HORSES HELP FOUNDATION_REDACTED.PDF

Arizona Departmenit of Liquor Licenses and Control DLLC USE ONLY
lob #:
https://www.azliquor.gov
.
(602) 542-5141 Date Accepted:
Le:
SPECIAL EVENT LICENSE
License #:
APPLICATION FEE $25.00 PER DAY
MUST be submitted to the Department.of Liquor 10 days prior to the event.
SECTION 4
Name of Non-Profit Organization, Candidate or Political Party: {{¢ ) ee él 18 Oy AA hoy
If the event will be held on an unlicensed premises; it (UST be approved and signed by the Local Governing
Body Before submitting to the Arizona Department of Liquor.
LOCAL GOVERNING BODY
Date Received:
CJ apprRovAL CI pisAPPROVAL
Goverment Official Title
On behalf of
City, Town, County Signature
SECTION 2
Will the event be at a location with a current liquor license and within the approved and licensed area?
[lYes [MNo {if no skip to section 3)
if yes, MUST attach a letter of explanation/permission/ suspension from the licensed location and choose ONE option below.
Name of Licensed Location Liquor License Number
[-] Suspend license for the duration of the Special Event; Licensee selling all alcohol without retailer involvement.
Letter of suspension required.
[-] Dispense and serve all spirituous liquors under retailer's license ~ Business operates normally, minimum of 25% of
gross revenue from alcohol sales will be donated to licensee. Letter of permission required.
C] Dispense and serve all spirituous liquors under special event - The special event licensee is in charge of selling alcohol
that was purchased or donated by the special event licensee. The retailers existing alcohol inventory must be kept
separate from any alcohol used during the special event. Letter of suspension required.
CJ Split premises between special event and licénsed location - Both the special event licensee and the licensed
location will conduct sales of alcohol. (These sales mist be done in separate areas. If alcohol is donated or purchased
by the special event licensee, it must be in a separate area from the alcohol that is dispensed by the licensed
location.) Letter of explanation and permission required,
] Off Sale only - Wine/Distilled Spirits Pull, Live or Silent Auctions — Retailer will be permitted to conduct all normal
sales and service of alcohol. Letter of permission required.
10/28/2025 Page 10f 4
Individuals reauiina ADA accommodations please call (602)1542-2999

SECTION 3
Applicant MUST be a member of a qualifying nonprofit organization, political party, or Government entity and
authorized by an Officer, Director, or Chairperson of the Organization.
Last
2. Applicant's mailing address
3, Applicants home/cell phon -profit organization phone:
4, Applicant's amail address:
5. Has the applicant been convicted of a felonyror had a liquor license revoked within the last five (5) years?
CTyes (if yes, attach letter of explanation}
SECTION 4
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HO y HS Leh Fog ali O YQ
1. Name of non-profit organization: ; ?
2. Non-Profit/IRS Tax Exempt Number: Va- LAV TO AT Arizona Corporation Commission File #: OL AS 2489
Required . Required
3. If Out Of State, specify State (Attach letter of good standing}:
- 4, Special Event Name: AY alicia
SECTION 5
5. Event Location Name: OSS LA ¢\ p Fok Vy) AON oy)
6. Event Address: \Y iw) 19 F, Di le LA iD [ive (V¥uC¥ A2 BF 47> |
SECTION 6
Must list type of security and control measures will you take to prevent violations of liquor laws at this event.
Z Number of Police Number of Security Personnel Fencing - Barriers
Must explain security measures: caval mee C9. ot CACM AK. PMLA SeA
Wand Axe \WO%eA tYVnYA Uny cen ad acl al
nas 4V S0ACL
AMES
1. How Is this special event going to conduct all dispensing, serving, and selling of spirituous liquors?
Check one of the following boxes. (R-19-318)
Aooth
[lon-site consumption [_Joft-site {auction/wine/distilled spirits pull)
Z
2, How many special event days have already been issued to this organization during the current year?
40/28/2025 Page 2 of4
Incéviduals reavitina ADA accommodations please coll [602)542-2999

SECTION 7
Dates and Hours of Event - and may not. exceed 10 days per year.
Days must: be consecittive
EVENTSTART =——sEVENTEND
DAYS DATE DAY OF WEEK TIMEAM/PM ss TIME AM/PM
atau
‘val 4APrv lo pr
DAY 1 Zhe
‘DAY 2
DAY 3
DAY 4
DAY 5
DAY 7
DAY 8 pe
_
DAY 9
DAY 10
SECTION 8
1. 1s the Organization using the services of a DLLC approved Special Event Contractor from the list on our website?
_
Wes M Ino if yes, please provide the Name of the Special Event Contractor:
Special Event Contractor Signature:
2. Is the organization using the services of a series 6, 7, 11, or 12 licensee to manage the sale or service of alcohol?
who hold a series 6, 7, 11, or 12 license are automatically qualified to be a special event contractor)
eed,
hes
o if yes, Name of Licensee: Liquor License #:
3.List the name of the Organization/individual that will receive revenues:
MUST EQUAL 100 PERCENT, APPLYING NON- PROFIT MUST RECEIVE A MINIMUM OF 25% OF THE PROCEEDS.
TRY 90S fo wndlah on \6.0°/ -
name: We percentage:
address: I 1S _& Dix reel Ute. Az 26
Ov Caves 22
_
percentage:
Name: _
|
Address: :
— = —- =
Please read A.R.S. § 4-203.02 and R19-1-205 Special event license rules and Requirements.
10/28/2025 Page 3 of 4
: Individuals reauitina ADA accammodations please call {6021542-2999

Licensed location diagram: The licensed premises for your special event is the area in which you are
authorized to sell, dispense, or serve alcoholic beverages under the provisions of your license.
Must attach a diagram of your-special event showing the area where alcohol will be sold,
served, and consumed. Must include dimensions of event area, fencing, barricades,
or other control measures, and include positions of security personnel.
NO ALCOHOLIC BEVERAGES SHALL LEAVE A SPECIAL EVENT UNLESS THEY ARE IN SEALED CONTAINERS FOR AN AUCTION OR
WINE/DISTILLED SPIRITS PULL, OR THE SPECIAL EVENT LICENSE iS STACKED WITH A WINE /CRAFT DISTILLERY FESTIVAL LICENSE,
Declaration:
_ ,
I, (Print Name) pal ECNMIG, LASY 6 , declare under penalty of perjury that | am
authorized to submit this application. | have read the contents and to the best of my knowledge believe all statements
made on this application to be true, correct, and complete.
[ L- >
Signature; ———
7 NL
ee |
SPECIAL EVENT DIAGRAM AND
SAFETY PLAN STANDARDS
Diagrams do not need to be overly complicated, they can be hand drawn. However, we
do not accept photographs or aerial views that do not show the premises clearly. The
diagram should clearly depict the special event area in relation to the entire premises.
Each diagram must include:
e Overview of the location
e The event area clearly outlined with black marker
¢ Where alcohol will be served/stored
e All entrances and exits
e Where security will be positioned
¢ Square footage of event area
e Show North, East, South, West
10/28/2025 page 4 of 4
Individuals requiring ADA accommedations please call (602}542-2999

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