Funding Request Habitat for Humanity

TOWN OF WICKENBURG

155 N. Tegner St., Ste. A, - Wickenburg, Arizona 85390
TEL (928) 684-5451 FAX (602) 506-1580

Non-Profit Funding Request

Applicant Name: Jo'Ann Montana

Non-Profit Name: _|Wickenburg Area Habitat for Humanity
370 W Center St

Address: PO Box 21117
Wickenburg, AZ 85390

Phone: 928.684.2220

Email: jmontana0416@outlook.com

Amount of Funds Requested: | $25,000.00
Intended Use of Funds: |Wickenburg Habitat has 3 main components:

1. Building affordable housing and repairs

| 2. Aging in place

3. Neighborhood revitalization

The public purpose served: |See attached

The proceeds would be used for construction and repairs on our citizens homes.

The nature and amount of the benefit to the Town. Include any direct benefits to
residents or other consideration received in exchange of funding.

The town will benefit with our citizens having a decent place to live:

stable,

1. Families become more stable and want to live in Wickenburg

2. They shop locally driving revenue

3. We hire local contractors and volunteers building jobs withing the community

4, Pay taxes

5. Become a strong citizen within the community

Attach an additional page if more space is needed.

Wickenburg Area Habitat for Humanity

1. Build and Repair: Affordable housing and home repair programs in Wickenburg
are actively helping families gain stability, strengthen community ties, and create
long-term opportunities for growth. Local initiatives include new affordable
housing developments, down payment assistance, and nonprofit-led repair
programs that empower families to thrive.

2. Aging in Place: ls a movement to not only enable people to age safely in their
homes but also to create an environment where older adults can continue to
learn and contribute, develop relationships with people of all ages, maintain a
healthy lifestyle, live independently, and receive healthcare and support services
that are community-based. At the end of the day, a livable community for older
adults is a livable community for everyone.

3. Neighborhood Revitalization: The ultimate goa! of neighborhood revitalization
is to improve quality of life, which is defined as a sense of well-being and
happiness experienced by individuals, groups, and communities. We are thrilled
your affiliate has decided to take this approach in furthering Habitat for
Humanity’s mission.

What's in it for Wickenburg

We help build stronger families with decent, affordable housing. That provides families
with a place to gather and grow. Even more, by working with Habitat to achieve
affordable homeownership, families can transform their lives.

Affordable homeownership helps create conditions that free families from stress and
fear, helping build stability and confidence. Having a strong and stable household is the
foundation for child development and growth. When home is foster, instead of
hindering health and safety, families can flourish. Owning an affordable home also
allows homeowners to lift their entire family by saving for their futures and investing in
educational opportunities

Checklist:

Application

{@] Any additional documents used to support request

TOWN OF WICKENBURG

155 N. Tegner St., Ste. A, - Wickenburg, Arizona 85390
TEL (928) 684-5451

FAX (602) 506-1580

{M] Drop application packet at Town Hall attention: Kathleen Crutchfield or email:

kcrutchfield@wickenburgaz.gov

Next Steps:

1. Town staff to review application for funding to ensure compliance with

Ordinance No. 1243.

2. fin compliance, Town Staff will schedule the request for council consideration

at a duly noticed public meeting of the council.

Questions:

Kathleen Crutchfield

Grants and PIO Administrator
kcrutchfield@wickenburgaz.gov
928-232-0037

Internal Use Only

Funding Source

Bed Tax Marketing Funds
General Funds

|
|
[] Agenda Date:

[] Approved J] Not Approved
( Notified Applicant Date:

a)

Reimbursement Review with Applicant
Reporting Requirement Dates:

Department of the Treasury Date:
Internal Revenue Service 05/12/2022
Tax Exempt and Government Entities Employer ID number:

P.O. Box 2508 86-0743284
Cincinnati, OH 45201

Person to contact:
Name: Customer Service

ID number: 31954
Telephone: 877-829-5500

WICKENBURG AREA HABITAT FOR HUMANITY Accounting period ending:
PO BOX 21117 June 30
WICKENBURG, AZ 85358 Public charity status:

170(b)(1)(A)(vi)
Form 990 / 990-EZ / 880-N required:
Yes
Effective date of exemption:
November 15, 2021
Contribution deductibility:
Yes
Addendum applies:
No
OLN:
26053516004982

Dear Applicant:

We're pleased to tell you we determined you're exempt from federal income tax under Internal Revenue Code
(RC) 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.

Based on the information you submitted with your application, we approved your request for reinstatement
under Revenue Procedure 2014-11. Your effective date of exemption, as listed at the top of this letter, is
retroactive to your date of revocation.

Our records show you were previously tax exempt as a subordinate under group exemption number 8545.
Because you applied for and were granted your own individual tax-exempt status, you no longer rely on your
affiliation with a parent organization for recognition of your tax exemption and you'll be listed individually in
the Tax Exempt Organization Search (Pub. 78 data).

If, in the future, you choose to become a subordinate under a group ruling, you'll lose your individual
recognition of tax-exempt status and you'll no longer appear in the Exempt Organizations Select Check

(Pub. 78 data). Moreover, if you become a subordinate under a group ruling and your parent organization loses
its tax-exempt status, you also will lose your exempt status. To reestablish your individual tax exemption after
rejoining a group exemption, you'll be required to reapply and pay the appropriate user fee.

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.

Letter 947 (Rev. 2-2020)
Catalog Number 35152P

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 50 1(c)(3) Public
Charities, which describes your recordkeeping, reporting, and disclosure requirements.

Sincerely,

—cTyfthat a. wine
Stephen A. Martin

Director, Exempt Organizations
Rulings and Agreements

Letter 947 (Rev. 2-2020)
Catalog Number 35152P