Please attach a Budget Summary to this document TOTAL PERSONNEL 44, Current Allocation

Size: px
Start display at page:

Download "Please attach a Budget Summary to this document TOTAL PERSONNEL 44,194.55 Current Allocation"

Transcription

1 FY 2013 CARRYOVER REIMBURSEMENT PERSONNEL BUDGET NARRATIVE SANTA FE TRAIL COMMUNITY CORRECTIONS Please attach a Budget Summary to this document TOTAL PERSONNEL 44, Current Allocation 1A PERSONNEL SECTION ADMIN PERSONNEL New Name FTE Staff Salary Detail Salary CC percent Subtotal Patrick Klecker 2% County Cola 1 $26.67X40hrsX52 weeks 55, % 1, , Sonja Channell 2% County Cola 0.5 $20.95X40hrsX52 weeks 43, % Janae Jones 2% County Cola 1 $14.62X37hrsX52 weeks 28, % TOTAL SALARY 2, Name Benefits Detail Salary etc CC percent Subtotal Name Total Patrick Klecker 1, FICA Social Security 1, % FICA Medicare 1, % KPERS (Retirement Benefits) 1, % State Unemployment 1, % 6.99 State t Workman's Comp 1, % Health Insurance % 0.00 Sonja Channell FICA Social Security % FICA Medicare % 6.32 KPERS (Retirement Benefits) % State Unemployment % 2.75 State Workman's Comp % 9.24 Health Insurance % 0.00 Janae Jones FICA Social Security % FICA Medicare % 8.16 KPERS (Retirement Benefits) % State Unemployment % 3.54 State Workman's Comp % 11.93

2 Health Insurance % 0.00 TOTAL BENEFITS A TOTAL ADMIN PERSONNEL 2,502.83

3 Personnel Category Comments: 1B AISP PERSONNEL Name FTE New Staff Salary Detail Salary CC percent Subtotal Sonja Channell 0.5 $20.92X40hrsX52 weeks 43, % Tiffany Carr 1 $20.67X40hrsX52 weeks 42, % Claudia Bunyan 1 $18.42X42hrsX52 weeks 38, % George Tovar 1 $15.70X40hrsX52 weeks 32, % Paola Alarcon 1 $15.38X40hrsX52 weeks 32, % New ISO 1 $14.42X40hrsX52 weeks 30, % 30, , TOTAL SALARY 33, Name Benefits Detail Salary etc CC percent Subtotal Name Total Sonja Channell FICA Social Security % FICA Medicare % 6.32 KPERS (Retirement Benefits) % State Unemployment % 4.36 State Workman's Comp % 4.36 Health Insurance % 00% Longevity (50 per year X 10 yrs) % 0.00 Tiffany Carr FICA Social Security % FICA Medicare % KPERS (Retirement Benefits) % State Unemployment % 8.60 State Workman's Comp % 8.60 Health Insurance % 0.00 Longevity (50 per year X 5 yrs) % 0.00

4 Claudia Bunyan FICA Social Security % FICA Medicare % KPERS (Retirement Benefits) % State Unemployment % 7.66 State Workman's Comp % 7.66 Health Insurance % 0.00 George Tovar FICA Social Security % FICA Medicare % 9.47 KPERS (Retirement Benefits) % State Unemployment % 6.53 State Workman's Comp % 6.53 Health Insurance % 0.00 Paola Alarcon FICA Social Security % FICA Medicare % 9.43 KPERS (Retirement Benefits) % State t Unemployment % 6.50 State Workman's Comp % 6.50 Health Insurance % 0.00 New ISO 30, , FICA Social Security 30, % 1, FICA Medicare 30, % KPERS (Retirement Benefits) 30, % 1, State Unemployment 30, % State Workman's Comp 30, % Health Insurance 6, % 3, TOTAL BENEFITS 8, B TOTAL AISP PERSONNEL 41, Personnel Category Comments:

5 TOTAL PERSONNEL SECTION 44,194.55

6 FY 2013 CARRYOVER REIMBURSEMENT NON-PERSONNEL BUDGET NARRATIVE SANTA FE TRAIL COMMUNITY CORRECTIONS Please attach a Budget Summary to this document TOTAL NON-PERSONNEL $ 31, Current Allocation AGENCY OPERATIONS SECTION 2A TRAVEL CATEGORY Details CC percent Subtotal CCAC & Director's Meetings X 4 Food@$25/day X % $ Mileage@.50/mile X 1200 miles % $ $80 X 4 nights % 0.00 $ Director's mtgs for DD X 2 Food@$25/day X % 0.00 $ KCCA - SFTCC Dues Annual Dues % $ NAFC - Director Annual Dues % 0.00 $ A TOTAL TRAVEL CATEGORY $ 1, Travel Category Comments: 2B TRAINING Details CC percent Subtotal 3 2-day Trainings for Director Food@ $25/day X 6 days % $ Mileage@.50/mile X 900 miles % $ Comp Plan Training Food@$25/day X 3 people % $ Mileage@.50/mile X 300 miles % $ day Training for 4 ISOs Food@ $25/day X 8 days % $ Mileage@.50/mile X 1200 miles % $ BIP trainings for Director Registration fees $150X % $ Hotel $90 X 2 nights % $ Food $25/day X 4 days % $ Mileage@.50/mile X 1200 miles % $ BIP trainings for ISO Alarcon Hotel $90 X 2 nights % $ Food $25/day X 5 days % $ Mileage@.50/mile X 1325 miles % $ Training in Junction City, KS for ISOHotel $90 X 2 nights X 5 ppl % $ Food $25/day X 2days X 5 ppl % $ Mileage@.50/mileX 1,012 for 2 ca % $ Registration fees $100 X 5 ppl % $ Day Training- Admin Assist. Fees % $ Regional training in Dodge City Food $8/plate X 50 plates % $ B TOTAL TRAINING CATEGORY $ 6, Training Category Comments: 2C COMMUNICATION Details CC percent Subtotal Verizon Wireless- Cell Phones $309/mo X 12 mos 3, % 3, $ 3, AT&T- Land Lines $85/mo X 12 mos 1, % 1, $ 1, United - Internet Service $74/mo X 12 mos % $ Birch - Long Dist. $55/ mo X 12 mos % $ C TOTAL COMMUNICATION CATEGORY $ 6, Communication Category Comments:

7 FY 2013 CARRYOVER REIMBURSEMENT NON-PERSONNEL BUDGET NARRATIVE SANTA FE TRAIL COMMUNITY CORRECTIONS Please attach a Budget Summary to this document TOTAL NON-PERSONNEL $ 31, Current Allocation 2D TOTAL EQUIPMENT Details CC percent Subtotal New Server Replace old server 4,000.0% 0.00 $ 4, Equipment Maintenance % $ D TOTAL EQUIPMENT CATEGORY $ 4,500.00

8 FY 2013 CARRYOVER REIMBURSEMENT NON-PERSONNEL BUDGET NARRATIVE SANTA FE TRAIL COMMUNITY CORRECTIONS Please attach a Budget Summary to this document TOTAL NON-PERSONNEL $ 31, Current Allocation Equipment Category Comments: 2E SUPPLIES/COMMODITIES Details CC percent Subtotal Office Supplies/Stamps/Printing $625/mo X12 mos 7, % 4, $ 4, E TOTAL SUPPLIES/COMMODITIES CATEGORY $ 4, Supplies/Commodities Comments: 2F FACILITY Details CC percent Subtotal Victory Electric- Electricity $495/mo X 12 mos 5, % 1, $ 1, Black Hills Energy- Natural Gas $160/mo X 12 mos 1, % $ City of Dodge City- Water $35/mo X 12 mos % $ Building Maintenance $100/mo X 12 mos 1, % $ F TOTAL FACILITY CATEGORY $ 1, Facility Category Comments: 2G CONTRACTUAL Details CC percent Subtotal 2G TOTAL CONTRACTUAL CATEGORY $ - Contractual Category Comments: TOTAL AGENCY OPERATIONS SECTION $ 25,416.00

9 FY 2013 CARRYOVER REIMBURSEMENT NON-PERSONNEL BUDGET NARRATIVE SANTA FE TRAIL COMMUNITY CORRECTIONS Please attach a Budget Summary to this document TOTAL NON-PERSONNEL $ 31, Current Allocation CONTRACTS/CLIENT SERVICES SECTION 3A CONTRACTS/CLIENT SERVICES Details CC percent Subtotal Drug Testing Supplies $.96/test X 2,085 tests; $1.40/test 2, % 2, $ 2, Drug Testing Services $325/mo X 12 mos 3, % 3, $ 3, Substance Abuse Evaluations Substance Abuse Treatment Mental Health Evaluations Mental Health Treatment Sex Offender Evaluations Sex Offender Treatment Academic Education Services Vocational Education Services Transportation Assistance Housing Assistance Subsistence Cognitive Skills Client Incentives Electronic Monitoring Services Surveillance Services 3A TOTAL CONTRACTS/CLIENT SERVICES $ 6, Contractual Category Comments: TOTAL CONTRACTS/CLIENT SERVICES SECTION $ 6, TOTAL AGENCY OPERATIONS & CONTRACTS/CLIENT SERVICES SECTION $ 31,943.00

10 FY 2013 CARRYOVER REIMBURSMENT BUDGET SUMMARY SANTA FE TRAIL COMMUNITY CORRECTIONS Please attach a Budget Narrative to this document 1A 1B Current Allocation PERSONNEL SECTION Cells auto fill-verify amounts against Narrative ADMIN PERSONNEL CATEGORY Salary 2, Benefits AISP PERSONNEL CATEGORY Salary 33, Benefits 8, TOTAL PERSONNEL SECTION 44, AGENCY OPERATIONS SECTION Cells auto fill-verify amounts against Narrative 2A TRAVEL CATEGORY 1, B TRAINING CATEGORY 6, C COMMUNICATIONS CATEGORY 6, D EQUIPMENT CATEGORY 4, E SUPPLIES/COMMODITIES CATEGORY 4, F FACILITY CATEGORY 1, G CONTRACTUAL CATEGORY 0.00 TOTAL AGENCY OPERATIONS SECTION 25, A CONTRACTS/CLIENT SERVICES SECTION Cells auto fill-verify amounts against Narrative CONTRACTS/CLIENT SERVICES CATEGORY Drug Testing Supplies 2, Drug Testing Services 3, Substance Abuse Evaluations 0.00 Substance Abuse Treatment 0.00 Mental Health Evaluations 0.00 Mental Health Treatment 0.00 Sex Offender Evaluations 0.00 Sex Offender Treatment 0.00 Academic Education Services 0.00 Vocational Education Services 0.00 Transportation Assistance 0.00 Housing Assistance 0.00 Subsistence 0.00 Cognitive Skills 0.00 Client Incentives 0.00 Electronic Monitoring Services 0.00 Surveillance Services 0.00 TOTAL CONTRACTS/CLIENT SERVICES CATEGORY 6, TOTAL CONTRACTS/CLIENT SERVICES SECTION 6, TOTAL NON-RESIDENTIAL FY12 BUDGET SUMMARY 76,137.55

11 SIGNATORY APPROVAL FY 2013 Carryover Reimbursements Plan Budget Summary and Budget Narrative Santa Fe Trail Community Corrections DIRECTOR I hereby certify by my signature that I have developed my agency s FY 2013 Carryover Reimbursements Plan, attached hereto, with the active participation of my agency s Community Corrections Advisory Board, and that I have reviewed the Plan for accuracy. I further certify that I find the Plan complies with the written directions supplied to me by KDOC and with applicable Kansas statutes, regulations, and community corrections field services standards. Patrick Klecker Signature Date ADVISORY BOARD CHAIRPERSON I hereby certify by my signature below that the Community Corrections Advisory Board has actively participated in the development of the attached FY 2013 Carryover Reimbursements Plan and that the Board has reviewed the Plan for accuracy and compliance with applicable Kansas statutes, regulations, and community corrections field services standards, and approves it. Dick Robbins Signature Date BOARD(S) OF COUNTY COMMISSIONERS I hereby certify by my signature below that the Board of County Commissioners has reviewed the attached FY 2013 Carryover Reimbursements Plan for accuracy and compliance with applicable Kansas statutes, regulations, and community corrections field services standards, and approves it. Jerry King Ford County Signature Date County Name of Chairperson (Typed or Printed) Signature Date County Name of Chairperson (Typed or Printed) Signature Date County Name of Chairperson (Typed or Printed) Signature Date Please attach additional sheets as necessary to obtain all county commissioner chairperson signatures.

12

Table of Contents Attachment 2 Budget Justification. Itemized Budget...1. Budget Narrative Year 1...2. Budget Narrative Year 2...6

Table of Contents Attachment 2 Budget Justification. Itemized Budget...1. Budget Narrative Year 1...2. Budget Narrative Year 2...6 Table of Contents Attachment 2 Budget Justification Page Itemized Budget...1 Budget Narrative Year 1...2 Budget Narrative Year 2...6 Budget Narrative Year 3...9 Senior Outreach Services Consortium Itemized

More information

PERSONNEL (FEDERAL) Computation. Cost. Salary Basis Percentage of Time Length of Time. TBD Work Readiness Asst. II $37,936.50 Year 100.

PERSONNEL (FEDERAL) Computation. Cost. Salary Basis Percentage of Time Length of Time. TBD Work Readiness Asst. II $37,936.50 Year 100. A. Personnel List each position by title and name of employee, if available. Show the annual salary rate and the percentage of time to be devoted to the project. Compensation paid for employees engaged

More information

2013-2014 Budget. Emergency Communication District of Ector County. Board of Managers:

2013-2014 Budget. Emergency Communication District of Ector County. Board of Managers: 2013-2014 Budget Emergency Communication District of Ector County Board of Managers: Bennie Cope, Chairman Freddie Gardner, Vice-Chairman Timothy Burton, Secretary Thomas McCain Jimmy Ellis Staff: Kevin

More information

Travelling Tips & Tricks - PlayStation 2

Travelling Tips & Tricks - PlayStation 2 ATTACHMENT 2 2011 CHARGES FOR SERVICES Associated Counsel for the Accused 2011 BUDGET (effective 7/1/11) with City Atty Salary Schedule City of Seattle Public Defense Services TOTAL COSTS Funding Level:

More information

Billings Public Schools FREQUENTLY ASKED QUESTIONS:

Billings Public Schools FREQUENTLY ASKED QUESTIONS: Billings Public Schools FREQUENTLY ASKED QUESTIONS: EMPLOYEE COMPENSATION 1. What categories of employees does the District hire, and how are they organized? Three different collective bargaining associations

More information

Computation. TBD Sr. Project Assistant $67,818.00 Year 100.00 1 $67,818. TBD Sr. Project Assitant $67,818.00 Year 85.00 1 $57,645

Computation. TBD Sr. Project Assistant $67,818.00 Year 100.00 1 $67,818. TBD Sr. Project Assitant $67,818.00 Year 85.00 1 $57,645 A. Personnel List each position by title and name of employee, if available. Show the annual salary rate and the percentage of time to be devoted to the project. Compensation paid for employees engaged

More information

Residential Substance Abuse Treatment (RSAT 2014/2015)

Residential Substance Abuse Treatment (RSAT 2014/2015) State of Wisconsin Department of Justice 17 W. Main St. P.O. Box 7857 Madison, WI 53707-7857 Brad D. Schimel Attorney General Criminal Justice Residential Substance Abuse Treatment (RSAT 2014/2015) Grant

More information

INDEPENDENT CONTRACT PHARMACIST Name:

INDEPENDENT CONTRACT PHARMACIST Name: Linda Moran, D.Ph. President and CEO PO Box 520976 Tulsa, OK 74152 Phone: 1-800-686-RPHS Fax: 1-918-583-RPHS E-Mail: lmoran@rphrelief.com R.Ph.S., Inc. INDEPENDENT CONTRACT PHARMACIST REQUIREMENTS CHECKLIST

More information

Residential Substance Abuse Treatment (RSAT) DOC 2011

Residential Substance Abuse Treatment (RSAT) DOC 2011 State of Wisconsin Department of Justice 17 W. Main St. P.O. Box 7070 Madison, WI 53707-7070 J.B. Van Hollen Attorney General Criminal Justice Residential Substance Abuse Treatment (RSAT) DOC 2011 Grant

More information

Table A - San Diego Convention Center Corporation Budget Summary

Table A - San Diego Convention Center Corporation Budget Summary Table A San Diego Convention Center Corporation Budget Summary FY 2014 Budget FY 2014 Actual FY 2015 Budget FY 2015 Projected Budget FY 20152016 Change Positions 328.52 N/A 324.23 N/A 326.70 2.47 Personnel

More information

Hotel/Motel Lodging Tax Funding Request Application For Budget Year 2014

Hotel/Motel Lodging Tax Funding Request Application For Budget Year 2014 Hotel/Motel Lodging Tax Funding Request Application For Budget Year 2014 Name of Organization: The City of Centralia Lodging Tax Advisory Committee is accepting proposals for tourism related services to

More information

Our goal is to reach out to all the veterans in Klamath County, making sure they are aware of the benefits that are available to them.

Our goal is to reach out to all the veterans in Klamath County, making sure they are aware of the benefits that are available to them. Department: Veterans FY 2014 Proposed Budget Department Mission: To give aid and assistance to any veteran, the spouse or dependents of the veteran or the survivors of the veteran in applying for all benefits

More information

KANSAS DEPARTMENT FOR AGING AND DISABILITY SERVICES

KANSAS DEPARTMENT FOR AGING AND DISABILITY SERVICES KANSAS DEPARTMENT FOR AGING AND DISABILITY SERVICES Actual FY 2014 Agency Est. Agency Req. Agency Req. FY 2017 FY 2017 Operating Expenditures: State General Fund $ 561,860,405 $ 618,190,288 $ 632,670,211

More information

FL-150. John Smith. George J Jones SUPERIOR COURT OF CALIFORNIA, COUNTY OF

FL-150. John Smith. George J Jones SUPERIOR COURT OF CALIFORNIA, COUNTY OF ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number and address): John Smith FOR COURT USE ONLY FL-150 CA TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): George J Jones SUPERIOR COURT

More information

SBHC Pro-Forma Financial Statement Instruction Manual

SBHC Pro-Forma Financial Statement Instruction Manual SBHC Pro-Forma Financial Statement Instruction Manual Overview The pro-forma financial statement is an integral component of any business plan. It represents a projection of revenue and expenses (or cash

More information

SAMPLE INDIRECT COST PROPOSAL FORMAT FOR NONPROFIT ORGANIZATIONS

SAMPLE INDIRECT COST PROPOSAL FORMAT FOR NONPROFIT ORGANIZATIONS SAMPLE INDIRECT COST PROPOSAL FORMAT FOR NONPROFIT ORGANIZATIONS A. INTRODUCTION Name of Organization (nonprofit) is a nonprofit located in Anytown, USA. The nonprofit administers a variety of programs

More information

IOWA VETERANS TRUST FUND ASSISTANCE REQUEST

IOWA VETERANS TRUST FUND ASSISTANCE REQUEST Please Submit to: IOWA DEPARTMENT OF VETERANS AFFAIRS Camp Dodge Bldg 3465, 7105 NW 70 th Avenue Johnston, Iowa 50131-1824 Phone (515) 727-3440 www.iowava.org Personal and Military Data Full Name (First)

More information

Street City State Zip. Street City State Zip

Street City State Zip. Street City State Zip SAN PATRICIO COUNTY APPLICATION FOR EMPLOYMENT AN EQUAL OPPORTUNITY/ AFFIRMATIVE ACTION EMPLOYER PRINT IN BLACK INK OR TYPE. FILL OUT APPLICATION FORM COMPLETELY. RESUME NOT ACCEPTED. BE SURE TO SIGN THE

More information

SIMPLIFIED BASIC CALCULATIONS FOR DEVELOPING FULLY LOADED HOURLY RATES

SIMPLIFIED BASIC CALCULATIONS FOR DEVELOPING FULLY LOADED HOURLY RATES SIMPLIFIED BASIC CALCULATIONS FOR DEVELOPING FULLY LOADED HOURLY RATES FOR A SMALL CONTRACTOR OF CONSULTING SERVICES AT A GOVERNMENT FACILITY Step 1: Assemble Direct and Indirect Costs Direct Costs are

More information

County of Santa Clara Finance Agency Controller-Treasurer Department

County of Santa Clara Finance Agency Controller-Treasurer Department County of Santa Clara Finance Agency Controller-Treasurer Department Internal Audit Division 55 West Younger Avenue Suite 450 San Jose, CA 95110 408.808.4330 Fax 408.279.8417 October 27, 2006 To: Distribution

More information

Department of Information Technology

Department of Information Technology Department Description The Department of Information Technology (IT) is responsible for providing strategic technology direction, managing and implementing IT governance processes in support of the cross-departmental

More information

BOARD OF COUNTY COMMISSIONERS LAKE OF THE WOODS COUNTY, MINNESOTA APPLICATION FOR EMPLOYMENT

BOARD OF COUNTY COMMISSIONERS LAKE OF THE WOODS COUNTY, MINNESOTA APPLICATION FOR EMPLOYMENT BOARD OF COUNTY COMMISSIONERS LAKE OF THE WOODS COUNTY, MINNESOTA APPLICATION FOR EMPLOYMENT Human Resources Office 206 8 th Ave SE Baudette, MN 56623 (218) 634-2430 IF YOU NEED ASSISTANCE IN COMPLETING

More information

Executive County Superintendent Review of Administrator Contracts Q&A. Updated 1/2013

Executive County Superintendent Review of Administrator Contracts Q&A. Updated 1/2013 Executive County Superintendent Review of Administrator Contracts Q&A Updated 1/2013 This Q&A is to be used for the Executive County Superintendent required review and approval of administrator contracts

More information

MISSISSIPPI DRUG COURT FISCAL POLICY

MISSISSIPPI DRUG COURT FISCAL POLICY MISSISSIPPI DRUG COURT FISCAL POLICY As promulgated by the STATE DRUG COURT ADVISORY COMMITTEE Distributed by the Administrative Office of Courts BACKGROUND Certified drug court programs operating in Mississippi

More information

MARTIN LUTHER KING JR. DAY OF SERVICE

MARTIN LUTHER KING JR. DAY OF SERVICE MARTIN LUTHER KING JR. DAY OF SERVICE REQUEST FOR PROPOSALS Proposals due: Friday, September 14, 2012 ISSUED BY THE MASSACHUSETTS SERVICE ALLIANCE Please direct any questions about this RFP to Shana Lothrop

More information

VERMONT DEPARTMENT OF STATE S ATTORNEYS FISCAL YEAR 2015 BUDGET PRESENTATION

VERMONT DEPARTMENT OF STATE S ATTORNEYS FISCAL YEAR 2015 BUDGET PRESENTATION VERMONT DEPARTMENT OF STATE S ATTORNEYS FISCAL YEAR 2015 BUDGET PRESENTATION Mission Statement State s Attorneys are tasked with prosecuting criminal cases, enforcing Vermont s laws, and upholding the

More information

TECHNICAL ASSISTANCE WORKSHOP

TECHNICAL ASSISTANCE WORKSHOP 2016 Capital, Housing, Economic Development, Blight and Non-Homeless Services RFP TECHNICAL ASSISTANCE WORKSHOP Released Friday, August 7 th Applications Due Friday, September 25 th CONTACT INFORMATION

More information

Enterprise Resource Planning

Enterprise Resource Planning Department Description The Enterprise Resource Planning Department was created to provide a support structure for the City s Enterprise Resource Planning (ERP) system. The ERP system consolidates a wide

More information

Human Resources Summary

Human Resources Summary Summary FY 09 FY 10 FY 10 FY 11 Orig. FY 10 Adj. FY 10 Administration $721,092 $723,185 $676,295 $653,900-9.58% -3.31% Health and Fringe Benefits 15,402,800 22,428,000 22,428,000 20,100,000-10.38% -10.38%

More information

Employee Benefits. To provide centralized budgetary and financial control over employee fringe benefits paid by the County.

Employee Benefits. To provide centralized budgetary and financial control over employee fringe benefits paid by the County. Mission To provide centralized budgetary and financial control over employee fringe benefits paid by the County. Focus Agency 89, Employee Benefits, is a set of consolidated accounts that provide budgetary

More information

IOWA. Recent news, pending action: Pending legislation: Medicaid law and regulations: From Telemedicine for CSHCN: A State- by- State

IOWA. Recent news, pending action: Pending legislation: Medicaid law and regulations: From Telemedicine for CSHCN: A State- by- State IOWA State Recent news, pending action: Pending legislation: for CSHCN: A State- by- State Comparison of Medicaid Policies and Title V Activities (2005) prepared by Connections for Children and Youth:

More information

Debt Management. Department Description

Debt Management. Department Description Department Description Debt Management conducts planning, structuring, and issuance activities for short-term and long-term financing to meet the City's cash flow needs and to provide funds for capital

More information

Texas Department of Criminal Justice. Reentry Overview

Texas Department of Criminal Justice. Reentry Overview Texas Department of Criminal Justice Reentry Overview Reentry Within the TDCJ The reentry process begins upon intake of an offender into the TDCJ. Offenders receive a variety of assessments: mental health,

More information

ACCOUNTABILITY COURT DATA. Ren Yang Hafner, Operations Analyst Statistical Analysis Center Criminal Justice Coordinating Council

ACCOUNTABILITY COURT DATA. Ren Yang Hafner, Operations Analyst Statistical Analysis Center Criminal Justice Coordinating Council ACCOUNTABILITY COURT DATA Ren Yang Hafner, Operations Analyst Statistical Analysis Center Criminal Justice Coordinating Council Nov. 15, 2013 Adult Felony Drug & Mental Health Court Adult Felony Drug Court

More information

HAMILTON COMMUNITY CONSOLIDATED SCHOOL DISTRICT NO.328 Hamilton, Illinois 62341 217-847-3315 (Phone) 217-847-3915 (Fax)

HAMILTON COMMUNITY CONSOLIDATED SCHOOL DISTRICT NO.328 Hamilton, Illinois 62341 217-847-3315 (Phone) 217-847-3915 (Fax) HAMILTON COMMUNITY CONSOLIDATED SCHOOL DISTRICT NO.328 Hamilton, Illinois 62341 217-847-3315 (Phone) 217-847-3915 (Fax) APPLICATION FORM FOR TEACHING Date: Name Address Street City State Zip Current Telephone

More information

FINANCIAL ASSISTANCE APPLICATION: COVER LETTER

FINANCIAL ASSISTANCE APPLICATION: COVER LETTER FINANCIAL ASSISTANCE APPLICATION: COVER LETTER Thank you for choosing Children s of Alabama to provide for the healthcare needs of your child. Please find attached the forms you must complete in order

More information

SPARTANBURG COUNTY EMPLOYMENT APPLICATION

SPARTANBURG COUNTY EMPLOYMENT APPLICATION SPARTANBURG COUNTY EMPLOYMENT APPLICATION Spartanburg County is an equal employment opportunity employer, and makes all employment decisions without regard to disability, handicap, race, color, religion,

More information

Gov. Rec. FY 2015. Agency Req. FY 2016

Gov. Rec. FY 2015. Agency Req. FY 2016 UNIVERSITY OF KANSAS Actual FY 2014 Agency Est. Agency Req. Agency Req. FY 2017 FY 2017 Operating Expenditures: State General Fund $ 135,402,775 $ 137,384,253 $ 137,168,039 $ 136,930,098 $ 135,932,220

More information

COUNTY ADMINISTRATOR 220 NORTH MAIN STREET, P.O. BOX 8645 ANN ARBOR, MICHIGAN 48107-8645 (734)222-6850 FAX (734)222-6715

COUNTY ADMINISTRATOR 220 NORTH MAIN STREET, P.O. BOX 8645 ANN ARBOR, MICHIGAN 48107-8645 (734)222-6850 FAX (734)222-6715 COUNTY ADMINISTRATOR 220 NORTH MAIN STREET, P.O. BOX 8645 ANN ARBOR, MICHIGAN 48107-8645 (734)222-6850 FAX (734)222-6715 TO: THROUGH: FROM: Martha Kern, Chair Ways & Means Committee Robert E. Guenzel County

More information

NEW MEXICO SCHOOL FOR THE DEAF 1060 Cerrillos Road Santa Fe, NM 87505 (505) 476-6300-V/TTY/VP (505)476-6315-Fax Website: www.nmsd.k12.nm.

NEW MEXICO SCHOOL FOR THE DEAF 1060 Cerrillos Road Santa Fe, NM 87505 (505) 476-6300-V/TTY/VP (505)476-6315-Fax Website: www.nmsd.k12.nm. NEW MEXICO SCHOOL FOR THE DEAF 1060 Cerrillos Road Santa Fe, NM 87505 (505) 476-6300-V/TTY/VP (505)476-6315-Fax Website: www.nmsd.k12.nm.us EMPLOYMENT APPLICATION Application : Last First Middle Initial:

More information

COMMITTEE ON LEGISLATIVE RESEARCH OVERSIGHT DIVISION FISCAL NOTE

COMMITTEE ON LEGISLATIVE RESEARCH OVERSIGHT DIVISION FISCAL NOTE COMMITTEE ON LEGISLATIVE RESEARCH OVERSIGHT DIVISION FISCAL NOTE L.R. No.: 0635-01 Bill No.: SB 429 Subject: Victims of Crime; Attorney General; Highway Patrol; Crimes and Punishment; Department of Health

More information

FORT HAYS STATE UNIVERSITY

FORT HAYS STATE UNIVERSITY FORT HAYS STATE UNIVERSITY Actual FY 2014 Agency Est. FY 2015 FY 2015 Agency Req. Agency Req. FY 2017 FY 2017 Operating Expenditures: State General Fund $ 32,656,997 $ 34,036,691 $ 33,988,112 $ 33,921,728

More information

APPLICATION FOR EMPLOYMENT Please TYPE or print using BLACK or BLUE ink

APPLICATION FOR EMPLOYMENT Please TYPE or print using BLACK or BLUE ink Name: First Last 11878 Avenue of Industry San Diego, CA 92128 Telephone: (858) 675-4200 Fax: (858) 675-9241 APPLICATION FOR EMPLOYMENT Please TYPE or print using BLACK or BLUE ink Date Application Completed:

More information

APPLICATION for AUTHORIZATION to provide Alcohol and Drug Education Traffic School (ADETS) for DWI OFFENDERS

APPLICATION for AUTHORIZATION to provide Alcohol and Drug Education Traffic School (ADETS) for DWI OFFENDERS APPLICATION for AUTHORIZATION to provide Alcohol and Drug Education Traffic School (ADETS) for DWI OFFENDERS Application for ADETS Services (Revised 03/14/11) Office of DWI Services Justice Systems Innovations

More information

COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES ALCOHOL AND DRUG PROGRAM ADMINISTRATION COST REPORT FOR CONTRACTED SERVICES INSTRUCTIONS

COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES ALCOHOL AND DRUG PROGRAM ADMINISTRATION COST REPORT FOR CONTRACTED SERVICES INSTRUCTIONS COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES ALCOHOL AND DRUG PROGRAM ADMINISTRATION COST REPORT FOR CONTRACTED SERVICES INSTRUCTIONS COST REPORT FOR CONTRACTED SERVICES (SUMMARY PAGE) Complete

More information

PROGRAM IMPROVEMENT DECISION PACKAGE

PROGRAM IMPROVEMENT DECISION PACKAGE Fund Department Division Dept Rank City Rank 001 1025 575 1 TYPE OF PROGRAM ADJUSTMENT DESCRIPTION OF PROGRAM Vision Internet CMS/web agenda software program The software is used for submission of agenda

More information

Loan Participation Enrollment Form

Loan Participation Enrollment Form Loan Participation Enrollment Form Emerging Entrepreneur s Fund Program Business Information 1. Name and Address of Business: 2. NAICS Code: 3. DUNS No.: 4. Number of Employees Employed by Business at

More information

HowWhat You Can Benefit From Being a Millionaire!

HowWhat You Can Benefit From Being a Millionaire! Circle USD 375 Budget General Information (characteristics of district) Supplemental Information for Tables in Summary of Expenditures KSDE Website Information Available Summary of Expenditures (Sumexpen.xls)

More information

FY 2012 Total County - $388,239,166. FY 2012 Health County Dollars - $29,978,137. Medical Examiner 0.6%

FY 2012 Total County - $388,239,166. FY 2012 Health County Dollars - $29,978,137. Medical Examiner 0.6% Health Service Area FY 2012 Total County - $388,239,166 Health 7.7% FY 2012 Health County Dollars - $29,978,137 Medical Examiner 0.6% CenterPoint Human Svcs. 20.9% Public Health 78.5% OPERATING POLICIES

More information

FILL THE GAP (FTG) APPLICATION

FILL THE GAP (FTG) APPLICATION FILL THE GAP (FTG) APPLICATION A. APPLICANT INFORMATION 1. COURT NAME: SUPERIOR COURT IN YAVAPAI COUNTY 2. CONTACT PERSON: DEBORAH M. SCHAEFER 3. TITLE: COURT ADMINISTRATOR 4. ADDRESS (STREET, CITY, STATE,

More information

Budget General Information (characteristics of district) Supplemental Information for Tables in Summary of Expenditures

Budget General Information (characteristics of district) Supplemental Information for Tables in Summary of Expenditures Liberal USD 48 Budget General Information (characteristics of district) Supplemental Information for Tables in Summary of Expenditures KSDE Website Information Available Summary of Expenditures (Sumexpen.xls)

More information

A RESOLUTION IMPLEMENTING A SECOND ASSERTIVE COMMUNITY TREATMENT TEAM BY CREATING FOUR (4.0 FTE) POSITIONS WASHTENAW COUNTY BOARD OF COMMISSIONERS

A RESOLUTION IMPLEMENTING A SECOND ASSERTIVE COMMUNITY TREATMENT TEAM BY CREATING FOUR (4.0 FTE) POSITIONS WASHTENAW COUNTY BOARD OF COMMISSIONERS A RESOLUTION IMPLEMENTING A SECOND ASSERTIVE COMMUNITY TREATMENT TEAM BY CREATING FOUR (4.0 FTE) POSITIONS WASHTENAW COUNTY BOARD OF COMMISSIONERS December 8, 1999 WHEREAS, Washtenaw County Community Mental

More information

INSTRUCTIONS FOR PREPAID SERVICE PLANS NEW OR RENEWAL APPLICATIONS

INSTRUCTIONS FOR PREPAID SERVICE PLANS NEW OR RENEWAL APPLICATIONS INSTRUCTIONS FOR PREPAID SERVICE PLANS NEW OR RENEWAL APPLICATIONS The attached documents comprise the application necessary to obtain a Certificate of Registration as a prepaid legal or dental service

More information

TABLE OF CONTENTS CENTRAL SERVICES FUND

TABLE OF CONTENTS CENTRAL SERVICES FUND TABLE OF CONTENTS Central Services Fund Overview... 83 Income Summary with Requirements by Department and by Category... 83 Central Services Fund Resources... 84 Central Services Fund Resources Allocation

More information

Note: All attachments should be BEHIND the grant application in an ATTACHMENT SECTION.

Note: All attachments should be BEHIND the grant application in an ATTACHMENT SECTION. Arizona Criminal Justice Commission (ACJC) Crime Victim Assistance Program Grant Application Instructions Fiscal Year 2007 (July 1, 2006 June 30, 2007) Filling Out the Automated Form in Word This year

More information

Florida Department of Agriculture and Consumer Services Office of Energy

Florida Department of Agriculture and Consumer Services Office of Energy Florida Department of Agriculture and Consumer Services Office of Energy ADAM H. PUTNAM COMMISSIONER RENEWABLE ENERGY AND ENERGY-EFFICIENT TECHNOLOGIES GRANT MATCHING PROGRAM APPLICATION RULE 5O-1.003,

More information

Chapter 15 PAYROLL 15-1

Chapter 15 PAYROLL 15-1 Chapter 15 PAYROLL Payroll responsibility varies from municipality to municipality. In smaller municipalities the Clerk- Treasurer is responsible for payroll preparation and maintenance of records. In

More information

OP-B-11-D2 ADMINISTRATION OF CONSTRUCTION MANAGER AGREEMENTS

OP-B-11-D2 ADMINISTRATION OF CONSTRUCTION MANAGER AGREEMENTS OP-B-11-D2 ADMINISTRATION OF CONSTRUCTION MANAGER AGREEMENTS SPECIFIC AUTHORITY Sections 240.209(3)(p), 1001.74, 1013.46, F. S. OBJECTIVE To establish procedures for the administration of construction

More information

Application for Vocational Rehabilitation Services

Application for Vocational Rehabilitation Services Strong Families Make a Strong Kansas Application for Vocational Rehabilitation Services Is Vocational Rehabilitation the right program for you? Some brief information about the Vocational Rehabilitation

More information

MISSISSIPPI DEVELOPMENT AUTHORITY SMALL BUSINESS LOAN GUARANTY PROGRAM

MISSISSIPPI DEVELOPMENT AUTHORITY SMALL BUSINESS LOAN GUARANTY PROGRAM EXHIBIT C MISSISSIPPI DEVELOPMENT AUTHORITY SMALL BUSINESS LOAN GUARANTY PROGRAM APPLICATION MISSISSIPPI DEVELOPMENT AUTHORITY APPLICATION FOR SMALL BUSINESS LOAN GUARANTY PROGRAM INSTRUCTIONS TO LENDER:

More information

2. See additional Oral Exam sections on this website area for additional information: http://certbd.org/testing/oral-test-questions/

2. See additional Oral Exam sections on this website area for additional information: http://certbd.org/testing/oral-test-questions/ Addiction Professionals Certification Board, Inc. East Brunswick, New Jersey www.certbd.org fax: 732-249-1559 Directions for the Case Presentation Method and Oral Test Registration 1. You must have an

More information

DOC - Community Corrections HB 464 - DMHA HB 1006 - IJC

DOC - Community Corrections HB 464 - DMHA HB 1006 - IJC IC 11-12-3.8 Mental Health and Addiction Forensic Treatment Services (MHAFTS) Sec. 1. As used in this chapter, "mental health and addiction forensic treatment services" (MHAFTS) means evidence based treatment

More information

Child Placing Agency (CPA) Cost Report

Child Placing Agency (CPA) Cost Report Child Placing Agency (CPA) Cost Report Reporting Period: 1/1/2011 to: 12/31/2011 VENDOR Vendor Name Street Address City State Zip Code Telephone Number Agency Type License Facility Type Federal Tax Identification

More information

How To Become A Teacher In A Rural School District

How To Become A Teacher In A Rural School District ROSE HILL SCHOOLS U.S.D. 394 104 North Rose Hill Road Rose Hill, KS 67133-9785 316 776-3300 (fax 316 776-3309) http://www.usd394.com An Equal Opportunity Employer We are proud to be a Drug Free WORKPLACE

More information

DEPARTMENT REVIEW FINANCE

DEPARTMENT REVIEW FINANCE DEPARTMENT REVIEW FINANCE Department Description: This department is responsible for the establishment and maintenance of an effective financial accounting system, which accurately reflects the financial

More information

[As Amended by Senate Committee of the Whole] SENATE BILL No. 351. By Joint Committee on Corrections and Juvenile Justice Oversight 1-11

[As Amended by Senate Committee of the Whole] SENATE BILL No. 351. By Joint Committee on Corrections and Juvenile Justice Oversight 1-11 Session of 00 [As Amended by Senate Committee of the Whole] SENATE BILL No. By Joint Committee on Corrections and Juvenile Justice Oversight - 0 0 0 AN ACT concerning crimes, punishment and criminal procedure;

More information

INSTRUCTIONS FOR COMPLETING BUDGET REQUEST FORM

INSTRUCTIONS FOR COMPLETING BUDGET REQUEST FORM 1. 2. INSTRUCTIONS FOR COMPLETING BUDGET REQUEST FORM In accordance with the requirements of WS 16-4-104 The Department of Audit has modified the Standard Form. Please follow the steps below: a. Download

More information

Capital Area Council of Governments FY 2015 Cost Allocation Plan

Capital Area Council of Governments FY 2015 Cost Allocation Plan Capital Area Council of Governments FY 2015 Cost Allocation Plan The Capital Area Council of Governments uses the cost allocation method prescribed in OMB Circular A 87, Department of Health and Human

More information

David A. Wang, MD Primary Care Sports Medicine Physician PRINT NAME: ADDRESS: DOB: AGE: SEX: SS# HOME: MOBILE PHONE: WORK: FAX:

David A. Wang, MD Primary Care Sports Medicine Physician PRINT NAME: ADDRESS: DOB: AGE: SEX: SS# HOME: MOBILE PHONE: WORK: FAX: David A. Wang, MD Primary Care Sports Medicine Physician PRINT NAME: ADDRESS: DOB: AGE: SEX: SS# HOME: MOBILE PHONE: WORK: FAX: INSURANCE INFORMATION Did you injure yourself at work or is this injury a

More information

City of Charlottesville Preliminary Projected Budget and Long Term Forecast General Fund Fiscal Year 2017-2021

City of Charlottesville Preliminary Projected Budget and Long Term Forecast General Fund Fiscal Year 2017-2021 1 1/20/2016 City of Charlottesville Preliminary Budget and Long Term Forecast General Fund Fiscal Year 2017-2021 General Fund Revenues FY2016 Adopted FY2016 Revised * FY2017 FY2018 FY2019 FY2020 FY2021

More information

Cell Phone Policy. 1. Purpose: Establish a policy for cell phone use and compensation allowance.

Cell Phone Policy. 1. Purpose: Establish a policy for cell phone use and compensation allowance. Cell Phone Policy 1. Purpose: Establish a policy for cell phone use and compensation allowance. 2. Authority: The Clinton County Board of Commissioners. 3. Application: This Cell Phone Policy (the Policy)

More information

JUDICIARY. FY 2013-14 Year-To-Date as of 2/5/14 92.0 $13,101,300 664,300 $12,437,000. FTEs-Exempt Gross Restricted GF/GP

JUDICIARY. FY 2013-14 Year-To-Date as of 2/5/14 92.0 $13,101,300 664,300 $12,437,000. FTEs-Exempt Gross Restricted GF/GP Changes from FY 213-14 YTD SUPREME COURT Phone: 373-88 FY 213-14 1. Supreme Court Administration Executive: $13,371,8 House: $13,371,8 Senate: $13,371,8 92. $13,11,3 664,3 $12,437, $27,5 13,7 $256,8 $27,5

More information

CITY OF CHARLOTTE OFFICE OF INTERNAL AUDIT. Independent Report of Internal Audit

CITY OF CHARLOTTE OFFICE OF INTERNAL AUDIT. Independent Report of Internal Audit CITY OF CHARLOTTE OFFICE OF INTERNAL AUDIT Independent Report of Internal Audit To: City Manager s Office and Charlotte Water June 21, 2016 From: Greg McDowell, City Auditor Re: Union County Wastewater

More information

LEVEL TEXT TEXT AMT COMR RESTRICTED-CLAIMS FOR FY15 & PRIOR YEARS 2,573,000 2,573,000

LEVEL TEXT TEXT AMT COMR RESTRICTED-CLAIMS FOR FY15 & PRIOR YEARS 2,573,000 2,573,000 13:49:43 FOR FISCAL YEAR 15/16 REVENUES FY 15/16 FY 12/13 FY 13/14 AMENDED COMMISION ACCOUNT ACCOUNT DESCRIPTION ACTUAL ACTUAL BUDGET REVIEW Miscellaneous Revenues 502-361-0000 Interest Earnings 22,041

More information

City of Terrell Hills 5100 North New Braunfels Avenue San Antonio, Texas 78209 210-824-7401

City of Terrell Hills 5100 North New Braunfels Avenue San Antonio, Texas 78209 210-824-7401 To All Applicants: In order for the City of Terrell Hills to process this application, it must be complete. All lines must be filled in. If something does not apply to you, then write N/A in that blank.

More information

Manchester, New Hampshire

Manchester, New Hampshire DRUG EVALUATION AND CLASSIFICATION (DRE) & BREATH ALCOHOL TESTING TRAINING FOR LEGAL PROFESSIONALS Manchester, New Hampshire November 13 th 14 th, 2015 HILTON GARDEN INN MANCHESTER DOWNTOWN HOTEL ADDRESS:

More information

Name of victim (last, first, middle) Home telephone Work telephone. Name of claimant (last, first, middle) Home telephone Work telephone

Name of victim (last, first, middle) Home telephone Work telephone. Name of claimant (last, first, middle) Home telephone Work telephone Personal injury compensation application JD-VS-8PI Rev. 12/07 section one - Victim information Name of victim (last, first, middle) Home telephone Work telephone Address cell telephone age City State Zip

More information

BARTON COUNTY DUI DIVERSION PROGRAM GUIDELINES

BARTON COUNTY DUI DIVERSION PROGRAM GUIDELINES BARTON COUNTY DUI DIVERSION PROGRAM GUIDELINES WHAT IS DIVERSION? The DUI diversion program offered and supervised by the Barton County Attorney enables certain people to complete a performance plan rather

More information

SECOND CONFERENCE COMMITTEE REPORT BRIEF HOUSE SUBSTITUTE FOR SENATE BILL NO. 35

SECOND CONFERENCE COMMITTEE REPORT BRIEF HOUSE SUBSTITUTE FOR SENATE BILL NO. 35 SESSION OF 2007 SECOND CONFERENCE COMMITTEE REPORT BRIEF HOUSE SUBSTITUTE FOR SENATE BILL NO. 35 Brief* As Agreed to April 25, 2007 House Sub. for SB 35 would:! Clarify when a violation for speeding would

More information

Social and Rehabilitation Services

Social and Rehabilitation Services Kansas Department of Social and Rehabilitation Services Gary Daniels, Secretary Joint Committee on Corrections and Juvenile Justice Oversight November 2, 2006 Overview of Substance Abuse Treatment Services

More information

USD #466 Scott County

USD #466 Scott County USD #466 Scott County Budget General Information (characteristics of district) Supplemental Information for Tables in Summary of Expenditures KSDE Website Information Available Summary of Expenditures

More information

HEADING: CONTRACT AGENCY LEGAL NAME

HEADING: CONTRACT AGENCY LEGAL NAME COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES ALCOHOL AND DRUG PROGRAM ADMINISTRATION COST REPORT FOR CONTRACTED SERVICES OUTPATIENT DRUG FREE SERVICES INSTRUCTIONS COST REPORT FOR CONTRACTED SERVICES

More information

This Agreement is based on the following general principles:

This Agreement is based on the following general principles: CERTIFIED MEDICAID MATCH AGREEMENT BETWEEN THE AGENCY FOR HEALTH CARE ADMINISTRATION AND COUNTY FOR THE REIMBURSEMENT OF SPECIFIED SUBSTANCE ABUSE TREATMENT SERVICES FOR MEDICAID RECIPIENTS The Agency

More information

Page Intentionally Left Blank

Page Intentionally Left Blank Page Intentionally Left Blank Division Description The Airports Division, part of the Real Estate Assets Department (READ), is responsible for operating two general aviation airports, Montgomery Field

More information

Please list the areas in which you are qualified to teach based on training, experience and preference. 1) 2) 3)

Please list the areas in which you are qualified to teach based on training, experience and preference. 1) 2) 3) CERTIFIED TEACHER APPLICATION Home of the Bobcats Dent-Phelps R-III School District 27870 Highway C Salem, MO 65560 573-729-4680 Website: www.dentphelps.k12.mo.us Fax: 573-729-8644 email: admin@dentphelps.k12.mo.us

More information

M E M O R A N D U M. April 15, 2010. Planning, Housing, and Economic Development Committee

M E M O R A N D U M. April 15, 2010. Planning, Housing, and Economic Development Committee M E M O R A N D U M April 15, 2010 TO: FROM: SUBJECT: Planning, Housing, and Economic Development Committee Jennifer Renkema, Research Associate Office of Legislative Oversight Examples of Proposed FY11

More information

REPORT NO. 2012-024 NOVEMBER 2011 EDISON STATE COLLEGE. Operational Audit

REPORT NO. 2012-024 NOVEMBER 2011 EDISON STATE COLLEGE. Operational Audit REPORT NO. 2012-024 NOVEMBER 2011 EDISON STATE COLLEGE Operational Audit BOARD OF TRUSTEES AND PRESIDENT Members of the Board of Trustees and President who served during the 2010-11 fiscal year are listed

More information

INFORMATION/INSTRUCTION SHEET CERTIFIED PODIATRIC X-RAY ASSISTANT

INFORMATION/INSTRUCTION SHEET CERTIFIED PODIATRIC X-RAY ASSISTANT Chapter 461, Florida Statutes Rule Chapter 64B18-24, Florida Administrative Code INFORMATION/INSTRUCTION SHEET CERTIFIED PODIATRIC X-RAY ASSISTANT Any Certified Podiatric X-ray Assistant may perform services

More information

OHIO VICTIMS OF CRIME COMPENSATION PROGRAM

OHIO VICTIMS OF CRIME COMPENSATION PROGRAM OHIO VICTIMS OF CRIME COMPENSATION PROGRAM Application for Supplemental Compensation If you or your family members are innocent victims of a violent crime, financial assistance may be available. For more

More information

APPLICATION FOR 21 ST CCLC GRANTS DEPARTMENT OF PUBLIC INSTRUCTION SPECIAL PROJECTS SFN 53515 (Rev. 04/2013)

APPLICATION FOR 21 ST CCLC GRANTS DEPARTMENT OF PUBLIC INSTRUCTION SPECIAL PROJECTS SFN 53515 (Rev. 04/2013) Applicant Information Name of Applicant APPLICATION FOR 21 ST CCLC GRANTS DEPARTMENT OF PUBLIC INSTRUCTION SPECIAL PROJECTS SFN 53515 (Rev. 04/2013) Tax ID Number RETURN TO: Department of Public Instruction

More information

Relationship to Victim. Mailing Address City/State/Zip. SSN Date of Birth. Home Telephone Cell phone Other. Email address

Relationship to Victim. Mailing Address City/State/Zip. SSN Date of Birth. Home Telephone Cell phone Other. Email address State of Alaska Violent Crimes Compensation Board Application for Crime Victim Compensation Application for Crime Victim Compensation Section 1 Claimant A separate application must be completed for each

More information

GLCAC, Inc. - Head Start Program HEAD START Proposed Budget 2014/2015

GLCAC, Inc. - Head Start Program HEAD START Proposed Budget 2014/2015 Funded Enrollment: 417 PROGRAM AND BUDGET NARRATIVE Cost for Program Operations: $3,751,804 Cost for Training & Technical Assistance $42,370 T/TA funds are divided equally amongst every employee in our

More information

Budget General Information (characteristics of district) Supplemental Information for Tables in Summary of Expenditures

Budget General Information (characteristics of district) Supplemental Information for Tables in Summary of Expenditures De Soto USD #232 Budget General Information (characteristics of district) Supplemental Information for Tables in Summary of Expenditures KSDE Website Information Available Summary of Expenditures (Sumexpen.xls)

More information

CHEROKEE COUNTY. Entrepreneurship (E-) Community Loan Application

CHEROKEE COUNTY. Entrepreneurship (E-) Community Loan Application CHEROKEE COUNTY Entrepreneurship (E-) Community Loan Application January 2015 Cherokee County E-Community Program A partnership project of Cherokee County Economic Development Corporation 104 S. Kansas

More information

EMPLOYMENT APPLICATION

EMPLOYMENT APPLICATION SPALDING COUNTY BOARD OF COMMISSIONERS 119 E. Solomon Street, P.O. Box 1087 Griffin, Georgia 30224 www.spaldingcounty.com EMPLOYMENT APPLICATION SPALDING COUNTY ONLY ACCEPTS APPLICATIONS FOR CURRENTLY

More information

MENTAL HEALTH INPATIENT INITIAL CERTIFICATION APPLICATION Chapter DHS 61.71 and 61.79

MENTAL HEALTH INPATIENT INITIAL CERTIFICATION APPLICATION Chapter DHS 61.71 and 61.79 DEPARTMENT OF HEALTH SERVICES STATE OF WISCONSIN Division of Quality Assurance Chapter DHS 61.71 and 61.79, Wis. Admin. Code Page 1 of 9 MENTAL HEALTH INPATIENT INITIAL CERTIFICATION APPLICATION Chapter

More information

Planning Commission. Planning Commission. Clerical Support Branch. Administrative/ Notification Branch

Planning Commission. Planning Commission. Clerical Support Branch. Administrative/ Notification Branch Planning Commission Clerical Support Branch Administrative/ Notification Branch Mission To provide recommendations to the Board of Supervisors and/or the Board of Zoning Appeals on land use policies and

More information

Quarterly Medicaid Statement of Expenditures For the Medical Assistance Program

Quarterly Medicaid Statement of Expenditures For the Medical Assistance Program Quarterly Medicaid Statement of Expenditures For the Medical Assistance Program CMS 64 Summary Sheet Net Expenditures Reported In This Period (Sum of Items 6, 7 and 8 Less 9 and 10) I certify that: Certification

More information

{REMOVE THIS 1 page cover memo before sending to applicant/rp} DIVISION OF WASTE MANAGEMENT & DISTRICT PERSONNEL

{REMOVE THIS 1 page cover memo before sending to applicant/rp} DIVISION OF WASTE MANAGEMENT & DISTRICT PERSONNEL MEMORANDUM {REMOVE THIS 1 page cover memo before sending to applicant/rp} TO: FROM: SUBJECT: DIVISION OF WASTE MANAGEMENT & DISTRICT PERSONNEL OFFICE OF GENERAL COUNSEL / OFFICE OF INSPECTOR GENERAL FINANCIAL

More information

Fiscal Year 2014 Certified Financial Statement

Fiscal Year 2014 Certified Financial Statement Fiscal Year 2014 Certified Financial Statement Reporting Manual and Forms for Second Class Cities State of Alaska Sean Parnell, Governor Department of Commerce, Community, and Economic Development Susan

More information