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EXHIBIT "A" <br />CLTAC:Application for Lodging Tax Grant Funding <br />Grant Application Od you attend the Grant Ap¢ication V\brkshop -2019 hosted by the Kttilas OJunty Clarrber of rmerce? <br />Workshop -2019 E Yes <br />C No <br />Submittal Instructions €Yes, <br />&General I have read and understand Subnittal Instructions and General Infornation for the 2019 Lodging Tax G ant Funding <br />Information *Rocem <br />You are strongly encouraged to compose your responses to the questions of this form with a desktop text <br />editor and save your work,then copy and paste the information into the form.You may also save a draft by selecting <br />the button at the bottom of this page.When you do this you will be logged out and must log back in to continue.In order <br />to save a draft you will need to provide an email address and a passvuord.After completing the save draft,you will be <br />redirected to landing page containing a link to log back into the form.We suggest you save this link as a bookmark.The <br />link will also be sent to you in an email. <br />Organization Information <br />Name of Organization *Kittitas County Historical Society,Inc. <br />Organization Address*Street Address <br />114 East Third Avenue <br />Address Line 2 <br />Oty State /Fiovince /Region <br />EIIe nsbu rg WA <br />Fostal /Zip Cade Country <br />98926 US <br />Website http://www.kchm.org <br />Federal Tax ID <br />#*91-6037783 <br />UBI #*600-167-001 <br />Organization is <br />a:*C Government Entity <br />G 501(c)3 <br />C 501(c)4 <br />C 501(c)6 <br />O Other <br />(Note;you must submit 501(c)3,501(c)4,or 501(c)6 approval documentation.) <br />Click here to view sample documents (redacted). <br />Upload Proof of irs letter.pdf 44.31KB <br />Organization Status Acceptablefileforrmts include:JFO FDFor [1FF. <br />Contact Information <br />First Name*Sadie <br />Last Name*Thayer