New Mexico Administrative Code › Title 1 - GENERAL GOVERNMENT ADMINISTRATION › Chapter 5 - PUBLIC PROPERTY PROCUREMENT AND MANAGEMENT › Part 22 - CHARITABLE USE OF REAL PROPERTY REGULATION: USE OF PROPERTY CONTROL DIVISION, REQUIREMENTS FOR CHARITABLE USE OF REAL PROPERTY › Section 1.5.22.10 - APPLICATION FORM

Current through Register Vol. 35, No. 13, July 16, 2024
Charitable Use of Property Control Division Land and
				  Buildings
Name of Applicant: ___________________________________
				  (include names of all Professional Fundraisers to be used by
				  applicant***)
Address: _________________________ Telephone:
				  _________________
Town: ___________________________ Zip:______________
Name of Applicant's Agent or Representative:
				  __________________________
Town: ___________________________ Zip: ______________
Telephone: _______________________
Applicant requests the Property Control Division, GSD, State
				  of New Mexico authorize applicant's use of Division buildings and/or land, as
				  follows:
1. Address of building(s) or
				land to be used*:
Street address: ____________________________________
City: _______________________________
2. Location(s)
within the building to be
				used
*:______________________________________________
3. Dates of use (not to exceed 30 consecutive
				calendar days): ___________________________________
___________________________________________________________________________________________
4. Time of day for the activities
				listed below: __________________________________________
5. Activities of Applicant (describe
				activities to be conducted in Division Buildings and/or land in detail)*:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
6. Purpose of activities (describe
				nature of applicant, if funds are raised or solicitations requested, list how
				funds are to be used, list non-profit incorporations, if any, IRS status,
				etc.)*: _____________________________
___________________________________________________________________________________________
7. If sales of product or service
				are involved in case of Division and/or Buildings, describe product** including
				origin and price*:
_____________________________________________________________________________________
_____________________________________________________________________________________
8. The requirements of the
				Charitable Organization and Solicitation Act:
____ do not apply to Applicant
____ do apply to Applicant, proof of compliance is
				  attached***
Applicant hereby certifies that the foregoing information is
				  correct, and agrees that the Property Control Division Director or his designee
				  may, by advanced written notice, cancel this permission to conduct the
				  above-listed activities or modify the times and places allowed for such
				  activities.
Applicant further agrees to defend, indemnify and hold the
				  Property Control Division and the State of New Mexico harmless from all
				  actions, proceedings, claims, demands, costs, damages, attorney's fees and all
				  other liabilities and expenses of any kind from any source which may arise out
				  of applicant's use of the buildings or land described heretofore, unless caused
				  by the tortuous act or omission of the State of New Mexico, its officials,
				  employees or servants.
Applicant agrees to not interfere with the work functions of
				  any (state) Agency in the buildings or on land in which applicant's activities
				  are conducted, agrees to comply with all provisions of Regulation GSD 86-503
				  [now 1.5.22 NMAC], and further agrees that any such interference or violation
				  of said regulation may result in immediate termination of the permission
				  granted herein, at the option of the Director of the Property Control
				  Division.
This application shall become the registration required under
				  Regulation GSD 86-503, Section 6.2 [now Subsection B of 1.5.22.10 NMAC], only
				  upon approval of the Property Control Division Director or his designee.
Applicant's Name:
				  __________________________________________
By: __________________________________________
Name of Authorized Agent
Approved: Property Control Division
By: __________________________________________
* Continue on separate sheet if necessary and attach.
** If the product is food, the Director of the Property
				  Control Division shall require proof of compliance with applicable Health
				  Standards and may require proof of food purveyors and product liability
				  insurance coverage in an amount acceptable to the Director.
*** Proof of compliance shall consist of a showing of filing
				  and current compliance with the Act. Proof of compliance is required for each
				  Professional Fundraiser (as defined in GSD 86-503, Section 4.9 [now Subsection
				  I of 1.5.22.7 NMAC]) to be used by Applicant.