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2. Organization/Agency Name:*
3. Federal Tax ID Number:
5. Contact Name and Title:*
7. Mailing Address:
9. Phone:
10. Email Address:
12. Event or Activity Name (If Applicable):
14. Amount of Lodging Tax Requested:
16. Check all service categories that apply to this application:

    1. Tourism Promotion/Marketing Activities
    2. Operation of a Special Event/Festival Designed to Attract Tourists
    3. Operation of a Tourism Promotion Agency
    4. Operation of a Tourism-Related Facility Owned or Operated or Non-Profit Organization
    5. Operation and/or Capital Costs of a Tourism-Related Facility Owned by a Municipality
18. Check which one of the following applies to your agency:

    1. Nonprofit (Attach copy of current nonprofit corporate registration with Washington Secretary of State)
    2. Public Agency
19. Attachment
21. 1. Describe your tourism-related event, festival or facility. If an event/festival, list the name, date(s), and projected overall attendance.
23. 2. Is there a host hotel for your event?

    1. Yes
    2. No
24. Name of host hotel:
26. 3. Describe your target tourist audience (location, demographics, etc.)
28. 4. Describe why tourists will travel to Mountlake Terrace to attend your event/activity/facility.
30. 5. For what specific tourism-generated activities will the City of Mountlake Terrace lodging tax funds be used? Complete and submit the Lodging Tax Budget Form specific to your special event, festival or tourism-related facility.
32. 6. Describe the prior success of your event/activity/facility in attracting tourists.
34. 7. If you are a returning applicant, please identify any major changes in the event or organization since the last funding cycle.
36. 8. Do other cities or governmental entities in the area help fund your special event, festival, or tourism-related facility? If so, which jurisdictions and how much were you funded from each jurisdiction last year or awarded this year?
38. 9. Did you apply for lodging tax funds from Snohomish County this year? If not, why? If so, please explain how you will use Mountlake Terrace’s lodging tax funds as well as the County’s lodging tax funds you may have received.
40. 10. Describe the tourism promotion impact on the economy from your special event, festival or tourism-related facility with the City of Mountlake Terrace, particularly on the lodging and food service sectors.
42. 11. Describe how you will promote overnight stays in Mountlake Terrace lodging establishments as well as how you will promote its restaurants and businesses.
44. 12. The City of Mountlake Terrace urges applicants to have self-sustaining events, festivals and facilities that are not dependent upon lodging tax funds should they not be available. How do you intend to fund your program/event/facility if your proposal is only partially funded?
46. 13. List other organizations that you are partnered with for this special event, festival or facility.
48. 14. As a direct result of your proposed tourism-related service, provide an estimate of the following: (Note: Some of the estimates below are required by State law.)
50. a. Overall attendance at your proposed event/activity/facility
52. b. Number of people who will travel more than 50 miles for your event/activity
54. c. Of the people who travel more than 50 miles, the number of people who will travel from another country or state
56. d. Of the people who travel more than 50 miles, the number of people who will stay overnight in Mountlake Terrace or the Mountlake Terrace area
58. e. Of the people staying overnight, the number of people who will stay in PAID accommodations (hotel/motel/bed-breakfast) in Mountlake Terrace
60. f. Number of paid lodging room nights resulting from your proposed event/ activity/facility (example: 25 paid rooms on Friday and 50 paid rooms on Saturday = 75 paid lodging room nights)
62. 15. What methodology will you use to calculate the estimates?
    More information can be found here: http://leg.wa.gov/jlarc/Documents/LodgingTax/Data_Field_Definitions.pdf
    
    Direct Count: Actual count of visitors by using paid admissions or registrations, clicker counts, etc.
    
    Indirect Count: Estimate based on information related to number of visitors such as raffle tickets sold, redeemed discount certificates, brochures handed out, visual estimates.
    
    Representative Survey: Information collected directly from individual visitors or participants. This is a highly structured data collection tool, based on a defined random sample of participants. That can be reliably projected to the entire population attending an event.
    
    Informal Survey: Information collected directly from individual visitors or participants in a nonrandom manner that is not representative of all visitors or participants. Informal survey results cannot be projected to the entire visitor population.
    
    Structured Estimate: Estimate produced by computing known information related to the event or location. For example, one jurisdiction divided the square footage of the event area by the international building code allowance for persons (3 square feet).
    
    Please enter notes about the specific type of method used to determine the attendance count (such as vehicle counts, raffle tickets sold, etc.). Submit a sample tracking form, if available.
64. CERTIFICATION

    I am an authorized agent of the organization/agency applying for funding. I understand that:

    
    

    •I am proposing a tourism-related service for 2022. If awarded, my organization intends to enter into a Partnership Agreement with the City of Mountlake Terrace; provide liability insurance for the duration of the contract naming the City as additional insured and in an amount determined by the City; and file for a permit to use City property, if applicable.

    
    

    •The City of Mountlake Terrace will only reimburse those costs actually incurred by my organization/agency and only after the service is rendered, paid for if provided by a third party, and a signed Request for Reimbursement form (or other form acceptable to the City) has been submitted to the City, including copies of invoices and payment documentation.

    
    

    My agency will be required to submit a report documenting economic impact results in a format determined by the City which shall include, but not be limited to, the actual number of people traveling for business or pleasure on a trip: (A) away from their place of residence or business and staying overnight in paid accommodations; (B) to a place fifty miles or more one way from their place of residence or business for the day or staying overnight; or (C) from another country or state outside of their place of residence or their business.

66. Name:
67. Date:
69. APPLICANT CHECKLIST
71. Attachment (Submit a Letter of Endorsement from Studio 6 Hotel (city’s only lodging establishment) offering overnight accommodations (if applicable to your program, event, festival))
73. Attachment (For nonprofits, submit a copy of state certificate of nonprofit incorporation and/or Federal 501 (c) letter)
75. Attachment (For public agencies, submit a copy of meeting minutes showing official approval of project and authorization of this project)
77. Attachment (Complete the online budget form or submit a completed paper copy of the form)
79. Attachment (Submit copies of financial/bank statements for the two most recent years to include beginning cash balances, a listing of annual actual revenues, a listing of annual actual expenditures, and the resulting ending fund cash balances. (Beginning fund balance plus revenues minus expenditures equals the ending cash balance.))
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81. 1. Receive an email copy of this form.
82. Email address

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