RECREATION CENTERS OF SUN CITY- REDACTED.PDF

FOR DLLC USE ONLY
Event Date(s):
Arizona Department of Liquor Licenses and Control
800 W Washington 5th Floor Event time start/end:
Phoenix, AZ 85007-2934 CSR:
www.azliquor.gov
(602) 542-5141 License:
APPLICATION FOR SPECIAL EVENT LICENSE
Fee= $25.00 per day for 1-10 days (consecutive)
Cash Checks or Money Orders Only
A service fee of $25.00 will be charged for all dishonored checks (A.R.S § 44-6852)
IMPORTANT INFORMATION: This document must be fully completed or it will be returned.
The Department of Liquor Licenses and Control must receive this application ten (10) business days prior to the event. If the special
event will be held at a location without a permanent liquor license or if the event will be on any portion of a location that is not covered
by the existing liquor license, this application must be approved by the local government before submission to the Department of
Liquor Licenses and Control (see Section 12).
SECTION 1 Name of Organization: Rockin' Thru the Years Dance Club
efe-142-eA-A
Name of Licensed Contractor only (if any):
SECTION 2 Non-Profit/IRS Tax Exempt Number: 30-0609651
SECTION 3 Event Location: Bell Recreation Center, Social Halls 1 & 2
Event Address: 16820 N. 99th Ave, Sun City, AZ 85351
SECTION 4 Applicant must be a member of the qualifying organization and authorized by an Officer, Director, or Chairperson
of the Organization.
Nixon Nancy Belle
1. Applicant:
Last
2. Applicant's mailing address:
City State Zip
3. Applicant's home/cell phone: Applicant's business phone: )
4. Applicant's email address
Nancy Belle Nixon
(Print Full Name) declare that I am the APPLICANT filing this application
as listed above. I have read the application and the contents and at statements are true, correct and complete.
di-e4af 4,7,L)17
Date Phone Numbel
The foregoing instrument was acknowledged before me this d-0 /7
Day JANET DIVER
State County of NOTARY PUBLIC, ARIZONA
MARICOPA COUNTY
My Commission Expires
My Commission Expires on: Wil(g/ _lune411-2024-
'Date Signature
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Individuals requiring ADA accommodations call (602)542-2999

SECTION 5 Regarding the Applicant's application for a special event permit, I hereby certify that the Organization
meets the criteria in A.R.S. § 4-203.02(E) for the issuance of the permit as indicated by checking one of
the boxes below.
(1) El The Applicant is a political party or a campaign committee supporting a candidate for public office. Please
indicate the name of the candidate that the Applicant supports, the office that the candidate seeks, and
the month and year that the applicant would first fill the office if successful.
Candidate:
Name Office Month/Year
(2) IS The Applicant is a non-profit entity organized in Arizona, or pursuant to the laws of another state that is eligible for
designation as a nonprofit entity under Section 501(C) of the internal revenue code of the United States.
If the Applicant is applying under option (2) as a nonprofit entity, please also INITIAL in the space provided next
to all following statements to indicate that, to the best of the applicant's knowledge, they are true and correct.
nbn
The Applicant has received a determination letter from the Internal Revenue Service ("IRS") indicating that it is
eligible for designation as a nonprofit entity under Section 501(C), eligibility or will be eligible on all days that the
special event will occur, or has a pending application with the IRS for such treatment that has not been resolved
but that will retroactively cover all days that the special event will occur. (Please provide a copy of either the IRS
determination letter or the application [without attachments] with this application).
nbn
The Applicant is not aware of any action by the IRS to revoke, suspend, or otherwise eliminate the Applicant's
eligibility under 501(C), or if there is a pending application, the Applicant has not received any indication that
the IRS will deny its application and has a good faith basis formed upon a reasonable inquiry into IRS regulations,
guidelines, and forms that it is eligible under 501(C).
nbn
The Applicant understands that if there is a change in circumstances after completing this form that may cause
or has caused it to lose its eligibility under 501(C), whether before or after receiving an IRS determination letter,
that it has an affirmative duty to notify the Department of Liquor, which may then take appropriate action with
regard to the loss of eligibility.
To be completed only by an Officer, Director, or Chairperson of the organization.
Nancy B. Nixon
(Print Full Name) declare that I am an Officer, Director, or Chairperson of
the organization filing this application as listed above. I have read the application and the contents and all statements are
true, corrpct and complete.
/
Title/ Position Date Phone Number
The foregoing instrument was acknowledged before me this /401" A)oilhtber 01017
_ Day eur
State HY/ ria.. County of r2la.,-6 pa_ JANET DIVEN
NOTARY PUBLIC, ARIZONA
MARICOPA COUNTY
/II/ 41 My Commission Expires
Date i Notary Publibille 11, 2021
SECTION '6' Will this event be held on a currently licensed premise and within the already approved premises? raes FiNo
. (If yes, Local Governing Body Signature not required)
Name of Business license Number Phone (Include Area Code)
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Individuals requiring ADA accommodations call (602)542-2999

erns! Revenut (8arvice vepartmentameireatury
egionalCommissioner
1 11011 146; Revenue eiedo:
RECEIVED Seabee 001(e)( 4 )
9 KAY 1961 NerDWatt
Los Angeles
Dets ei Kay Destriers Proposed
Adverie
'January 30, 1010
f• • EinfteclokmeaultionNurnbec
Recreation Centers of Sun City 064214132
1064 Thunderbird Boulevard htountingftoiodEntilv
Sun city, Riii0ha -05351 December 31
Pers000Cemook
Sanford Robbins
Control Telephone Numbon
213101-4686
Dear Applicant:
This letter revokes the proposed adverse letter issued to you by your key District
Director on the above date and reflects our consideration of your appeal. 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 the provisions of the Internal Revenue Code section indicated above.,
Unless specifically excepted, you are liable for taxes under the Federal Insurance
Contributions Act (social security taxes) for each employee to whom you pay $100 or more
.during a calendar year. And, unless excepted, you are also liable for tax under the
'Federal Unemployment Tax Act for each employee to whom you pay $50 or more during a
calendar Quarter if, during the current or preceding calendar year, you had one or more
employees at any time in each of 20 calendar weeks or you paid vageS.of $1,500 or more-in
any calendar quarter. If you have any questions about excise, employment, or other Federal
taxes, please address them to your key District Director.
If,you change yourpurposes, character, or method of operation, please let your key
district office know* so.that it can consider the effect of the change on your exempt
status. Also, you should advise your key District Director of all changes in your name
or address.
You are required to file Form 990, Return of Organization Exempt from Income Tax,
only if your gross Teceipts,each year are normally more than $10,000. 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. This penalty
may also be charged if a return is not complete. So please make sure your return is
opmplite before you file it.
You are not required to file Federal income tax returns unless you are subject to the
,tax on unrelated business income under Code section 511. If you are subject to this tax,
you must file 'an income tax return on Fors 990—T. In this letter, we are not determining
whether any of your present or proposed aotiyities ars unrelated trade or business as
defined in Code section 513.
Oree
1.0. Sox 2471, Les Abolfs, WIC 00053 Latter 1366(RO) i144
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vu not i'au enterod mud an on esployer your application, identification 111321tber oven if you bare no employees. It a mu*.
of it. Tleue use thw umber on all »turas oft will you bi assignPA tiles. in to you and you grill be'adrisee
Internal Pierian' Serviou. all oorreapondenoe with the
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bell; Ri resolr.• are informlog any questions your key District Director of this action. Because• this letter Doult
records. about your aseapt atqtus, you should keep it Le your peniansnt
are shown It you Sr hare the any headinpof (mentions, please contact the person 'whose name -and telephone number
this litter.
Sincerely yours,
NOel E. Ezekiel
Associate Chief
This determination letter modifies the letters Issued to you August, 1 .968 end July 21, 197

SE TI .N How is this special event going to conduct all dispensing, serving, and selling of spirituous liquors? Please read R-19-
318 for explanation and check one of the following boxes.
OPlace license in non-use
ElDispense and serve all spirituous liquors under retailer's license
I / I Dispense and serve all spirituous liquors under special event
ESplit premise between special event and retail location
(IF USING RETAIL LICENSE, PLEASE SUBMIT A LETTER OF AGREEMENT FROM THE AGENT/OWNER OF THE LICENSED PREMISES TO SUSPEND OR
RUN CONCURRENT WITH THE PERMANENT LICENSE DURING THE EVENT. IF THE SPECIAL EVENT IS ONLY USING A PORTION OF THE PREMISES,
AGENT/OWNER WILL NEED TO SUSPEND THAT PORTION OF THE PREMISES.)
SECTION 8
What is the purpose of this event? Ej3n-site consumption EOff-site (auction/wine/distilled spirits pull) EBoth
SECTION 9
1. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
lEifes ENO (if yes, attach explanation.)
0
2. How many special event days have been issued to this organization during the calendar year?
(The number cannot exceed 10 days per year.)
3. Is the organization using the services of a promoter or other person to manage the sale or service of alcohol? Ekes Eklo
(If yes, must be a licensed contractor or licensee of series 6, 7, 11, or 12)
4. List all people and organizations who will receive the proceeds. Account for 100% of the proceeds. The organization
applying must receive 25% of the gross revenues of the special event liquor sales. Attach an additional page if necessary.
Name Rockin' Thru the Years Dance Club Percentage: 100%
Address 13426 N 100th Ave, Sun City, AZ 85351
Name Percentage:
Address
Street City State Tip
Please read A.R.S. § 4-203.02 Special event license; rules and R19-1-205 Requirements for a Special Event License,
Note: ALL ALCOHOLIC BEVERAGE SALES MUST BE FOR CONSUMPTION AT THE EVENT SITE ONLY.
NO AL OHOLI I BEVERAGE HALL LEAVE A PE AL EVENT NLES THEY ARE IN A TI •N WINE •R DISTILLED S IRI P
SEALED CONTAINERS OR THE SPECIAL EVENT LICENSE IS STACKED WITH WINE /CRAFT DISTILLERY FESTIVAL LICENSE.
5. What type of security and control measures will you take to prevent violations of liquor laws at this event?
(List type and number of police/security personnel and type of fencing or control barriers, if applicable.)
Number of Police Number of Security Personnel Ekencing EBarriers
Explanation:
-66 „eQ.„ f--7 -d--A6e (--;
/o 0./kee-44 )
cr.,ff_e-44----ete-c- , 44-1-4-t;zAz
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Individuals requiring ADA accommodations call (6021542-2999

SECTION 10 Dates and Hours of Event. Days must be consecutive but may not exceed 10 consecutive days.
See A.R.S. § 4-244(15) and (17) for legal hours of service.
PLEASE FILL OUT A SEPARATE APPLICATION FOR EACH "NON-CONSECUTIVE" DAY
Date Day of Week Event Start License End
Time AM/PM Time AM/PM
DAY 1: 12/31/2017 Sunday 7:30 PM 12:00 AM
DAY 2:
DAY 3:
DAY 4:
DAY 5:
DAY 6:
DAY 7:
DAY 8:
DAY 9:
DAY10:
SECTION 11 License premises 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. Please attach a diagram
of your special event licensed premises. Please show dimensions, serving areas, fencing, barricades, or other control
measures and security position.
ATTACH DIAGRAM
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Individuals requiring ADA accommodations call (602)542-2999


RTTY 2016 Table setup Seating for 352 67 Tables
DJ's Table layout
1 Storage closet I
3 tables I 1 choir 3 tables 1 I chairs
Projector
5
5
RTTY 2016 Table setup Seating for 352 67 Tables
DJ's Table layout
_IStorage closet
3 tables II choir 3 tables I I choirs
Projector—TI
5 5
5

Please contact the local governing board for additional application requirements and submission deadlines. Additional
licensing fees may also be required before approval may be granted. For more information, please contact your local
jurisdiction.
SECTION 12 Local Governing Body Approval Section.
r,
Date Received:
recommend 0APPR0VAL 0 DISAPPROVAL
(Government Official) (Title)
On behalf of
(City, Town, County) Signature Date Phone
SECTION 13 For Department of Liquor Licenses and Control use only.
0APPROVAL ODISAPPROVAL BY: DATE:
A.R.S. § 41-1030. Invalidity of rules not made according to this chapter; prohibited a enc action . urohibited acts
by state employees; enforcement: notice
B. An agency shall not base a licensing decision in whole or in part on a licensing requirement or condition that is
not specifically authorized by statute, rule or state -tribal gaming compact. A general grant of authority in statute does not
constitute a basis for imposing a licensing requirement or condition unless a rule is made pursuant to that general grant of
authority that specifically authorizes the requirement or condition.
D. THIS SECTION MAY BE ENFORCED IN A PRIVATE CIVIL ACTION AND RELIEF MAY BE AWARDED AGAINST THE STATE.
THE COURT MAY AWARD REASONABLE ATTORNEY FEES, DAMAGES AND ALL FEES ASSOCIATED WITH THE LICENSE
APPLICATION TO A PARTY THAT PREVAILS IN AN ACTION AGAINST THE STATE FOR A VIOLATION OF THIS SECTION.
E. A STATE EMPLOYEE MAY NOT INTENTIONALLY OR KNOWINGLY VIOLATE THIS SECTION. A VIOLATION OF THIS
SECTION IS CAUSE FOR DISCIPLINARY ACTION OR DISMISSAL PURSUANT TO THE AGENCY'S ADOPTED PERSONNEL POLICY.
F. THIS SECTION DOES HOT ABROGATE THE IMMUNITY PROVIDED BY SECTION 12-820.0i OR 12-820.02.
9/12/2017 Page 5 of 5
Individuals requiring ADA accommodations call 16021542-2999