09 Bingo Permit De Anza Soccer
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City Hall
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3223
FAX' (40R) 777-11óó
ITV F
CUPEIQ1NO
OFFICE OF THE CITY CLERK
SUMMARY
Agenda Item No. ~
Meeting Date: April 18, 2006
SUBJECT AND ISSUE
Consider approving a new bingo permit for the De Anza Force Soccer Club, Inc.
BACKGROUND
The De Anza Force Soccer Club, Inc. has applied for a bingo permit as required by the
Municipal Code, and all forms and fees haye been received.
The Sheriff's Department, Central Fire Protection District, the County Health Officer,
Cupertino's Chief Building Inspector and Director of Planning have approved the
application.
RECOMMENDATION:
Conduct the public hearing, and approve the application for a permit.
Submitted by:
Approved for submission:
. ~
~~
City Clerk
~
Dayid W. Knapp
City Manager
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Printed on Recycled Paper
City Hall
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3223
FAX: (408) 777-3366
OFFICE OF THE CITY CLERK
APPLICATION FOR BINGO PERMIT
1. Name of Organization bG AtJ:?A ÆJ,¡u.t;;. SóC-¿eR. Ú--i-16 }).}c..
Name of Officers Pa. T ~ ~~ -vP
Address of Officers E -Þ"'-. -il: 1,/
1 '-FJCJsol'I
2. Days of operation 7f1ùR. "'ioN Hours of Operation II f'111
3. Address of Bingo game .2ð5 $1 tØQlEc·¡rEft:;' t'õ fÞ.PMTIJ.Jb, I" A
4. Purpose of premises used by organization t',¡)J(,ô ;':n,,"):, €'A, ~ JJ..V;
5. Ownership of Bingo equipment ":bE AAI?:A ¡:¡~LE ~YL__ (¡" A JAJ/.
6. Name of person responsible for operation of Bingo game JF.FF ðŸt¡~k!
7. Name of everyone who has any financial interest in Bingo game Ì)£ A)./¿A
H'>.e //=. _91/1 bi2- r I 1 J8 è../J PF72.7/}oJ t5 ::rM F ,t)A7 ¡
.
MUST HAVE FOLLOWING STATEMENTS
CHECK
./ A.
B.
v C.
Consent for Sheriff to inspect bank account containing Bingo profits.
Statement of ownership/lease of premises.
Copies of exempt status ITom Internal Revenue and Franchise Tax Board
or tax identificatio ber.
on responsible for Bingo game
FEE: $50.00 - Genera cense annual. Over 10 games.
5.00 - Gener License each game. Under 10 games.
THIS PERMIT IS NONTRANSFERABLE EITHER AS TO THE LICENSE OR
LOCATION
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Sheriff recommendation
Fire District
Health Officer
Chief Building Inspector
Director of Planning
Time of public hearing
Business License No.
FOR OFFICIAL USE ONLY /JA-L.I
YES ,,/' NO _ ~T - p,.,J $(..'
YES v/ NO U> v¡w.t
YES~NO- rUJA6e ~k M fl,5f:J.:¡>.IJ£
YES ~ NO - &tp<j CA 5J.es¿ L
YES v NO= ~e. f.AýfLC .::':·
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December 28, 2005
De Anza Force Soccer Club, Inc.
10553 La Roda Dr.
Cupertino, CA 95014
To Whom It May Concern:
This letter is to proyide the written consent of the De Anza Force Soccer Club, Inc.
officer and treasurer, Richard A. Bell, to the Santa Clara County Sheriff office to inspect
any and all bank accounts of the said club.
The De Anza Force Soccer Club, Inc. currently maintains two checking accounts at Bank
of America:
06815-20255
06819-13767
Regards,
~~
Richard A. Bell
Treasurer
De Anza Force Soccer Club, Inc.
q - 3
10300 TORRE AVENUE
CUPERTINO, CA 95014-3255
(408) 777-3221
ACCOUNT #
CITY OF CUPERTINO
BUSINESS LICENSE APPLICATION
NAME OF BUSINESS D£ I'lA/ZA FéN2-C¡;¿ ~CL-EA. C-J.¿t..e,. / Ai c.. .
LOCATION OF BUSINESS /óSS3 L~ R6D"I "bIZ..
STREET ADDRESS
CIAP£/2:7/)VD
CITY
C/J
STATE
qS{)/Lj
ZIP
PHONE ('/03') b 71 - ô66 <I
MAILING ADDRESS IF DIFFERENT THAN ABOVE
NATURE OF BUSINESS Y6tJTH .sOCL¿R- L¿iA ß
HOURS OF OPERATION 'fAIn - "IS f'F71
IF YOU ARE OPERATING AN APARTMENT COMPLEX, PLEASE STATE NUMBER OF UNITS
SQUARE FOOTAGE OF YOUR BUILDING SPACE IN CUPERTINO
LEGAL STATUS OF BUSINESS
j.. CORPORATION
PARTNERSHIP
SOLE PROPRIETOR
START DATE OF BUSINESS IN CUPERTINO (MONTH/DAY NEAR)
STATE EMPLOYER ID NO.
2'13 - ()II£, - 3
FEDERAL TAX ID NO. ;)ð - "'12. '$ 7¿'~
STATE BOARD OF EQUALIZATION TAX NUMBER
OWNER/OFFICER NAME Jt:EF
)05::;3 LA R.DÎ.:Y7 DR
STREET ADDRESS
6/Itc.;-/£ç;¿ SOCIAL SECURITY NUMBER_-_-_
CilP£Æ7¡N{) , Cft qSO;</ PHONE ('/t:fj (p 79 - tJ¿.~</
CITY/STATE/ZIP
OWNER/OFFICER NAME AN: IA-J.J>J£ FA£. <;
SOCIAL SECURITY NUMBER_-
10/3£, /ft.P¡/V£ M. iI-'/
STREET ADDRESS
(t(Pe£.TIN6, C It 'ìf;ôl'/
CITY/STATE/ZIP
PHONE (70:\') ¥38· ð2ð 8"
OWNER/OFFICER NAME If'CIf14R. b
¡':.>-5 6e.-LIxl(;J./.A.m /AJI'1Ý
STREET ADDRESS
OCU
5f,¡nl1'Ýl/A-t ¡:;:. /'.fr
CITY/STATE/ZIP
SOCIAL SECURITY NUMBER 5t/;- ~- 77 C/O
qJfð)7 PHONE(~8 ) 736-61'1.6
*HOME BUSINESS APPLICANTS PLEASE COMPLETE REVERSE SIDE*
TO THE BEST OF M KNOWLEDGE, THE ABOYE INFORMATION IS TRUE AND CORRECT.
/"l-,Z 8-2tJð;-
DATE
FOR OFFICE USE ONLY
DATE PROCESSED
DATE APPROYED
AMOUNT
ZONING APPROVAL
RECEIPT NUMBER
INITlALS_
9,-'-1
City of Cupertino
Application for Waiver of Business License Tax
(Non-Profit Organizations)
(408) 777-3221
Organization Name: ÐE I}¡..}ZA fflæ¿£ SoU&;¿ (i-UlS, /NC
Address: /ÔSS.s LF¡ ¡¿DbA 2I€. Ú/':?&<..TI/\/O LA
,
qSòl<I
Describe organization's pmpose:
/6 /l>ENTlFý r9Nò 'DEv£LOf" /J'v<tL€ ßNÒ
F£P<¡qL!;; YOtÆTH ~T,HL.E'T£S INTo 5G¿F-Lt:>NF,ðÐv/, út'..Ð''l-7IVl? /).ITELU6éHr
. ,
flNb SKILIJUL ~L-£t< f'LJ'9Y£ß5.
Describe type of activities perfonned, location of activities, and the hours activities will be perfonned:
S()CC éfl. T(2Æ¡¡v/M6
I 6~FS
(¿¡PG£.-7IND , Sl'/fV'I7C6A . f' S?:IN ;jO?/E PF¡I3-J<.5
Wlié.KhI'/y.s </I"n> - 2>riæK
f.AJ~Ð-I~S '1/f71o. - bl<ll2k:
, FW"l"h £A/-.:.JM6 ßIM;,C> - CtlPVZ7/Alð 10ðF H¡! ¿¿, .;:¿ðS;;q I-bmesr£fj~ l2ô.
Wpel2JlNC; ,CA
'T#tNV3 (" pp-. - IIPI71, sul-IW/ý·- c"p/?\ - II Pn-..
List Officers of the Organization (please Print or Type)
Name ,7t"FF tf{ýqICrlU<
Title I'.eež, I ~N r
Name ft&I/'INNE ¡::;'tj!!;.
Title VIe<; f'~~/})ENr
LI1P£R-T/Að ("A C}!;ú)'-/
Phone Number 1fJB- - t, 71- tJM, <I
Address 1M3'" IJ¿,PIAlF bR.. -P- <f
CU/Ð12-TlIVO , (',4 <1SW</
.
Address /ðS5:$ [4 ~ou~ Î:>R.
Phone Number '11.)&- li3,g--0..208'
11<.1?51.à£NT
Title
¡(OD/ì ~
'Iðf- "'79- CYht,'/
Pnone Number
1.2 - 28- 2aJS
Ú1.0H'TINO, (.4 960/(/
Date
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Return your completed application and copies of your Federal and State tax exempt status to: Finance
Department, 10300 Torre Avenue, Cupertino, CA 95014
9-~
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IN'1'BRNAL REVENUB SERVICE
P. O. BOX 2508
CINCINNATI, OH 45201
DEPARTMENT OF THE TREASURY
DE ANZA FORCE SOCCER CLUB
1425 BELLINGHAM WAY
SUNNYVALE, CA 94087
INC
Employer Identification Number:
20-0428766
DLN'
17053146098034
Contact Person:
~YB NG IDI 31290
Contact Telephone Number:
(877) 829-5500
Accounting Period Ending:
JANOARY 31
Form 990 Required:
YES
Addendum Applies:
NO
Date:
. ";UN t :j 2~G",
Dear Applicant:
Based on inforlMtion 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 section 501 (a) of tbe Internal
Revenue COde as an organization described in section 501 (c) (3) .
We have further determined that you are not a private foundation within
the meaning of section 509 (a) of the Code, because you are an organization
described in section 509 (a) (2).
If your sources of support, or 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 and foundation status. In the case of an amend-
ment to your organizational document or byla_, please send us a copy of the
amended document or byla_. Also, you should inform us of all changes in your
name or address.
As of January 1, 1984, you are liable for taxes under the Federal
InSurance contributions Act (social security taxes) on remuneration of $100
or more you pay to each of your employees during a calendar year. YoU are
not liable for the tax imposed under the Federal unemployment Tax Act (FUTA).
Since you are not a private foundation, you are not subject to the excise
taxes under Chapter 42 of the Code. However, if you are involved in an excess
benefit transaction, that transaction might be subject to the excise taxes of
section 4958. Additionally, you are not autanatically exempt from other
federal excise taxes. If you have any questions about excise, employment, or
other federal taxes, please contact your key district office.
Grantors and contributors may rely on this determination unl.ess the
Internal Revenue service publishes notice to the contrary. However, if you
lose your section 509(a) (2) status, a grantor or contributor may not rely
on this determination if he or she was in part responsible for, or was aware
of, the act or failure to act, or the substantial or material change on the
Letter 947 (DO/CO)
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.J..L
STATE OF CALIFORNIA
FRANCHISE TAX BOARD
PO BOX 1286
RANCHO CORDOVA CA 95741-1286
In reply refer to
755:G :EMM
June 21, 2004
DE ANZA FORCE SOCCER CLUB INC
RICHARD BELL
1425 BELLINGHAM WAY
SUNNYVALE CA 94087-3812
Purpose
Code Section :
Form of Organization :
Accounting Period Ending:
Organization Number
EDUCATIONAL
23701d
Corporation
January 31
2430463
You are exempt from state franchise or income tax under the section of
the Revenue and Taxation Code indicated above.
This decision is based on information you submitted and assumes that
your present operations continue unchanged or conform to those proposed
in your application. Any change in operation, character, or purpose of
the organization must be reported immediatelY to this office so that we
may determine the effect on your exempt status. Any change of name or
address must also be reported.
In the event of a change in relevant statutory, administrative, judicial
case law, a change in federal interpretation of federal law in cases
where our opinion is based upon such an interpretation, or a change in
the material facts or circumstances relating to your application upon
which this opinion is based, this opinion may no longer be applicable.
It is your responsibility to be aware of these changes should they occur.
This paragraph constitutes written advice, other than a chief counsel
ruling, within the meaning of Revenue and Taxation Code Section
21012(a)(2).
You may be required to file Form 199 (Exempt Organization Annual
Information Return) on or before the 15th day of the 5th month (4 1/2
months) after the close of your accounting period. Please see annual
instructions with forms for requirements.
You are not required to file state franchise or income tax returns
unless YOU have income subject to the unrelated business income tax
under Section 23731 of the Code. In this event, you are required to
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