THEATRE WEST 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
www.azliquor.goy CSR:
(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: /fin I PE- 14A— S
Name of Licensed Contractor (if any):
(Please complete if anyone other than the organization is receiving profits or assisting in the managing of the event)
SECTION 2 Non-Profit/IRS Tax Exempt Number: 9 .Y
SECTION 3 Event Location: Phi '' Ri 4 t CE-lo ing
Event Event Address: Address: 1 /30,60 3E:0 1/t/ , rc dIAl 6.1 fa• • V arykik-7,57- "." • • I AZ 111-,L." g--373.--
SECTION 4 Applicant must be a member of the qualifying organization and authorized by an Officer, Director, or Chairperson
of the Organization.
1. Applicant: DE
Last
2. Applicant's mailing address:
1. Applicant's home/cell pho 423) (7(;)0-
3. Applicant's email address:
I, (Print Full Name) k."4/9 WES P. -D 2.1. declare that I am the APPLICANT filing this application
asAlisted above. kave read the application and the contents and all statements are true, csrrect and complete.
110/26
Signati5re Title/ Position Date
The foregoing instrument was acknowledged before me this eic 6
Month Year
State A-1— 2.,c)N4County of air
My Commission Expires on: /V/WeRs
Signature-of Notary Public
Ir itileadassweismaIda.e-:_x
ITRIMMITURNE I
Notary Public - Arizona Ie
8/3/2017 Page 1 of 5 Maricopa County
Individuals requiring ADA accommodations call (602)542-2999 My Comm. Expires Apr 14, 2019
10014641IP IlLqvitti

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) P 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
o all following statements to indicate that, to the best of the applicant's knowledge, they are true and correct.
e 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).
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).
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,
declare that I am an Officer, Director, or Chairperson of
the (Print organization Full Name) filing this application as listed above. I have read the application and the contents and all statements are
true, visafirect and copipfEN• .
Title/ Position Date
The foregoing instrument was acknowledged before me this 06-1-avsyee ICU-1 r
Day Month Year
State c r County of akor': p.
My Commission Expires on: c;), gnature of NDA RCOO
Date Public -Arizona
Maricopa County
telietbanzalasizaz@
February 11, 2019
SECTION 6 Will this event be held on a currently licensed premise and within the alreadyaPproved
(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

Internal Revenue Service Department of the Treasury
District Director
Date: FE3 1 1983 Employer Identification Number
Vu I
Internal Revenue Code
Section 501(0( 7)
Accounting Period Ending:
Theatre West August 31
13114 Seville Drive Form 990 Required: 121 Yes 12 No
Sun City West, AZ 85375
Person to Contact
I. Hill
Contact Telephone Number:
(213) 688-4589
Dear 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 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 wages 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 this office.
If 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. Also, you should
inform us of all changes in your name or address.
The block checked at the top of this letter shows whether you must, file Form
990, Return of Organization Exempt from Income Tax. If the Yes box is checked,
you are only required to file Form 990 if your gross receipts each year are normally
more than $10,000If 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 provides
for 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 complete 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 section 511 of the Internal Revenue
toyed
P.O. Box 2350, Los Angeles, Calif. 90053 Letter 948(DO) (3-79)

Code. If you are subject to thifl tax, you must file an income tax return on Form
990—T. In this letter we am not determining whether any of your present or proposed
activities are unrelated trade or business as defined in Code section 513.
You need an employer idontification'number even if you have no employees.
If an eaployer identification number was not entered on your applidation, 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.
Because this letter could help resolve any questions about your •xespt status:
you should keep it in your -permanent records.
If you have any questions, please contact the person whose name and telephone
number are shown in the heading of this letter.
Sincerely yours .;
/
District Director
** For tax years ending on and after December 31, 1982, organizations
whose gross receipts are not noLmally more than $25,000 are excused
from filing Form 990. For guidance in determining if your gross
receipts are "normally" not more than the $25,000 limit, see the
instructions for the Form 990.

SECTION 7 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.
ElPlace license in non-use
Dispense and serve all spirituous liquors under retailer's license
g
Dispense and serve all spirituous liquors under special event
C3Split 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? On-site consumption 00ff-site (auction/wine/distilled spirits pull) OBoth
SECTION?
1. Has the pplicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
Des No (If yes, attach explanation.)
2. How many special event days have been issued to this organization during the calendar year?
(The number cannot exceed 10 days per year; exceptions under A.A.C.§19-1-205)
3. Is the organization using the services of a promoter or other person to manage the event?ElYes
(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 1"-"NrA7/W WZ57 Percentage: 25%
Address hitTomsod 81.146 e_rm- pug-er FE313"
Namae:ArtTri DA) T/?.‹ 6/ 6 N C2 /74- ii)E--„5-7- Percentage: 475 ah
Address19,62p3 A) EL VO 3a A} e.1-7-p ker;c0-7- g,c67c.
Sheet City State zip
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 ALCOHOLIC BEVERAGES SHALL LEAV_E_A SPECIAL EVENT UNLESS THEY ARE IN AUCTION WINE OR DISTILLED SPIRITS PULL
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 anci number of police/security personnel and type of fencing or control barriers, if applicable.)
Number of Police 7 Number of Security Personnel Dencing OBarriers
Explanation: eLuA N-r/1_714 at- )///1 sLt-s
4 a elV, LaTr 10&t,tive
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Individuals requiring ADA accommodations call (602)542-2999

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: /o? , 6?oi 7 -Thfsbdy /a.-00 4/4 2'4.0
DAY 2:
DAY 3 .
DAY 4
DAY 5
DAY 6 RID4_g 5C4E477) .E-NTEA
7—W/5 75 44/ 2711S/Pr 69C/4/72
DAY 7
DAY 8
DAY 9 IVCS-r 7-0 S _A2 E
DAY11
SECTION •;h you are
authorize( ce°46 C.oettPu-reg2. a diagram
of your sr 44-1- her control
measures
,650 C> 0
o o
Oe D
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Individuals requiring ADA accommodations call (602)542-2999

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: htto://www.azliouor.gov/assets/documents/homeoage docs/soec event links.odf.
SECTION 12 Local Governing Body Approval Section.
Date Received:
I, recommend 0APPROVAL 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 agency action; prohibited 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 NOT ABROGATE THE IMMUNITY PROVIDED BY SECTION 12-820.01 OR 12-820.02.
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Individuals requiring ADA accommodations call (602)542-2999