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EXHIBIT "A" <br />CLTAC:Application for Lodging Tax Grant Funding <br />Grant Application Od you attend the Grant Ap¢ication Workshop -2019 hosted by the Kttitas County Olanter of ConTorce? <br />Workshop -2019 R Yes <br />C No <br />Submittal Instructions G Yes, <br />&General I have read and understand Subtrittal Instructions and General Inforrmtion for the 2019 Lodging Tax Grant 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 password.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 Chamber of Commerce <br />Organization Address *Street Address <br />609 N Main st <br />Address Line 2 <br />Oty State /R ovince /Region <br />Ellensburg WA <br />Fbstal /Zip Cbde ¾ntry <br />98926 USA <br />Website https://www.kittitascountychamber.com <br />Federal Tax ID <br />#*91-0210430 <br />UBI #*601-133-921 <br />Organization is <br />a:*O Government Entity <br />C 501(c)3 <br />C 501(c)4 <br />G 501(c)6 <br />C 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 Kittitas County Chamber of Commerce W-9 Form.pdf 122.32KB <br />Organization Status Acceptablefileforrrets include:JFG,FDFor TlFF. <br />Contact Information <br />First Name*Madison <br />Last Name*Ford