA S BOWDEN 1D# 31183
Contact Telephone Number:
(677) 829-5500
Accounting Period Ending;
September 30
Foundation status Classification:

S09(a) (l)
Advance Ruling Period Begins:

December 10, 1998
Advance Ruling Period Ends;
September 30, 2003
Addendum Applies:

No
Based on information you supplied, and assuming your operations will be as stated in your application for recognition of exemption, we have determined you are exempt from federal income tax under section 501(a) of the Internal Revenue Code as an organization described in section 501(c) 0).

Because you are a newly created organization, we are not now making a final determination of your foundation status under section 509(a) of the Cade.

However, we have determined that you: can reasonably expect to be a publicly supported organization described to sections 509(a)(1) and 170(b)(1)(A)(v).

Accordingly, during an advance ruling period you will be treated as a publicly supportedorganization, and not a9 a private foundation. This advance ruling period begins and ends on the dates shown above.

Within �O daR�4 after the end of your advance ruling period, you must send us the information needed to determine whether you have met the require- ments of the applicable support test during the advance ruling period. If you establish that you have been a publicly supported organization, we will classi- fy you as a section 509(a)(1) or 509(a)(2) organization as long as you continue to meet the requirements of the applicable support test. If you do not meet the public support requirements during the advance ruling period, we will classify you as a private foundation for future periods. Also, if we classify you as a private foundation, we will treat you as a Private foundatiorx from your beginning date for purposes of section 507(d) and 4940.

Grantors and contributors may rely on our determination that you are not a private foundation until 90 days after the end of your advance ruling periD;i If you send us the required information within the 90 days, grantors and contributors may continue to rely on the advance determination until we make a final determination of your foundation status.
1E we publish a notice in the Internal Revenue Bulletin stating that we Letter 1045 (DO/CG)

INTERNAL REVENUE SERVICE
P. O. Box 2508
CINCINNATI, OH 45201
Date: DEC 3 0 2003
SAFE ALTERNATIVES FOR EVERYONE 114C
30520 RANCHO CALIFORNIA RD 107
TEMECULA, CA 92591-0000
Dear Applicant:

DEPARTMENT OF THE TREASURY
Employer Identification Number:
91-1962947
DLN :
17053291735043
Contact Person:

I{AREN CHAO IV# 31003
Contact Telephone Number:
(877) 829-5500
Public Charity Status:
170 (b) (1) (A) (vi)
Our letter dated May 1999, stated you would be exempt from Federal income tax under section 501(c)(3) of the Internal Revenue Code, and you would be treated as a public charity during an advance ruling period.

Based on our records and on the information you submitted, we are pleased to confirm that you are exempt under section 501(c)(3) of the Code, and you are classified as a public charity under the Code section listed in the heading of this letter.

Publication 557, Tax -Exempt Status for Your Organization, provides detailed information about your rights and responsibilities as an exempt organization.

You may request a copy by calling the tall -free number for forms, (800) 829-3676. Information is also available on our Internet Web Site at www.irs.gov .

If you have general questions about exempt organizations, please call our tall -free number shown in the heading between 8:00 a.m. - 6:30 p.m. Eastern time.

Please keep this letter in your permanent records.

Sincerely yours,
Lois G. Lerner
Director, Exempt Organizations
Rulings and Agreements
Letter 1050 (DO/CG)

FY 23/24 Community Service Funding (CSF) Grant
Application
32 SMILES BY ANGELS FOUNDATION

Ift
Community Service Funding Application
IN
�R
(T 11, o� .�_i.r Fi:.. -C I I I:.-
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Confirm
Applicant Organization
Name:

Smiles By Angels Foundation
Mailing Address: *
* Year Organization
Founded:
2019
* Website:
littps:llsm i Iesbya ngel s.o rgl
Number of Paid Staff: * Number of Volunteers:
0 30
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Luis Peralta
Does the nonprofit have a current City of * Geographic Area(s) the Organization Serves:* Temecula Business License? Riverside, LA, San Bernardino Counties Yes No
A current City of Temecula Business
License may be required to submit prior to
fund disbursement.

Understand
Project/Program
Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Amount Requested:* Project/Program Title:*
$5,000.00 Temecula Smiles
MAX: $5,000 PER DRG
Start Date:* End date: * Physical Address of Project/Program* 2023-08-01 2024-12-31 42248 Via Nortada, Temecula, CA 92590 Preferred Payment Method: Make Check Payable to:*
(If grant is awarded.) Smiles By Angels Foundation

Check Mailed Check Packed Up
Electronic File Transfer
Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes Na

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS deductibility Status
State of California Entity I0:*
4287742
To find CA Entity Status Letter,
click the link below:.
http s://www.ft b. ca.gGv/h e I p Ib u s i n ess/e nt ity- status-Ietter.asp7wT.mc_id=a kBEStatus
IRS Employer Identification Number (EiN): *
8419`}1401
To find IRS Deductibility Status,
click the link below:
https.//app!s.irs.gov/app/eos/
Date of Incorporation:*
Attach State of California Entity Status Letter:*
FTB exemption letter.pdf
Attach IRS Deductibility Status:*
IRS determination letter.pdf
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 994
Detailed info about your charity found on the State Registry Search Tool (link below) You might find IRS Form 990
Attach First Page of Most Recent Form 990 *
990-N 2022.pdf
on the link below: (990, 990-EZ, 990-PF, 990-T)
370.1 KB
423.54KB
8011K8

https://rct.d oj,ca.govIVe ri f icat i o n /We b/Sea rc h, a s px? faciliity Y
State Registry Search Tool:
https:/Irct.doj. ca.govNerification/Web/Search.aspx?
facility=Y
Application Authorization
Attach State Registry Documentllnfo*
Proof of Registration & Active Status with the CA Attorney 181.573fB
General's Office 7-27-23,pf d
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?
Yes No
Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization?
Yes No
This Application has been authorized by the organization's:* Executive Committee Board of Directors Members -at -Larne Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* Smiles By Angels is a nonprofit organization dedicated to providing books to underserved children in hospitals, foster care, and various communities. Our mission Is to empowerthese disadvantaged and underserved children by promoting literary, inspiring hope, strength, and joy through the gift of reading. By giving children access to books, we not only put smiles on their faces but also help improve their literacy skills, reduce their stress, and transport there to different worlds through the power of storytelling.

We 'believe that literacy Is a fundamental right and an essential toot for personal growth, education, and success in life. By providing books to children facing difficult circumstances, we aim to create positive changes and foster a love for reading that will stay with them throughout their lives,
Our vision is to create a world where every child, regardless of their background or circumstances, has access to books and the opportunity to improve their literacy skills. We envision a society where the gift of reading not only brings smiles to children's faces but also opens doors to brighter futures, better education, and improved well-being.

A grant will enable us to reach a larger number of underserved children in hospitals, foster care, and other communities, By partnering with institutions like Riverside County Hospital, Oak Grove Center, Brandywood Foundation, and others, we will distribute age -appropriate books to children who need them the most.

We aim to enhance literacy rates by encouraging children to read and fostering a love for books. Studies have shown that reading to hospitalized children can reduce pain and stress, which can have a positive impact on their overall well-being.

Improved literacy can lead to bettered ucational outcomes and increased opportunities for success

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 TO DEMONSTRATE SOUND FINANCIAL MANAGEMENT. DO NOT SUBMIT NOW. Understand

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
Yes Nc
Project/Program description

RECEIPTVINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PROJECTIPROGRAM AS DESCRIBED HERE. Uflderstand
ProjectlProgram Title: Temecula Smiles

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.* In our pursuit to empower communities and organizations to inspire hope, strength, and joy in disadvantaged and underserved children through literacy, we have outlined the following success criteria and measurable outcomes.

Short-term Success Criteria:

1. Book Distribution: Distribute 1,000 new books to hospitalized children, foster care homes, and other communities in Temecula by the end of 2024.

2. Community Participation: Engage 50 new individuals or families in book donation drives within the next 6 months. 3, Partnerships: Establish partnerships with 3 more foster care homes to extend our reach.

Long-term Success Criteria:.

I . Literacy Rate Improvement: Over the next 3 years, contribute towards improving literacy rates in the communities we serve, as measured by local education authorities.
2, Continued Community Involvement: increase community participation in our initiatives by 25% annually for the next 3 years.

3. Sustained Partnership: Maintain enduring partnerships with hospitals, foster care homes and other community organizations, with a minimum of onejoint activity per quarter.

Measurable Outcomes:

I , Book Distribution: Track the number of books distributed to children in need. This not only encourages literacy but also brings joy and reduces stress as per research findings.

2. Donation Drives: Measure the success and growth of donation drives by tracking the number of books donated and the number of donors participating.

3. Partnerships: Keep a record of new partnerships established and joint activities undertaken with partner organizations.

4. Community Engagement: Monitor the number of families and individuals participating In our book shopping, sorting, and packing activities.. 5, Literacy Improvement: Work closely with local education authorities and partner organizations to measure improvements in literacy rates in our target communities.

By meeting these goads, we move closer to ensuring no child is underserved when it comes to literacy.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.

ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

The grant funds will be utilized to procure 1,000 books to be distributed to Temecula children that use an existing or new partnership with hospitals, foster care organizations, and other communities.

3. EXPLAIN IHOW MS GRAFT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.*

TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING, The books will be distributed only to Temecula -based children. 3b. ESTIMATED NUMBER OF PEOPLE FROM 3c. ESTIMATED NUMBER OF VOLUNTEERS TEMECULA EXPECTED TO BENEFIT FROM INVOLVED IN THIS PROJECT/PROGRAM:

THIS PROJECTIPROGRAM: 310
1,000

4. SUMMARY STATEMENT— SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.* Book Distribution: Distribute 1,000 new books to hosprtaiized children, foster care homes, and other communities in Temecula by the end of 2024.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment* EXPENSES*
'%Ics e $0.00
Facilities/Rentli ns u ra nce *
None $0.00
Supplies*
^J o,i e
Marketing*
None $0.00
Services*
None $0.00

TOTAL EXPENSES
$5,000.00
$5,000.00
$0.00
If your organization is awarded a Community Service Funding Grant in Fiscal Year 2023-2024 by the City of Temecula, all grant funds received must be expended anytime on or between July 1, 2023, and June 30, 2024.

In addition, all grant funds must be substantiated with proper back-up documentation. Failure to provide proper documentation mayjeopardize 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 are not spent in accordance with the approved purpose stated on the Application, the organization will be required to refund the amount of funds.

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
confirm
Acknowledgement/Signature
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 66 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 in a previous fiscal year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete.

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

Name of Applicant Organization:

Smiles By Angels Foundation
President/Authorized Officer:* E-mai(:`
Luis Peralta - President
Name & Title
President/Authorized Officer Signature*
elv rF -) ?'fl'%
Requested Amount:
$5,000.00
Date Time
2023-07-28
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Name, Title, & Organization
If you have any questions, please contact.,
[email protected] (951) 693-3959 or
[email protected] (951) 694-6413
Phone:'

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 5/19/2023
ESL ID: 7968348452
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: 4287742
Entity Name; SMILES BY ANGELS 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.

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.

INTERNAL REVENUE SERVICE
P. A. BOX 2508
CINCINNATI, CH 45201
Date. JUN 1 8 2020

SMILES BY ANGELS FOUNDATION

CIO LUIS PERALTA
925 STH PLACE
HERMOSA BEACH, CA 90254-0000
Dear Applicant:

DEPARTMENT OF THE TREASURY
Employer Identification Number:
84-1991401
DLN:
26053561001600
Contact Person:

CUSTOMER SERVICE ID# 31954
Contact Telephone Number:
(877) 829-5500
Accounting Period Ending:

December 31
Public Charity Status:
509(a)(2)
Form 990/990-EZ/990-N Required:

Yes
Effective Date of Exemption:

June 7, 2020
Contribution Deductibility:

Yes
Addendum Applies:

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

Letter 947

-2-

SMILES BY ANGELS FOUNDATION
Sincerely,
Director, Exempt Organizations
Rulings and Agreements
Letter 947

HOME ABOUT MEDIA CAREERS REGUI-Ai ION'-, RESOURCES F'ROGF AKA C:ONIAC'i Registrant Details
Entity type: Corporate Class as registered with the Secretary of State or bused on founding & registration documents.

Organization Name: SMILES BYANGELS FOUNDATION IRSFEIN: 841991401 Entity Type: PLiblic Benefit SOSIFTB CorporatelOrganlzatlon Number: 4287742 Registry Status: Current Renewal Due/Exp. Date: 5/15/2024 RCT Registration Number: CT0280096 Issue Date: 7/8/2022 Record Type: Charity Registration Effective Date: 71812022 Date of Last Renewal: 3/15/2023 DBA:

Mailing Address
Street:

Street Line 2:

City, State Zip: TEMECULA CA 92590
Filings & Correspondence
Farm CT--TR-1 2022
Online Renewal Submission 2022
Renewal Filing 2021
Renewal Filing 2020
Form RRF-1 2019
Founding Documents Click on Document Type at the lets: to open PDF CT 451C 1st Delinquency Notice Click on Document Type at the left to open PDF Annual Renewal Data
Status of Filing: Acceptod
Accounting Period Begin Date: II112019
Accounting Period End Date: 12/31/2019
Filing Received Date: 7/25/2022
Form RRF- I Rejectllncomplete Reason
Form CT TR-1 Relectflncomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepter]
Accounting Period Begin Date:
1/1/2020
Accounting Period End Date:
12/31/2020
Filing Received Date:
7/25/2022
Form RRF- I Reject/Incomplete Reason:

Form C.T TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Acc owrting Period Begin Date:

I / I /2021
Accounting Period End Date:
12/3 1/2021
Filing Received Date:
7/25/2022
Form RRF- I Reject/Incomplete Reaso►>:

Form CT-TR-I Rejectllncomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Status of Filing:

C-Acccptcd
Accounting Period Begin Date:

I! I/2022
Accounting Period End Date:
12/31/2022
Filing Received Date:
3/ 11 /2023
Form RRF- I Reject/incomplete Reason:

Form CT TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Related Registrations
& Event Reports
The related rwrords shown below depend on
the record type being viewed
Charity Registrations relate to Profes.:ional FundralKing Event:; which relate to Professional Fundrais;er Re�rlstratlons.

Raffle Registrations Mate to Raffle Report=.

Clint+ on the RCT Registration No to navigate to the related record No Related Records

Form990-N Electronic Notice (e-Postcard) OMB No 1545-2085 Department of the Treasury for Tax -Exempt Organization not Required to File Form 990 or 990-E2 �©�� Inlemal Revenue Service
D en to Public In ion
A For the 2022 Calendar year. or tax year beginning 2022-01-Oland ending 2022-12-31 B Check if available C Name of Organization. SMILES BY ANGELS FOUNDATION D Employee Identification f _ Terminated for Business Number 84-1991401
Q Gro" receipts are normally 150.000 or less emecula, CA, US.. 9M E Website F Name of Principal Officer Imes Peralts
Temecula. CA US, 92590
Privacy Act and Paperwork Reduction Act Notice: We ask for the information on this form to carry out the Internal Revenue taws of the United States You are required to give us the information We need It to ensure that you are complying with these laws The organization is not required to provide information requested on a form that Is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law The rulas governing the confidentiality of the Form 990-N is covered in code section 6104 The time needed to complete and file this farm and related schedules will vary depending on the individual circumstances. The estimated average times is 15 minutes.

Note: This image is provided for your records only. Do Not mail this page to the IRS. The IRS will not accept this filing via paper. You must file your Form 990-N (e-Postcard) electronically.

FY 23/24 Community Service Funding (CSF) Grant
Application
33 SOUTHWEST WOMEN'S CHORUS

r Community Service Funding Application
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Confirm
Applicant Organization Year Organization Website:

Name: Founded: www.southwestwomenschorus.org
Southwest Women's Choru 2004
Mailing Address:* Number of Paid Staff: Number of Volunteers:* [email protected]� 2 50
Contact Name &Title: * Contact's Email: * Contact's Phone Number:

Dolly Nickerson president@southwestwomenschr_)i
Does the nonprofit have a current City of
Temecula Business License?
Yes No
Business License No.*
QS51S4
Copy of Business License's
City of Temecula PL 055154.pdf 95.54KB
https://css.temeculaca.gov
Geographic Area(s) the Organization Serves:

Temecula, Murrieta, Wildomar, Lake Elsinore,
Hemet, Menifee
Geographic Area(s) the Project/Program
Serves:

Temecula School District

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:*
$ 5, 000.00
MAX: $5,000 PER ORG
Start Date:`
2024-05-04
Project/Program Title:*
Southwest Women's Chorus 2nd Annual Invitational Choir
End Date:*
2024-05-OS
Preferred Payment Method:
(if grant is awarded.)
Check Mailed Check Picked Up
Electronic File Transfer
Physical Address of Project/Program'
42051 Main St, Temecula, CA, Seminar Venue TBD
Make Check Payable to: x
Southwest Women's Chorus

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNDING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS Deductibility Status
IRS Employer Identification Number (EIN):
20-1694150
To find IRS Deductibility Status,
click the link below:
https://apps.irs.gov/appleosl
Provide further verification as follows:*
Date of Incorporation:
07/20/2004
Attach IRS Deductibility Status:*
Publication 78.pdf
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (link below) Attach First Page of Most Recent Form 990*
You might find IRS Form 990 swc tax,jpeg
on the link below: , •• -
http s:I1 rct. d of .ca.govNe ri f icat i o nlwe b/Sea rc h . a s px? facility=Y
(990, 990-EZ, 990-PF, 990-T)

48.47KS

45.97K8

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objecti►res:

Southwest Women's Chorus` mission is to provide women who dove to sing with the experience of performing quality choral music while empowering them through artistic growth, camaraderie, and community involvement.

Our goal is to "build community through song". We participate in community events and hold performances at a wine variety of Temecula venues. We encourage participation by a vast age group from young singers just out of high school up to and including retirees,

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
NAME of PROGRAM/PROJECT

FUNDED BY THE CITY GRANT
OR SPONSORSHIP *
Empowering Young
Women - Find your
Voice through Song
AMOUNT,*
$5,000.00
MONTH + YEAR FUNDING
RECEIVED*
05/2023
NAME ❑F CITY GRANT OR

SPONSORSHIP
Investing in Temecula
Grant

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
Project/Program Title: Southwest Women's Chorus 2nd Annual Invitational Choir

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT' Southwest Women's Chorus - Second Annual Invitational Choir (Formerly Empowering Young Women - Find Your Voice through Song). A two day event for youth ages 12-18 will occur on May 4th & Sth, 2023 consisting of a learning event and subsequent performance at the theater. Our goal is to encourage participation) in organized singing groups in middle school, high school, and beyond.

The first day of the event is a one day seminar conducted by the Southwest Women's Chorus' members and directors. Curriculum will include warm up exercises, sight reading, how to practice and learn a musical number, performance techniques, and teamwork within the framework of a choir will be taught.

Three songs will be learned during the seminar on May 4th culminating in a performance with the Southwest Women's Chorus at the Old Town Temecula Theater on May 5th.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.' ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

Southwest Women's Chorus will use the funds for the following items:
--Rental of seminar venue
--Sheet music
--Meals for participants (breakfast and lunch)
--Miscellaneous office supplies
--Publicity for event
--Rental of performance venue

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA RESIDENTS IVIUST BENEFIT FROM THIS PROGRA.i I/PROJECT IF AWARDED CITY FUNDING.

There are approximately 20 middle schools, high schools, and charter schools in Temecula. In addition, there are home schooled youth who do not have access to in -school vocal music programs. Southwest Women's Chorus will publicize the event to all young people (boys and girls) ages 12-18 in the Temecula area to illustrate the benefit and joy of singing music in a group setting.

If awarded the grant, we will offer this seminar only to Temecula School district students. 3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
0 3c. ESTIMATED NUMBER OF VOLUNTEERS
INVOLVED IN THIS PROJECTIPROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.* Southwest Women's Chorus will conduct a one day seminar for young people age 1 2-18 teaching vocal performance in a group setting. The goal is to encourage young people to get involved in music during middle school and high school. The selected participants will perform three songs with the SWC at our musical performance at the theater on May 5th.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment* EXPENSES"
Rental of lights, microphones,etc $500.00
Facilities/Rentflnsurance *
OTTCT, Seminarvenue, Insurance $1,000.00
Supplies*
Handouts, ❑irections, Folders, paper, ink $750.00
Marketing*
Newspapers, Online Ads $750.00
Services*
Printing services, souvenir programs commemorating participation $500.00 Food*
Breakfast and Lunch $750.00
Other*
Music, T-Shirts, Name Tags $750.00
Staffing Expense
$1,000.00

TOTAL REVENUE TOTAL EXPENSES
$5, 00J0.00 $ 5,0 00_OD,

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: Requested Amount:

Southwest Women"s Choru $5,000.00
PresidentlAuthorized Officer:* E-mail:* Phone:*
Darlene [Dolly] Nickerson, President President@southwestwomen: - Name & Title
PresidentlAuthorized Officer Signature* Date
2023-09-12
IF DIFFERENT THAN ABOVE, APPIGATION PREPARED BY:

Name, Title, & Organization
If you have any questions, please contact. [email protected] (951) 693-3959 or [email protected] (951) 694-6413

9112/23 7 43 Ph9
Tax Exempt Organization Search Details I lntemal Revenue Service Southwest Womens Chorus
EIN: 20-1694150 J Murrieta. California, United States
Publication 78 Data
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
https://apps.irs.gov/app"eosidetaiis/ 10 1

�1
IZ-va� b y izS 4D

INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY
P. 0. BOX 2508
CINCINNATI, OH 45201
Employer Identification Number:

Date: DEC 10 2004
20-1694150
DLN:
17053307058034

SOUTHWEST WOMENS CHORUS
Contact Person:

C/O WILLIAM PAISNER
ERIC J BERTELSEN ID# 31323
Contact Telephone Number:

TEMECULA, CA 92591-1739
(877) 829-5500
Accounting Period Ending:

June 30
Public Charity Status:
509 (a) (2)
Form 990 Required:

Yes
Effective Date of Exemption:

July 23, 2004
Contribution Deductibility:

Yes
Advance Ruling Ending Date:

June 30, 2009
Dear Applicant:

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. During your advance ruling period, you will be treated as a public charity. Your advance ruling period begins with the effective date of your exemption and ends with advance ruling ending date shown in the heading of the letter.

Shortly before the end of your advance ruling period, we will send you Form 8734, Support Schedule for Advance Ruling Period. You will have 90 days after the end of your advance ruling period to return the completed form. We will then notify you, in writing, about your public charity status.

Please see enclosed Information for Exempt Organizations Under Section 501(c)(3) for some helpful information about your responsibilities as an exempt organization.

Letter 1045 (DO/CG)

-2-

SOUTHWEST WOMENS CHORUS
Sincerely,
Lois G Lerner
Director, Exempt Organizations
Rulings and Agreements
Enclosures: Information for Organizations Exempt Under Section 501(c)(3) Addendum
Letter 1045 (DO/C©)

STATE OF CALIFORNIA
p FRANCHISE TAX BOARD
�pPO BOA 942857
SA
� SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 9/5/2022
ESL ID: 2162142712
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: 2670632
Entity Name: SOUTHWEST WOMEN'S CHORUS
® 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.

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: 1711 or 800-735-2929 (For persons with hearing or speech impairments) FTB 4263A WEB (REV 12-2019)

iuII IN 111111111 IN 11111111 INN 11111 N111111111111111 BA20220591819
r.

STATE OF CALIFORNIA
Office of the Secretary of State
s =

STATEMENT OF INFORMATION

CA NONPROFIT CORPORATION
California Secretary of State
1500 filth Street
Sacramento, California 95814
(916) 653-3516
For Office Use Only
-FILED -
File No.: BA20220591819
Date Filed: 7/29/2022
Entity Details
Corporation Name SOUTHWEST WOMEN'S CHORUS
Entity No. 2670632
Formed In CALIFORNIA
Street Address of California Principal Office of Corporation Street Address of California Office
Mailing Address of Corporation
Mailing Address
Attention
I Officers
42051 MAIN ST.

TEMECULA, CA 92590

MURRIETA
TEMECULA, CA 92562
Dolly Nickerson
Officer Name
Officer Address
Position(s)
0 Darlene Nickerson
Chief Executive Officer
MURRIETA, CA 92562
0 Kiya Maxwell
Secretary
TEMECULA, CA 92592
0 Rhonda Maxwell
Chief Financial Officer
MURRIETA, CA 92562
Additional Officers
Officer Name
Officer Address
Position
Stated Position
0 Marion Miller
42200 MAIN ST.

Vice President
#139
TEMECULA, CA 92590
Agent for Service of Process
Agent Name
Agent Address
Darlene Nickerson
MURRIETA, CA 92562
Email Notifications
Opt -in Email Notifications Yes, I opt -in to receive entity notifications via email.

Electronic Signature
0 By signing, I affirm that the information herein is true and correct and that I am authorized by California law to sign.

Sara L Giampiccolo
Signature
0712912022
pans 1 Af

HOME ABOUT MEDIA CAREERS REGULATIONS RESOURCES PROGRAMS CONTACT Registrant [details
Entity type: Corporate Class as registered with the secretary of State or based on founding & registration documents.

Organization Name: SOUTHWEST WOMEN'S CHORUS IRS FEIN: 201694150 Entity Type: Public Benefit SOS/FTB Corporate/Organization Number: 2670632 Registry Status: Not Registered Renewal Due/Exp. Date:

RCT Registration Number: Issue Date:

Record Type: Charity Registration Effective Date:

Date of Last Renewal: DBA:

Mailing ,Address
Street:

Street Line 2:

City, State Zip: TEMECULA CA 92591
Filings & Correspondence
No Related Documents
Annual Renewai Data
No Annual Renewal Data
.elated Registrations & Event ep o t-
The related records shown below depend on the record type being viewed:
• Charity Registrations relate to Professional Fundraising Events which relate to Professional Fundraiser Registrations, • Raffle Registrations relate to Raffle Reports.
• Click on the RCT Registration No to navigate to the related record.

No Related Records

FY 23/24 Community Service Funding (CSF) Grant
Application
34 SPECIAL OLYMPICS

SOUTHERN CALIFORNIA

INLAND EMPIRE

Aft
Community Service Funding Application
T1,1.,,.

Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
confirm
Applicant Organization Year Organization Website:

Name: Founded: www.sosc.org/inlandempire
Special Olympics Southern 1996
California - Inland Empire
Mailing Address:* Number of Paid Staff:* Number of Volunteers:" 41880 Kalmia Street, Suite 140 7 263
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Brandon Adachi [email protected]
Does the nonprofit have a current City of Geographic Area(s) the Organization Serves:* Temecula Business License"? Riverside and San Bernardino Counties Yes f:e
Business License No.*
054523
Copy of Business License*
City of Temecula Business License - SOSC IE 1.3

1.2024. pdf
https://css,temeculaca.gov
WL"AI M
Geographic Area(s) the P'roject/Program
Serves:

City of Temecula and surrounding communites

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:*
$5,000.00 Special Olympics Southern California - Temecula MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program* 2023-07-01 2024-06-30 Various locations in Temecula
Preferred Payment Method: Make Check Payable to:*
(if grant is awarded.) Special Olympics Southern California Check Mailed Check Picked Up
Electronic File Transfer

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

4. 501(Q3 Affirmation Letter 2023.pdf
Provide further verification as follows: *
(one required, both preferred)
First Page of most recent IRS Form 990
Detaiied info about your charity found on the State Registry Search Tool (fink below) Attach First Page of Most Recent Form 990"
You might find IRS Form 990 2021 SO SC Farm 990 - Page I.pdf on the link below: (990, 990-EZ, 990-PF, 990-T)
https://rct.doj.ca.govNerification/Web/Search.aspx ?
facillty4Y
344.33KB

66.89KS
213.89KB

State Registry Search Tool:

Attach State Registry Document/Info*
https:ffrct.doj.ca.go►rNerification/Web/Search.aspx? CA DO] Registry Details - SOSC 9.2023,pdf 964.BKB facility=Y

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* The mission of Special Olympics Southern California (SOSC) - Temecula Valley is to provide year-round sports training and athletic competition in a variety of Olympic -type sports for children and adults with intellectual disabilities, giving them continuing opportunities to develop physical fitness, demonstrate courage, experience joy and participate in a sharing of gifts, skills and friendship with their families, other Special Olympics athletes and the community.

Special Olympics is faLInded on the belief that all persons with intellectual disabilities can, with proper instruction and encouragement, learn, enjoy, and benefit from participation in individual and team sports. Benefits include increased physical fitness, heightened self-esteem, and increased independence.

In addition, we believe sports can serve as a unifying force to achieve acceptance and inclusion of people with intellectual disabilities within their communities.

SOSC shares the City of Temecula's commitment to foster environments that allow individuals with developmental needs to thrive and reach their full potential. Our ultimate goal is to help persons with intellectual disabilities participate as productive and respected members of society by offering them a fair- opportunity to develop and compete, and by increasing the public's awareness of their capabilities and needs.

The City of Temecula is a valued collaborative partner, promoting our movement of inclusion and acceptance for all in the community as well as providing grant funding to support our programs since 2014. We look forward to continuing this legacy and we are grateful for the support provided by the City.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
ye

NAME OF PROGRAM/PROJECT
FUNDED BY THE CITY GRANT AMOUNT;'
OR SPONSORSHIP"
Special Olympics - $5,000.00
Temecula Program
MONTH + YEAR FUNDING

RECEIVED
January 2023

NAME OF CITY GRANT OR

SPONSORSHIP
CSF
Special Olympics $2,S00.00 ❑ecember 2021 CSF
Sports Programs

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. Uiiderstand
ProjectPrograrn Tale: Special Olympics Southern California - Temecula

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.' Special Olympics enriches the lives of individuals with intellectual disabilities in the Temecula "Valley through the power of sports, education, and by promoting athlete health. Athletes receive weekly sports instruction and training from volunteer coaches during the fall and spring seasons and teams attend local and regional competitions to highlight their- skills. Individuals and teams from Temecula Valley may advance to our chapter -wide Games in June/November depending on how they perform at the regional competitions. Special Olympics World Games (Summer and Winter) are held every four years and are organized by Special Olympics International alongside the Host Chapter.

All services are free for athletes and their families. No one is every turned away because of his or her disability and teams are formed based on age and ability level to create a positive experience for everyone. Through on -going participation in sport, our goal is to encourage healthy habits that will remain with athletes their entire lives.

The Temecula grant funding will provide Special Olympics athletes in Temecula the opportunity to participate in our upcoming Fall and Spring sport trainings and competitions. Sports offered will include Golf, Soccer, Softball, and Tennis in the Fall and Athletics (Track & Field), Basketball, Bocce, and Swimming in the Spring. Also, since the past year was the first year of returning to in -person programming, we did not have the interest in Flag Football. This year, there is interest and we are planning to develop and start a Flag Football program in Temecula.

These programs will provide sport development training free of charge for our ,athletes and families with the support from trained volunteers and funding from community champions like the City of Temecula and the Riverside County Sheriff's Department,

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.*

ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY, The grant funding Will help fund direct program expenses and growth in Temecula including facility rental fees, swimming training service fees, athlete uniforms and equipment for Special Olympics Temecula programs during the Fall 2023 (Golf, Soccer, Softball, and Tennis) and Spring 2024 (Athletics, Basketball, Bocce, Flag Football and Swimming).

After having our first year back to in -person programming in the past few years, our focus will be to grow the our Special Olympics programs in Temecula. Our plans to utilize the funds will help us continue to maintain the quality of sports and training programs for Special Olympics athletes at no cost to the participants,

Athlete Uniforms - are essential so that all of our athletes are united and feel part of a Team at each competition. After each season, there is natural wear and tear wear on uniforms that need replacement.

One of our goals is to increase the number of participants from the past year, so we have budgeted accordingly.

Facilities - funding for facilities is even more essential than ever. We are not able to host quality and safe sports programming without proper facilities for the athletes to train and compete in. Many of the facility sites that used to provide in -kind or discounted rates for us, are no longer able to provide this support because of the impact from the COVID-19 pandemic. Therefore, we understand and anticipate this being one of the highest expenses that Special Olympics Temecula.

Services -Swimming Training Fees (Lifeguards) -After starting and growing a swimming program in Temecula this past year, we anticipate continual growth for this program. In order to be in compliance with swimming facilities and Special Olympics program quality standards, we have to have certified lifeguards at each training and competition.

Equipment - Proper and safe equipment %s an integral part of hosting a quality sports program for our athletes. There is constant wear and tear on sports equipment after each season, so we need to purchase new equipment every season so that athletes are equipped with the right equipment in good condition.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.* TEMECULA, RESIDENT`~ MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

Special Olympics serves children and adults with intellectual disabilities in Temecula programs; athletes live in or within 10 miles of the City of Temecula. Over 80% of our athletes are classified as low-income.

The overwhelming majority of our athletes could not afford the costs associated with participation in sports program if fees were charged. In addition, Special Olympics would not be able to provide our - programs in Temecula at no cost without the commitment and enthusiasm of sports coaches, assistants, and volunteers from the community. We are dependent on volunteer leaders to help us ensure that athletes in Temecula have an opportunity to participate in quality sports training and competition.

Special Olympics has a long, established history in the City of Temecula, where we have served individuals with intellectual disabilities for over fifteen years. Our programs not only provide individuals with intellectual disabilities physical fitness, athletic training and competition, but also social interaction, community involvement, and empowerment.

The current sport offerings combine two very important activities that are key to individual health and well being; physical movement and social interaction. The skills gained through the sports programs translate into other realms of the athletes' lives, and benefits include increased physical fitness, heightened self-esteem, and increased independence. Our goal is to cultivate a love of sports training and competition in every athlete, resulting in a healthier, more active, lifestyle. For some athletes, Special Olympics is their only opportunity to interact in an accepting and inclusive environment.

Lastly, Temecula Valley has a long history of community engagement with Special Olympics, This includes residents volun-eering to coach and train children and adults wit' intellectual d sabil ties, laver enforcement raising funds and awareness through the Law Enforcement Torch Run, local businesses sponsoring events and civic groups staffing competitions. 3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
100
3c. ESTIMATED NUMBER OF VOLUNTEERS
INVOLVED IN THIS PROJECT/PROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.* The City of Temecula Service Funding Grant will be used to support the Special Olympics Temecula Fall and Spring Seasons for individuals with intellectual disabilities. Funds will be used training facility and associated fees, replace worn uniforms and purchase needed sports equipment. Participation in Special Olympics programming improves health and well-being through physical activity and social connection.

Project/Program Budget

LIST REVENUES/INCOME FOR PROJECT/PROGRAM
Amount requested from this City of Temecula Community Services Grant REVENUES* $5,000.00
Refer to Page 2
Amount contributed to the Project/Program by the Applicant Organization $16,790.00
Other grants or funding already awarded for Project/Program, if any $0.00
In -Kind match amount or volunteer credit hours estimated amount $0.00
xRI11111110 2:0511 010641X'1:1i]:a,:if1U IN a110Ie]:7�1AI Tools/Equipment* EXPENSES"
Sports equipment for athletics, basketball, golf, flag football, soccer, $1,450.00 softball, swimming, and tennis
Facilities/Rentllnsurance*
Training facilities - athletics, basketball, golf, flag football, soccer, softball, $5,690.00 swimming, and tennis
Supplies"
Athlete Uniforms - athletics, basketball, golf, flag football, soccer, softball, $4,250.00 swimming, and tennis
Marketing"
None
Services"
Lifeguards for Swimming Training
Food*
None
Other*
Transportation/Mileage ($2025), Games Registration Fees ($5925) *
$&00
$2,450.00
$0.00
*
$7,950.00

Staffing Expense
$0.00
TOTAL REVENUE:

TOTAL EXPENSES
$21,790.00 $21,790.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

Acknowledgement/Signature
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 in a previous fiscal year, then compliance receipts must be submitted on or before this application's due date or this application may be rejected as incomplete.

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

Name of Applicant Organization: *
Special Olympics Southern California - Inland
Empire
PresidentfAuthorized Officer:* E-mail:*
Requested Amount:
$5,000.00
Janet Rose - CFO & Sr. VP [email protected]
Administration
Name & Title
President/Authorized Officer Signature* date
2023-09-12
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Phone:*
Brandon Adachi, Director Foundation Relations, Special Olympics Southern California Name, Title, & Organization

STATE OF CALIFORNIA
'a FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
D ate: 1 f 11 t2022
ESL ID: 6382253959
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: 1898240
Entity Name; SPECIAL OLYMPICS SOUTHERN CALIFORNIA. INC.

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 infonmation about the entity.

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

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
TTYITDD: 800.822.6268 for persons with hearing or speech impairments FTB 4263A WEB (REV 12-2019)

State of California
Department of -Justice
Office of the
rz!•'
Attorney General
Registrant Details
Entity type: Corporate Class as registered with the Secretary of State or based on founding & registration documents.

Organization N ame: SPECIAL OLYMPICS SOUTHERN CALIFORNIA, INC. IRS FEIN: 954538450 Entity I�Te: Public Benefit SOS/FTB Corporate/Organization Number: 1898240 Registry Status:

RCT Registration Number:

Record T�-pe:

Date of Last Renewal:

Street:

Street Line 2:

City, State Zip:

Current Renewal Due/Exp. Date:
100686 Issue Date:

Charity Registration Effective Date:
l li7/2022 DBA:

Mailing
1600 FORBES WAY, SUITE 200
LONG BEACH CA 90810
5/15/2023
12/3112005
12/31/2005
Filings
Return Check Notice 2010
►Correspondence
Return Check Notice 2010
Founding Documents
Founding Documents
Renewal Filing
2021
Renewal Filing
2020
Correspondence from Registry_
2019 Raffle Registration Agreement
Renewal Filing
2019
Renewal Filing
2018
Renewal Filing
2017
2015 RRF-1
2015 RRF-1
2015 IRS Forin 990
2015 IRS Form 990
RRF-1 2014
2014 RRF-1
IRS Form 990 2014
2014 IRS Form 990
RRF-1 2013
2013 RRF-1
IRS Form 990 2013
2013 IRS Farm 990
RRF-1 2012
2012 RRF-1
IRS Form 990 2012
2012 IRS Form 990
RRF-1 2011
2011 RRF-1
IRS Form 990 2011
2011 IRS Form 990
RRF-1 2010
201 a RRF-1
IRS Form 990 2010
2010 IRS Form 990
RRF-1 2009
2009 RRF-1
IRS Form 990 2009
2009 IRS Form 990
RRF-1 2008
2008 RRF-1
IRS Form 990 2008
2008 IRS Form 990

RRF-1 2007
2007 RRF-1
IRS Forte 990 2007
2007 IRS Form 990
RRF-1 2006
2006 RRF-1
IRS Form 990 2006
2006 IRS Farm 990
RRF-1 2005
2005 RRF-1
IRS Form 990 2005
2005 IRS Form 990
RRF-1 2004
2004 RRF-1
IRS Form 990 2004
2004 IRS Form 990
RRF-1 2003
2003 RRF-1
IRS Form 990 2003
2003 IRS Form 990
RRF-1 2002
2002 RRF-1
IRS Form 990 2002
2002 IRS Form 990
RRF-1 2001
2001 RRF-1
IRS Form 990 2001
2001 IRS Form 990
RRF-1 2000
2000 RRF-1
IRS Form 990 2000
2000 IRS Form 990
2016 Form RRF-1
Click on Document Type at the left to open PDF
2016 IRS Form 990 Series
Click on Document Type at the left to open PDF
Annual
Status of Filing:

Accepted
Accounting Period Begin Date:
1/1/2010
Accounting Period End Date:
12/31/2010
Filing Received Date:
1111512011
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:
1/1/2011
Accounting Period End Date:
12131,12011
Filing Received Date:
10l912012
Form RRF-1 Reject4ncomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:
:Votes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
11112012
Accounting Period End Date:
12/31, 2012
Filing Received Date:

Si 14,'2013
Form RRF-1 Rejectllncomplete Reason:

Form CT-TR-1 Reject/lncomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
1'1'2013
Accounting Period End Date:
12 31,'2013
Filing Received Date:
8 11 2014
Form RRF-1 Rejectllncomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

IRSInlerllmesu of the Terri e,
1 ltticru:sl ke►•rtiur Service,
P.O. Box 2508
Cincinnati ❑H 45201

SPECIAL OLYMPICS SOUTHERN

CALIFORNIA INC
1600 F❑RBES WAY STE 200
w LONG BEACH CA 90810-1835
02505E
Employer ID number: 95-4538450
Form 990 required: Yes
Dear Taxpayer:

In reply refer to: 0752251763
Jan. 23, 2023 LTR 4168C 0
95-4538450 000000 Oo
00015905
B❑DC: TE
We're responding to your request dated Jan. 11, 2023, about your tax-exempt status.

We issued you a determination letter in May 1996, recognizing you as tax-exempt under Internal Revenue Code CIRC) 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)CA)(vi).

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 of this letter, 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 990EZ, 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 990-EZ - Form 990-PF, Return of Private Foundation or Section 4947Ca)C1) Trust Treated as Private Foundation
According to IRC Section 6033(j), 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.,

0752251763
Jan. 23, 2023 LTR 4168C 0
95-4538450 000000 00
00015906

SPECIAL OLYMPICS SOUTHERN

CALIFORNIA INC
1600 FORBES WAY STE 200
LONG BEACH CA 90B10-1833
local time, Monday through Friday (Alaska and Hawaii follow Pacific time).

Thank you for your cooperation.

Sincerely yours,
kB
Sheralyn C. Hanks
Ops. Manager, AM Ups. 3005

FY 23/24 Community Service Funding (CSF) Grant
Application
35 SPERO VINEYARDS INC

Community Service Funding Application
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Confirm
Applicant Organization Year Organization Website:

Name: Founders: www.sperovineyards.org
Spero Vineyards Inc. 2014
Mailing Address:* Number of Paid Staff:' Number of Volunteers:* 2076 Lincoln Ave. Pasadena, CA 91103 0 15
Contact Name &Title: * Contact's Email: * Contact's Phone Number:* Mark Woodsmall
Does the nonprofit have a current City of * Geographic Area(s) the Organization Serves:* Temecula Business License? Temecula Wine Country
Yes No
A current City of Temecula Business
License may be required to summit prior to
fund disbursement.

Understand
*
Geographic Area(s) the Project/Program
Serves:

Temecula (in partnership with City of Temecula)

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE
TEMECULA.

Project/Program
Amount Requested:* Project/Program Title:'
$5,000.00 The Spero Project
MAX: $5,000 PER ©RG
Start Date:* End Date:* Physical Address of Project/Program* 2023-09-01 2024-12-31
Preferred Payment Method:
(If grant is awarded.)
Check Mailed Check Picked Up
Electronic Fife Transfer
Temecula, CA 92591
Make Check Payable to:"
Spero Vineyards, Inc.

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS Deductibility Status
State of California Entity ID:*
3647270
To find CA Entity Status Letter,
click the link below:
https://www.ftb.ca.gov/help/business/entity-
statu s-letter.asp?WT.mc_i d=a kB EStatus
IRS Employer Identification plumber (EIN):
46-5288314
To find IRS Deductibility Status,
click the link below:
https://apps.irs.gov/app/eos/
Date of Incorporation:
02/14/2014
Attach State of California Entity Status Letter:*
Entity Status Letter.pdf
Attach IRS Deductibility Status:*
NRS.pdf
Provide further verification as follows:*
(ane required, bath preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (fink below) State Registry search Tool: Attach State Registry Document/Info* 370.08KB
637.22KB
https://rct.doj.ca.govNerification/Web/Search.aspx ? Details.pdf 202.8KB facility=Y

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?
Yes No
Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization?
Yes No
This Application has been authorized by the organization's: * Executive Committee Board of Directors Members -at -Large

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* Spero Vineyards is dedicated to creating meaningful workforce development and training for Our area's young adults with disabilities who have an interest in careers in Temecula's thriving wine and hospitality industries. Students are trained in essential skill areas designed to prepare them to apply for and secure employment in a mainstream work environment.

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
ye

NAME OF PROGRAM/PROJECT

FUNDED BY THE CITY GRANT
OR SPONSORSHIP"
Spero Vineyaf d5' 11 ine
Lab
NIA
AMOUNT:*
$37,000.00
$0.00
MONTH + YEAR FUNDING
RECEIVED*
01 /19/2023
NIA

NAME OF CITY GRANT OR

SPONSORSHIP
CSF Reinvest in
Temecula
NIA

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE PRQJECTIPROGRAM AS DESCRIBED HERE. Understand
ProjectlProgram Title: The Spero Project

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.* The Spero Project, in partnership with the City of Temeccila's Global Citizens program, is a program which students can learn and practice their skills in a hands-on environment on a working vineyard and winery.

Participants receive instruction on the history, science, hospitality, business and marketing, and agriculture aspects of the wine making business. Spero has proudly seared eight annual classes of approximately 15 students each since its founding in 2014. Program alumni also work with current students, creating a cycle of successful outcomes.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.* ALSO, INCLUDE EQUIPNIENT, SERVICES TO BE PURCHASED AND WHY.

The requested funding will expand Spero Vineyards' ability to provide essential training practices. The goal is to develop an extensive "hands-on" environment to kee up with rising water and operational casts. Working together with the City of Temecula's Community in Services Division along with County of Riverside's Community Improvement Designation program, purchased equipment will be used to expanded curriculum offering, including viticulture and hospitality.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS."

TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IP AWARDED CITY FUNDING, Only one-third of young adults with disabilities will attend college after graduating high school. Spero Vineyards focuses primarily on young adults with disabilities between the ages of 16 and 26. Job training and education during this age range is essential for individuals with disabilities to be able to attain employment and set themselves up for success. Though there are resources available through local school districts, many of these programs terminate services to individuals upon graduation or age 22, whichever occurs first. The goal of the program is to bridge the gap between available school district programs and the limited resources available through the Department of 'Rehabilitation. The Spero Vineyards' program will benefit 15-30+ Temecula area students With disabilities, with many more benefiting through volunteer opportunities during harvest season. 3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
3c. ESTIMATED NUMBER OF VOLUNTEERS
* INVOLVED IN THIS PROJECTIPROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.* In partnership with the City, Spero has graduated eight classes of Temecula area students, all given the opportunity to pursue their dreams. These opportunities do not exist for individuals with disabilities unless carefully planned and created. The funding will allow Spero to expand necessary training opportunities to these individuals.

Project/Program Budget
16�rV :k►J0110[ J IA1►Wi]►Iagi]:ia:0i11f:101111Na0ile]:t-1►►1 Amount requested from this City of Temecula Community Services Grant REVENUES* $5,000.00
Refer to Page 2
Amount contributed to the Project/Program by the Applicant Organization $10,000.00
Other grants or funding already awarded for Project/Program, if any City of Temecula's Reinvest in Temecula, County of Riverside CID, Mitsubishi $82,000.00 Electric Foundation
In -Kind match amount or volunteer credit hours estimated amount $0.00

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment* EXPENSES*
Viticulture maintance tools $24,000.00
Faci l ities]Rentfl ns ura nce -'
Rent, liability insurance $27,000.00
Supplies*
Viticulture and harvest season supplies, educational supplies $25,000.00 Marketing*
Handouts, website, flyers $5,000.00
Services*
Viticulture consultant fees $10,000.00
Food*
Student participant food $2,000.00
Other*
Evaluation costs $4,000.00
Staffing Expense
$20,000.00
TOTAL REVENUE: TOTAL EXPENSES
$97,00 .00 $97r000,0C

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization:*
Spero Vineyards Inc.

PresidentfAuthorized Officer:* E-mail:*
Mark Woodsmall, President _
Name & Title
PresidentlAuthorized Officer Signature*
Requested Amount:
$5,000.00
Date Time
2023-08-02
IF DIFFERENT THAN ABOVE, APPIGATION PREPARE❑ BY:

Name, Title, & Organization
If you have any questions, please contact:

Phone:*
Betsy.Lowrey@Ternecu[aCA.gov (951) 69 3-395 9 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 7/31 /2023
ESL ID: 4891328844
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: 3647270
Entity Name; SPERO VINEYARDS, INC.

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 abort the entity.

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

H kIE A&DUT P„MEDIA CAREERS E�--0JLATIONS RESOURCES PRf.JGRAMS GONT.Ai T Registrant Details
Entity type: Corporate Class as registered with the Secretary of State or based on founding & registration documents.

Organization Name: SPERO VINEYARDS, NC.

IRS FEIN:
465288314
Entity I�Tc: Public Benefit
SOS4 M Corporate/Organization Number:
3647270
Registry Status: Current
renewal Due/Exp. Date:
5/15/2024
RCT Registration Number: CT0206673
Issue Date:

SM2014
Record Type: Charity Registration
Effective Date:
5/7/2014
Date of Last Renewal: 5/5/2023
DBA:

Mailing Address
Street: M76 LNCOLN AVENUE
Street Line 2:

City, State Zip: PASADENA CA 91103
Filings &
Correspondence
Miscellaneous Documents
Miscellaneous Documents
Founding Documents
Founding Documents
Confirmation of Registration Letter
Confirmation of Registration Letter
Renewal Filing
2022
Fonn CT-TR-1
2021
Form RRF-1
2021
Renewal Filing
2020
Form RRF-1
2019
Form RRF-1
2018
Form RRF-1
2017
Forth RRF-1
2016
Form RRF-1
2015
CT-550D Form RRF-1 Incomplete Delingent
Click on Document Type at the left to open PDF
CT-547 Missing Documents
Click on Document Type at the left to open PDF
Annual
Renewal Data
Status of Filing:

Accepted
Accounting Period Begin Date:
1/1/2015
Accounting Period End Date:
12/31/2015
Filing Received Date:
101112021
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registrar° Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
l/t 2016
Accounting Period End Date:
12/31/2016
Filing Received Date:
9/30/2021

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:
1112017
Accounting Period End Date:
12131,2017
Filing Received Date:
913012021
Form RRF-1 Reject/Incomplete Reason:

Form CT-TRA RejecVlncomplete Reason:

HIS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Status of Filing:

Accepted
Accounting Period Begin Date:
1/1/2018
Accounting Period End Date:

1.2,'31/2018
Filing Received Date:
913012021
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:
l/112019
Accounting Period End Date:
12/31/2019
Filing Received Date:
9'3012021
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:
1/112020
Accounting Period End Date:
1231.2020
Filing Received Date:
9'30'2021
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Rejeet/Incomplete Reason:

Notes From Registry Staff:

Status of Filing: Accepted
Accounting Period Begin Date: l/l/2021
Accounting Period End Date: 12/31/2021
Filing Received Date: 5/31/2022
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff: Received duplicate fee check -7617 for S25 - sent duplicate fee check 7617 to the confidential shred box.

Status of Filing:

Accepted
Accounting Period Begin Date:
1i 1.'2022
Accounting Period End Date:
12i31/2022
Filing Received Date:
4/24/2023
Form RRF-1 Reject/Incomplete Reason:

Form CT-TR-1 Reject/Incomplete Reason:

IRS Form 990 Reject/Incomplete Reason:

Notes From Registry Staff:

Related Registrations
& Event Reports
The related records shorn below depend an
the record type being viewed-
• C.harity Registrations relate to professional Fundraising Events which relate to Profe-ssional Fun+dra%ser Registra-dons- Raffe Registrations relate to Raffle Reports_
Click on the RCT Registration No to navigate to the related record.

No Related Records

of the Treasury
Date:
raDepartment
Internal Revenue Service
02/1112022
Tax Exempt and Government Entities
IRS P.O. Bo* 2508
Employer ID number:
46-5288314
Cincinnati, OH 45201
Person to contact:

Name: Customer Service
ID number. 31954
Telephone: 877-829-5500

SPERO VINEYARDS INC
Accounting period ending:

CIO MARK WOODSMALL
December 31
2076 LINCOLN AVENTUE
Public charity status:

PASADENA, CA 91103
170(b)(1 ){A)(vi)
Form 99D / 990-EZ 1990-N required;
Yes
Effective date of exemption:

May 15, 2021
Contribution deductibility:

Yes
Addendum applies:

No
DLN:
26053742004861
Dear Applicant:

We're pleased to tell you we determined you're exempt from federal income tax under Internal Revenue Code (TRC) Section 501(c)(3). Donors can deduct contributions they make to you under IRC Section 1.70. You're also qualified to receive tax deductible bequests, devises, transfers or gi-fts under Section 2055, 2106, or 2522. This letter could help resolve questions on your exempt status. Please beep it for your records.

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

Based on the information you submitted with your application, we approved your request for reinstatement under Revenue Procedure 2014-11. Your effective elate of exemption, as listed at the top of this letter, is retroactive to your date of revocation.

If we indicated at the top of this letter that you're required to file Form 9901990-E7f990-N. our records show you're requtt ed to file an annual information return (Form 990 or Form 990-EZ) or electronic notice (Form 990-N, the e-Postcard). If you don't file a required return or notice for three consecutive years, your exempt status will be automatically revoked.

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

Letter 947 (Rev. 2-2020)
Catalog Number 35152P

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

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

Sincerely,
Stephen A. Martin
Director, Exempt Organizations
Rulings and Agreements
Letter 947 (Rev. 2-2020)
Catalog Number 35152P

FY 23/24 Community Service Funding (CSF) Grant
Application
36 TEMECULA CHILDREN'S

MUSIC FOUNDATION

Community Service Funding Application
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Confirm
Applicant Organization Year Organization Website:

Name: Founded: www.temeculachildrensmusicfoundati
Temecula Children's Music 2016
Foundation
Mailing Address:* Number of Paid Staff:* Number of Volunteers:* 28910 Rancho California Rd, Temecula, 2 10
CA 92592
Contact Name &Title: * Contact's Email: * Contact's Phone Number:* Lindsey Bohn lndsey@temeculachildrensmusicfi
Does the nonprofit have a current City of
Temecula Business License?
Yes ho
Business License No.*
054957
Copy of Business License*
TCMF Business License.pdf 96.04KB
https://css.temeculaca.gov
Geographic Area(s) the Organization Serves:*
Temecula, Menifee, Murrieta, Hemet, San
Bernardino, San Diego, Los Angeles
Geographic Area(s) the Project/Program
Serves:

Temecula

CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE

TEMECU LA,

Project/Program
Amount Requested:* Project/Program Title:*
ss,000.00 Austria Festival Fund
MAX: $5,000 PER ORG
Start Date:* End Date:* Physical Address of Project/Program* 2024-04-13 2024-04-20 28910 Rancho California Rd, Temecula, CA 92592 Preferred Payment Method: Make Check Payable to:
(If grant is awarded.) Temecula Children's Music Foundation Check Mailed Check Picked Up
Electronic File Transfer

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
-State of Cai110Fnia Entity Status Letter
IRS Deductibility Status
State of California Entity 1D: *
3834619
To find CA Entity Status Letter,
click the link below:
h ttps:// www.ftb . ca.gov/help/business/entity-
status-letter.asp?wT.mc_i d=a kB EStatus
IRS Employer Identification Number (EIN): *
47-5366735
To find IRS Deductibility Status,
click the link below:
https /Iapps.irs.govlappleosl
Date of Incorporation:"
0 /26/2016
Attach State of California Entity Status Letter:"
State of Cal Entity status fetter.pdf
Attach IRS Deductibility Status:*
IRS Determination. Letter.pdf
Provide further verification as follows:*
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your charity found on the State Registry Search Tool (link below) Attach First Page of Most Recent Form 990*
You might find IRS Form 990 2021 990_N (rEMECU LA CHILD RE INS MUS).pdf on the link below: (990, 990-EZ, 990-PF, 990-T)
https:/Irct.doj.ca.govNerification/Web/Search.aspx?
faclllty4Y
370,12 KB

2.2MS

3.84KB

Mission Statement
Briefly describe the nonprofit organization's mission/goals and objectives:* We provide children in Southern California opportunities to learn stringed instruments, participate in auditioned orchestras, and experience mentorship through our various programs. We offer music lessons as well as participation in our auditioned orchestras. One of the programs we provide is a Musical mentorship program where the advanced students mentor the beginner students. The advanced students of our chamber orchestra receives trainings weekly to help them learn how to mentor effectively and they regular instruction from professional musicians. We have the Cello Fellows and piano program where our head Cello and Piano Instructors holds regular trainings for the children that play cello and piano. These programs help the children learn and develop a deeper appreciation for their specific instrument.

Another program we have is our Annual Suzuki Recital where we invite all students in the surrounding areas of Southern California to come and perform a Suzuki solo piece in our recital. This is a uniting endeavor where teachers all over Temecula Valley unite to provide a musical opportunity for all musicians in the area.

We have hosted bi-annual concerts for the Temecula community to regularly enjoy in December and May every year for the past 10 years. This has greatly blessed Temecula with regular Music and the arts experiences. We also have an international performance program where the children have an opportunity to represent California. In 2019 we participated in Music of the Arts International competition on Carnegie Hall stage and received the highest award. Next year we plan to take our orchestras to Austria to perform and represent Temecula, CA.

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
Yes No

Project/Program description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U{iderstand
ProjectlProgram Title; Austria Festival Fund

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT.* In April of 2024, our Chamber orchestra is going to Austria and the Czech Republic to represent Temecula, California and perform for various audiences. This experience will greatly impact the children and will bring international attention to our city of Temecula. We {snow that it is a great undertaking, so we are requesting help from our community and local organizations to support the children in this endeavor. On behalf of the Temecula Children's Music Foundation, we would like to request a $5,000 donation.

Every penny of the donation will go towards subsidizing the expensive cost on Temecula families who will be sending their children abroad. It will be $4,000 per child to participate in this trip. These families are already working to fundraise and pay for the expense, but we are seeing the burden it is to come up with that amount (especially families with multiple children in the program). Each child attending this trip will receive a portion of this grant to decrease the expense.

2. DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.' ALSO, INCLUDE EQUdPMENT, SERVICES TO BE PURCHASED AND WHY.

We will divide the $5,000 to assist each individual child in our programs attending this festival. There are 20 children attending the conference. The $5,000 divided up will provide each child with $250 in assistance.

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS.` TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRP.MIPROJECT IF AWARDED CITY FUNDING.

We are the Temecula Children's Music Foundation and as such, we represent Temecula in every musical competition and festival we attend. As well, the children attending this festival are Temecula residents.

Their families are from our community and have roots and ties in Temecula. 3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
100
3c. ESTIMATED NUMBER OF VOLUNTEERS
INVOLVED IN THIS PROJECTIPROGRAM:

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS.* Our programs have greatly blessed the Temecula community for the past 8 years. We know that this funding will help families that are burdened by the cost of this expense, especially families with multiple children attending.. We can guarantee that every penny of this funding will be utilized for the sole purpose of assisting the children.

Project/Program Budget

LIST OF EXPENSES FOR PROJECT/PROGRAM
Tools/Equipment* EXPENSES*
NIA $0.00
Facilities/Rentllnsurance*
NIA $0.00
Supplies*
NIA $0.00
Marketing
NIA $0.00
Services*
NIA $0.00
Food*
NIA $0.00
Other*
Providing for the children $5,000.00
Staffing Expense
TOTAL REVENUE: MTAL EXPENSES $0.00
$5,00I0.00 $5,000.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: * Requested Amount:

Temecula Children's Music Foundation $5,000.00
PresidentlAuthorized Officer:* E-mail:* Phone:*
Brad Bohn
Name & Title
brad@temeculachildrensmusi 951-710-4330
PresidentfAuthorized Officer Signature*
Date Time
2023-08-18
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

Name, Title, & Organization
If you have any questions, please contact:

[email protected] (951) 593-3959 or

STATE OF CAUFORNIA

FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 94257-0540
Entity Status Letter
Date: 8/18/2023
ESL ID: 5642243831
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: 3834619
Entity Name; TEMECULA CHILDREN'S MUSIC 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.

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.

INTERNAL REVENUE SERVICE
P. 0. BOX 2508
CINCINNATI, OH 45201
date: AUGZ42018

TEMECULA CHILDRENS MUSIC FOUNDATION

C/O BRAD BOHN
28910 RANCHO CALIFORNIA STE 102
TEMECULA, CA 92592
Dear Applicant:

DEPARTMENT OF THE
Employer Identification Number:
47-5366735
DLN:
17053033322008
Contact Person:

JAMIE N HEITBRINK
Contact Telephone Number:
(877) 829-5500
Accounting Period Ending:

December 31
Public Charity Status:
170(b)(1)(A)(vi)
I D# 31644
Form 990/990-EZ/990-N Required:

Y - 4 --
eS
Effective Date of Exemption:

October 14, 2015
Contribution Deductibility:

Yes
Addendum Applies:

You formed October 14, 2015, and filed your Form 1023, Application for Recognition of Exemption Under Section 501(c)(3) of the Internal Revenue Code,. on January 31, 2018. You failed to file a required annual return or notice (Form 990, Form 990-EZ, Form 990-PF, or Form 990-N) for three consecutive years after you formed and while your application was pending. As a result, your tax-exempt status was automatically revoked on May 15, 2018, the due date of your third year return or notice. We're treating your Form 1023 as an application for reinstatement and are recognizing your exemption as reinstated on the same day it was automatically revoked. As a result, you are recognized as tax exempt continuously from the effective date of exemption as listed at the top of this letter.

If we indicated at the top of this letter that you're required to file Form 990/990-EZ1990-N, our records show you're required to file an annual information return (Form 990 or Form 990-EZ) or electronic notice (Form 990-N, the e-Postcard). If you don't file a required return or notice for three Letter 947

_Z_

TEMECULA CHILDRENS MUSIC FOUNDATION
consecutive years, your exempt status will be automatically revoked.

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

For important information about your responsibilities as a tax-exempt organization, go t❑ www.irs.gov/charities . Enter "4221-PC" in the search bar to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, which describes your recordkeeping, reporting, and disclosure requirements.

Sincerely,
R..

Director, Exempt Organizations
Rulings and Agreements
Letter 947

Form 990-N ELECTRONIC NOTICE (e-Postcard)
D21
For Tax -Exempt Organizations Not Required to File Form 990 or Form 990-EZ.

Information about Form 990-N is at �"".v.irs.gov/ct3arities-non-profits!annual-electronic-frlrng-requirement-for-small- Open to Public
exem,af-orgarvizatrons-form-990-n�-pastcard. Inspection NOTE- This is not an IRS form. This form was created by Drake Software and is intended for information purposes only. Do NOT mail this form to the IRS.

A. Tax Period:

Start: 01-01-2021 Ending: 12-31-2021
B. Employer Identification Number (EIN)
47-5366735
C. Legal Name:

TEMECULA CHILDRENS MUSIC FOUNDATION
D. Mailing Address:
28910 RANCHO CALIFORNIA RD STE 102
Temecula, CA 92590
E. Doing Business As:

TEMECULA CHILDRENS MUSIC FOUNDATION
F. Gross receipts not greater than:
$50,000
G. Organization has terminated:

H. Principal Officer's Name and Address:

BRAD BOHN
Temecula, CA 92592
I. Website URL:

WWW.TENECULACONSERVATORY.COM
994_N.LD

FY 23/24 Community Service Funding (CSF) Grant
Application
37 TEMECULA VALLEY PLAYHOUSE

TEMECULA VALLEY PLAYERS

Community Service Funding Application
T1, I.,,,, ,
Organization
https://temeculaca.gov/grants

CHECK THE BOX TO CONFIRM YOU HAVE READ COMMUNITY SERVICE FUNDING GRANT PROGRAM POLICY (link above)
Confirm
Applicant Organization Year Organization x Website:

Name: Founded: temeculavalleyplayers.com
Temecula Valley Playhouse dba 1983
Temecula Valley Players
Mailing Address:* Number of Paid Staff:* Number of Volunteers:* PO Box 1293 Temecula, CA 92593 0 13D
Contact Name & Title:* Contact's Email:* Contact's Phone Number:* Lisa S Wunderlich, Board
Member/Director
Does the nonprofit have a current City of _ Geographic Area(s) the Organization Serves:* Temecula Business License? Temecula, Murrieta, Menifee, and surrounding Yes No areas.

Business License No.* Geographic Area(s) the ProjectlProgram R-202300227 Serves:

Temecula, incorporated and unincorporated
Copy of Business License* CSF GRANT MUST BE EXCLUSIVELY USED TO SERVE 2023fictitious bsn Iic.pdf 1,022.03KB TEMECU LA,
https://css.temecu laca.gov

Project/Program
Amount Requested:* Project/Program Title:`
$S'000.00 TVP Youth Education Artist
MAX: $5,000 PER DRG
Start Date:` End Date:* Physical Address of Project/Program* 2024-01-01 2024-06-30 42051 Main Street, Temecula, CA 92590 (CITTCT) Preferred Payment Method: Make Check Payable to:*
(If grant is awarded.) Temecula Valley Playhouse dba Temecula Valley Players Check Mailed Check Picked Up
Electronic File Transfer

Nonprofit Status
Is the organization incorporated as a nonprofit?*
Yes No

IF NO, THEN INELIGIBLE TO RECEIVE CITY FUNNING
Provide nonprofit status verification as follows:*
(one required, both preferred)
State of California Entity Status Letter
IRS Deductibility Status
IRS Employer Identification Number (EIN):*
33-0008806
To find IRS Deductibility Status,
click the link below:
https://apps . irs.govla ppleos/
Date of Incorporation:
07/23/1991
Attach IRS Deductibility Status:*
IRS Letter,pdrl'
Provide further verification as follows:
(one required, both preferred)
First Page of most recent IRS Form 990
Detailed info about your chanty found on the State Registry Search Tool (link below) You might find IRS Form 990
on the link below:
httpE //rct.dof .ca.govNerif ication/Web/Search.aspx?
facilitypY
State Registry Search Tool
Attach First Page of Most Recent Form 990*
TVP 990 2021.pdf
(990, 990-EZ, 990-PF, 990-T)
Attach State Registry ❑ocument/Info*
717.54KB

39.48KB
https:/1rct.doj.ca.govNerification/Web/Search.aspx? FFB Entity Status Letter Temecula Valley Playhouse. pdf 459.63KB facility=Y

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?
Yes No
Is a Temecula City Council Member a member of the Board of Directors or an Officer of the organization?
Yes No
This Application has been authorized by the organization's: * Executive Committee Board of Directors Members -at -Large

Mission Statement
Briefly describe the nonprofit 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://temeculavalleyplayers.comltvp-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.

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

Funding Sources
Within the past two years, has your organization received (or is concurrently requesting) any other sources of funding from the City of Temecula?
ye .,

NAME OF PROGRAM/PROJECT
FUNDED BY THE CITY GRANT AMOUNT,.*

OR SPONSORSHIP'S
TEMECULA TALENT $30,000.00
REVIVED!
MONTH + YEAR FUNDING NAME OF CITY GRANT OR
RECEIVED* SPONSORSHIP
09/2022 Community Service
Funding -
Reinvestment in
Temecula
NIA $0.00 0 NIA

Project/Program Description

RECEIPTSIINVOICES WILL BE REQUIRED TO BE SUBMITTED TO THE CITY TO DEMONSTRATE THE

ORGANIZATION USED GRANT FUNDING AWARDED BY THE CITY TO SUPPORT THE P ROJ EC TIPROG RAM AS DESCRIBED HERE. U+iderstand
ProjecfJPrograrn Title: TVP Youth Education Artist

1. DESCRIBE THE PROJECT/PROGRAM THE TEMECULA GRANT FUNDING WILL SUPPORT,* The TVP Youth Education Artist Program will select two Temecula Youth in Middle School or High School, who are interested in learning behind the scenes aspects of live theatre such as set design/building or, costume design/creation/sewing. TVP volunteers (with background checks) will work hands-on with the selected youth to assist them with: 1) Designing, purchasing all needed resources, building, constructing, painting, and decorating sets, and 2) Designing and creating character looks including accessories for characters and all costume changes throughout the production, purchasing all necessary materials, and sewing/altering costumes. These positions will be available for our upcoming productions of The Music Man (April 2024) and Oklahoma (May 2024). We may select both youth for The Music Man, both youth for Oklahoma, or one for each production depending on their availability. The two selected youth will gain knowledge from professionals in the field and discover if this type of work is something that they wish to continue in the future. These youth will receive constructive feedback, be featured in the show's program and on our website, and have seasoned experience that can be reflected on a resume. Please note that many of the youth who performed with TVP over the years have gone on to perform professionally.

2. 'DESCRIBE HOW THE ORGANIZATION WILL SPEND THE GRANT FUNDING, IF AWARDED.* ALSO, INCLUDE EQUIPMENT, SERVICES TO BE PURCHASED AND WHY.

TVP will spend the grant funding on all items the youths require for:
1) Designing, building, constructing, painting, and decorating sets. These items may include: lumbar, screws, nails, hammer, saw, muslin, brakes, casters, paint, all additional hardware required to make the set safe, all necessary safety equipment for the youth, and essentials for decorating the set. 2) Designing and creating character looks including accessories for characters and all costume changes throughout the production and sewing/altering costumes. These items may include: material, patterns, thread, scissors/pinking shears, buttons, elastic, ribbon, and the purchase of second-hand items from thrift stores (sorne costume items, jewelry, hats, shoes, purses, etc.)

3. EXPLAIN HOW THIS GRANT FUNDING SPECIFICALLY BENEFITS TEMECULA RESIDENTS." TEMECULA RESIDENTS MUST BENEFIT FROM THIS PROGRAM/PROJECT IF AWARDED CITY FUNDING.

Temecula residents will benefit from the program as their youth will be selected for this hands-on experience which could lead to a lifetime profession. The selected youth will learn from professionals in the industry. Please note: many Temecula youth who called TVP their home over the years have gone on to become industry professionals themselves. Temecula residents will benefit as they will be experiencing quality sets and costumes in productions which have been completed by Temecula youth.

As the youth will be presented in the show Production Bill, this rnay open further opportunities for them in the community. We expect a minimum of 6000 patrons to see these productions and read about the selected youth in the Play Bill. 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 all resources for the sets and the costumes will be purchased in Temecula. Restaurants and other businesses close to OTTCT will benefit from theatre goers who often dine out prior to/after shows and shop in the establishments in Old Town.
3b. ESTIMATED NUMBER OF PEOPLE FROM

TEMECULA EXPECTED TO BENEFIT FROM
THIS PROJECT/PROGRAM:
6,000
3c. ESTIMATED NUMBER OF VOLUNTEERS
INVOLVED IN THIS PROJECTIPROGRAM:
71J

4. SUMMARY STATEMENT — SUMMARIZE ANSWERS 1 — 3 ABOVE IN 50 WORDS OR LESS." TVP will select two youths for the Youth Education Artist Program. They will receive hands-on experience building sets and creating costumes for upcoming productions. They will discover if they wish to continue this work in the future as a career. The experience may be included an a professional resume.

Project/Program Budget

Facilities/Rentflnsurance'
0 $0.00
Supplies*
All necessary safety equipment for youth (set building), essentials for $2,500.00 decorating set, material, patterns, thread, scissors/pinking shears, buttons, elastic, ribbon, and purchase of second-hand items from thrift stores (some costume items, jewelry, hats, shoes, purses, etc.).

Marketing` *
Youth featured in Playbill and on website $500.00
Services* "
0 $0.00
Food*
:) $0.00
Other*
$0.00

To substantiate that Fiscal Year 2023-2024 funds received from the City were spent appropriately, proper back-up documentation including the report (in the link below) with accompanying receipts/invoices, must be submitted to the City on or before due date: Monday, September 16, 2024.

CHECK THE BOX TO CONFIRM
Confirm

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

Name of Applicant Organization: *
Temecula Valley Playhouse dba Temecula Valley
Players
PresidentlAuthorized Officer:* E-mail:*
Lisa S Wunderlich _
Name &Title
PresidentlAuth+orized Officer Signature*
Requested Amount:
$5,000.00
Date Time
2023-09-05
IF DIFFERENT THAN ABOVE, APPICATION PREPARED BY:

NIA
Name, Title, & Organization
Phone:*
If you have any questions, please contact:

Temecula City CouncilNovember 14, 2023

Temecula City Council
November 14, 2023