RISEN SAVIOR LUTHERAN CHURCH_REDACTED.PDF

Maricopa County — Formal (2023-01-25)

Extracted text (via ocr_local) 13726 characters

DLLC USE ONLY
dob #:
SPECIAL EVENT LICENSE —
APPLICATION FEE $25.00 PER DAY ‘
CSR:
Arizona Department of Liquor Licenses and Control -
800 W. Washington St, 5" Floor Phoenix, AZ 85007 license #:

Se (602) 542-5141
Application MUST be submitted to the Department of Liquor 10 days prior to the event.

SECTION J 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.

1. Applicant: Lopez Jill
(Must be an Officer/Member of the Non Profit Enfi Last First Middle
2. applicant's malin tr All
City Slate Up
3. Applicants home/cell — Applicant's business phone: 480-895-6782
4, Applicant's email qccress

5. Special Event Name: Loco Moco Luau

6, Name of Non-Profit Organization, Candidate or Political Parly/Gov; Risen Savior Lutheran Church

7. Non-Profit/IRS Tax Exempt Number: 86-0724498

8. Arizona Corporation Commission File #: N/A If out of State please specify: N/A

(Attach letter of good standing)
9, Event Location Name: Risen Savior Lutheran Church
10. Event Address: 23620 S Alma School Rd Sun Lakes AZ 85248

Dates and Hours of Event - Days must be consecutive and may not exceed 10 consecutive days.

**SEPARATE APPLICATION FOR EACH “NON-CONSECUTIVE” DAY**

Event Start License End
Time AM/PM Time AM/PM

03-04-2023 —- Saturday 04:00pm 40:00pm

Days Date Day of Week

DAY 1:

DAY 2:

DAY 3:

DAY 4:

DAY 5:

DAY 6:

DAY 7:

DAY 8:

DAY 9:

DAY10:

11/7/2022 Page 1 of 3
Individuals requiring ADA accommodations please call (602)542-2999

SECTION 2 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.)

0 4 Volunteers

Number of Police Number of Security Personnel [Fencing Msarriers

. . Volunteers who will monitor ingress/egress points to ensure that alcohol does not leave premises.
Must explain security measures: 9 g p P

SECTION 3 What is the purpose of this event?
[lon-site consumption [lofi-site (auction/wine/distilled spirits pull) [Both

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}

A) 4 Special Event being held on an unlicensed premises will require approval and signature by the Local Governing
Body on page 3. {If checked move to section 4)

B) [1] Will this event be held on a currently licensed premises and within the already approved and licensed area?
(Must attach a letter from the licensed premises with an explanation of the option checked below)

Name of Business license Number Phone (Include Area Code)

[Place license in non-use - Special Event Licensee selling all alcohol without retailer involvement
Must attach letter from the location suspending license for duration of special event

[Dispense and serve all spirituous liquors under retailer's license — Business operates normally, minimum of 25% of gross
revenue from alcohol sales is donated to licensee

[dispense and serve alll 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 alcoho! inventory must be separated from any
alcohol used during the special event, Must attach letter from the location suspending license for duration of special event

Csplit premise between special event and retail location - Both the special event licensee and the retailer will conduct
sales of alcohol. (These sales will be done in separate areas. If alcohol is donated or purchased by the special event licensee
it must be in a separate area than the alcoho! that is clispensed by the licensed retailer.)

Llof sale only - Wine/Distilled Spirits Pull, Live or Silent Auctions - Retailer wil still be permitted fo conduct all normal sale
and service of alcohol.

SECTION 4

1, Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
Yes [¥]No If yes, attach letter of explanation.

2. How many special event days have been issued to this organization during the calendar year? 1

3. Is the Organization using the services of a Special Event Contractor? (A licensee can utilize the services of a special
event contractor who may purchase and sell alcoho! on behalf of the licensee. If no special event contractor is listed, the
licensee is responsible for the sales and service of afcohol. }

Cl yes [1 No If yes, please provide the Name of the Special Event Contractor:

4, ls the organization using the services of a series 6, 7, 11, or 12 licensee to manage the sale or service of alcohol?
(Licensees who hold a series 6, 7, 11, or 12 license are automatically qualified to be the special event contractor)

(Yes IY] No if yes, please provide the Name of Licensee: License #:

11/7/2022 Page 2 of 3
individuals requiring ADA accommodations please call (602)542-2999

5. List the name of the Individual or Organization that will receive revenues, MUST EQUAL 100 PERCENT.
Attach additional sheet if necessary.

Name: Risen Savior Lutheran Church Percentage: 100%
Address: 28020 S Alma School Rd Sun Lakes AZ 85248
Street Clty State up
Name: Percentage:
Address:
Street 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.
ALL ALCOHOLIC BEVERAGE SALES MUST BE FOR CONSUMPTION AT THE EVENT SITE ONLY.

SECTION. 5 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.

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 governing body before submitting
to the Department of Liquor Licenses and Control, Please contact the local governing board for additional information.

APPLICANT SIGNATURE

Declaration:
|, (Print Name) Jill Lopez , Geclare under penalty of perjury that | am

authorized to submit this application. | have read the contents of this application, and to the best of my knowledge
believe all statements made on this application to be true, correct and complete.
| .
UL | OLA
V" sighature
- een |
LOCAL GOVERNING BODY
Date Received: |
lL, recommend CIAPPROVAL [DISAPPROVAL
(Government Official) (Title)
On behalf of . , ,
(Clty, Town, County) Signature Date Phone
AZDLLC USE ONLY

CIAPPROVAL CI DISAPPROVAL BY:

11/7/2022 Page 3 of 3
Individuals requiring ADA accommodations please call (602}542-2999

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June 30, 2022

To Whom It May Concern:

Pacific Southwest District
1840 Concordia Drive East
Irvine, California 92612-3203
949.854.3232 or 888.773.5267
PAX: 949,854.8140

Risen Savior Lutheran Church (EIN: 86-0724498} located at 23914 S. Alma School Rd., Chandler, AZ 85428
is a member congregation of the Lutheran Church Missouri Synod (EIN: 43-0658188), is a subordinate unit
currently covered under the Synod’s group exemption number 1709 filed with the IRS.

The following documents included:
Federal Tax Exemption letter
Group Tax Exemption letter

Listing on LCMS Roster of Congregations

If you need any additional information to resolve this account, please do not hesitate to contact me (949) 854-

3232 x 208.

Sincerely,

Cui * lay

Catherine F. Korp, CPA
Chief Financial Officer
Pacific Southwest District, LCMS

23914 S. Alma School Road

RISEN SAVIOR Chandler, AZ 85248

LUTHERAN CHURCH Church Office: 480.895.6782
Preschool: 480.802.1505

www. rslcs.org

June 29, 2022

Risen Savior Lutheran Church (86-0724498) — Member of Lutheran Church Missouri Synod (LCMS)
The following documents are included to verify our Non-Profit Status.
Group Tax Exempt Ruling for the Lutheran Church Missouri Synod (43-0658188)
Document from the LCMS website showing our membership in the Pacific Southwest District (PSWD).

https://locator,|cms.org/church?range=25&name=Risen%20Savior%20Lutheran%20Church&address=&city=&
district=7 &state=ARIZONA&search=ARIZONA&s=y

Document from the LCMS website showing the membership of the PSWD.
https://locator.lcms.org/district/7

Engaging all generations to be passionate followers of our Risen Savior.

8.410;
Group Tax-Exempt Ruling

Internal Revenue Service

Department of the Treasury

230 South Dearborn Street

District
Director Chicago, IL 60604
theran Church-Missouri Synod Date: JUN 93 1992

: 43-0688188

Gentlemen:

In a letter dated January 6, 1965 your organization was issued a group
ruling under Code Section 501(c)(3) of the Internal Revenue Code to cover
your subordinate units. Based on the information recently submitted it
is held that the subordinate units referenced below by category are those

to be covered by the group ruling:

1. Your fund-raising and fund-administering entities, presently
consisting of The Lutheran Church-Missouri Synod Foundation.

Your archives, presently consisting of Concordia Historical
Institute.

3. The districts of the Synod existing within the United States,
including the circuits within those districts.

4. The incorporated church extension, funds of the Synod and its
districts, presently consisting of (i) Lutheran Church Extension
Fond-Missouri Synod, (ii) Ohio District Lutheran Church Extension
Fund, Inc., (iii) The Church Extension Board of the Michigan District
of the Lutheran Church-Missouri Synod, and (iv) The Southeastern
District-Lutheran Church Missouri Synod Church Extension Fund, Inc.

5. The institutions of higher education of the Synod.

6. The member congregations of the Synod, including those in the
formative stages of membership.

7. The elementary schools, middle schools and junior high schools, and
high schools (a) that are operated by member congregations of the
Synod and are not separately incorporated, (b) as well as those that
are either separately incorporated or are otherwise identified as
entities separate from congregations and which have consented in
writing to be included in this group ruling.

Donors may deduct contributions to these organization as provided in
Section 170 of the Code. Bequests, legacies, devises, transfers, or
gifts to your or for your use are deductible for Federal estate and gift

tax purposes if they meet the applicable provisions of Code Sections
2055, 2106, and 2522.
ee (Continued on next page.)
10/15 » Page 8-7

Lutheran Church-Missouri Synod -2-

olve any questions about subordinates

|Because this letter could help res
you should keep it in your permanent

which are covered by this rulings

records.
Sincerely yours,

SULA,

R. S. Wintrode, Jr.
District Director

and the GEN assigned to this group is 1709. Only
subordinate units referenced by category in Synod’s
group exemption letter are tax-exempt under GEN
1709.

8.160

Verifying Tax Exempt Status

Included under Synod’s group tax-exempt ruling are
LCMS member congregations, the schools they oper-
ate and are not separately incorporated, as well as those
that are separately incorporated and have consented

in writing to be included. Occasionally, these entities
need evidence of their ”“501(c)(3)" tax-exempt status.

A request of this nature may be satisfied by providing

a copy of the IRS tax-exempt group ruling acquired by
the LCMS and reproduced in Section 8.410; and, also a
copy of the page found inside “The Lutheran Annual” on
which lists your congregation or school as a member of
the LCMS. Alternatively, anyone may contact the LCMS
Accounting Department directly for verification. Either
verification method may be used and are described in
IRS Publication 4573. An LCMS congregation or a school
it operates need not be listed on the EO Business Master
File. Donors, grantors, or other interested persons may
rely on LCMS verification in this respect.

10/15 + Page 8-5

Risen Savior Lutheran Church

DETAILS

Organized Date: 12/31/1992
Date Join LCMS: 12/31/1994
Designation: Member Congregation

Last Stat Year: 2021

Average Weekly Attendance; 654
Baptized Membership: 1157
Confirmed Membership: 1151

District: Pacific Southwest District (7)

V-Circuit: (27N)

@ Mailing Address & Email & Pastor(s)
23914 S ALMA SCHOOL RD, Chandler, AZ, 85248-6182, USA NEWS@RSLCS.ORG Rev Ronald D Burcham
» Office > Business >» Pastor-Senior Administrative
& Phone @ Website
(480)895-6782 WWW.RSLCS.ORG
» Business/Office
(480)718-8252
>> Fax
SERVICES
Service Type . Begin End
TO Day Time Frequency
Service Sub Type Month Month
BIBLE CLASS
Sun 09:10 AM Dec Apr Weekly
Sun 09:15 AM Jan Dec Weekly
Sun 10:15 AM Dec Apr Weekly
SUNDAY SCHOOL
Sun 09:30 AM May Nov Weekly
Sun 10:30 AM Dec Apr Weekly
WORSHIP SVC
Sun 08:00 AM Jan Dec Weekly
Sun 09:00 AM Dec Apr Weekly
Sun 09:30 AM May Nov Weekly
Sun 10:30 AM Dec Apr Weekly
Sun 11:00 AM May Nov Weekly
Sun 11:30 AM Dec Apr Weekly
PASTOR(S)
Name Position

Rev Ronald D Burcham

Pastor-Senior Administrative