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The City of Sacramento Ann Land and Bertha Henschel Memorial Funds Commission invites you to apply for grants from the Ann Land and Bertha Henschel Memorial Funds.

To be considered, applications must be received no later than 5:00 p.m. on Monday, October 30th, 2020:  

GENERAL INFORMATION

Physcial Address

Mailing address different from physical address?

Mailing Address

PRIMARY GRANT CONTACT (Correspondence, Reporting)

AUTHORIZED REPRESENTATIVE (Authorized to sign Grant Agreement)

PROPOSED USE OF FUNDS REQUESTED

Please indicate below the services you are requesting

Total Amount Requested

The amount requested will be applied to the following.

The funds requested will be used to serve the following (please check all that apply)

Will other funds supplement Ann Land and Bertha Henschel Memorial Funds request for this program?

Did you lose any funding in 2020 from any source?

Do you anticipate, or have you been notified, that you will lose funding in 2021?

Are you aware of, or do you anticipate receiving, any new sources of funding in 2021, for example, stimulus or other funds?

Please upload a brief description (no more than two pages) of the program or service for which you are requesting funds. Explain how the program or service addresses the mission and funding priorities of the Ann Land and Bertha Henschel Memorial Funds.

ORGANIZATION DESCRIPTION

Date incorporated or otherwise formed

FINANCIAL INFORMATION

Please break down your organization’s income sources for the past fiscal year as follows:

Total Amount

REQUIRED ATTACHMENTS

The names of the members of your organization’s board of directors and of your organization’s officers

An organizational chart or description of your organization’s management structure

Verification of your organization’s not-for-profit status (letter from IRS confirming § 501(c)(3) status)

Verification that your organization (1) is currently registered and in good standing with the Registry of Charitable Trusts maintained by the California Attorney General or (2) is not required to register.

A copy of your organization’s current business license or a letter from the City of Sacramento Finance Department verifying your organization’s exemption from the City’s business-operations tax. The Sacramento City Code requires that anyone conducting business within the City of Sacramento have a current business license on file with the City. The City issues nonprofit organizations a waiver letter in lieu of a business license. A waiver letter can be obtained at the Revenue Counter in New City Hall, First Floor, Room 1214. Indicate your organization’s non-profit status on the application form. There is no charge for nonprofit organizations.

A copy of your organization’s most recent audit and any corrective actions or recommendations suggested by the auditor. If you do not have an annual audit, please explain why. You must also provide a copy of your organization’s most-recent annual financial statements, signed by your organization’s treasurer AND by the preparer, whether a CPA or bookkeeper

A budget sheet showing how awarded funds will be spent

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