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City of Roseville <br />Non-profit Application for use of ARPA Funds <br />SUPPORTING DOCUMENTATION <br />x IRS Form 990 from most recent tax filing <br />x Current year budget for organization <br />APPLICANT SIGNATURE <br />By signing below, the applicant represents, warrants, and certifies that the information provided herein <br />is true, correct, and complete. I also certify that I have the authority on behalf of the organization to <br />submit this application and legally bind the organization. <br />Authorized Signer Date <br />Print Name <br />Organization Name <br />2/17/2023 <br />2353 Rice St., Suite 240 <br />Karen Organization of Minnesota <br />Alexis <br />Walstad <br />Digitally signed by Alexis <br />Walstad <br />Date: 2023.02.17 <br />11:06:08 -06'00' <br />Attachment E