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<br />7 <br />To assist the COPS Office in forecasting future hiring, how many new officers would you like to have award- <br />ed by the COPS Office in each of the following calendar years? Do not include offrcers currently funded by the <br />COPS Office or included in yoirr request about. By completing this section, you will automatically be considered for <br />grant awards from the COPS Office. <br />Full-Time Part-Time <br />1997: 6 <br />1998: ~ <br />1999: a <br />2000: , ~ <br />Are you requesting a waiver of the local match requirement based upon severe fiscal distress? <br />O Yes ~ No <br />If "yes," attach a one page typewritten description of the extraordinary local fiscal hardship upon which yoir are <br />basing your rrgirest for a waivtr. (See "Guidelines for Waivers of Non-Federal Matching Contributions for COPS <br />Grants" in the instruction section) <br />I certify that the information provided on this form is true and accurate to thr best of my knowledge. I understand that <br />prior to any grant award, the applicant must comply with all applicat'on and program requirements of the Public Safety <br />Partnership and Community Policing Act of 1 ~ 4.an of r i is of federal law <br />Law Enforcement Executive's Si ~ . <br />~ ~ ~~~ Date• 4(1 ~~4~ <br />!signature of person named on ~ front of this form) <br />Government Executive's Signature: l~ ~ rQ D,rc~l . r~n.tlli~ Date: y' ~S q <br />v <br />(signature of person named on tht front of this form) <br />Please return 1 original and 2 copies of this form, the Community Polidng Information Worksheet, the <br />Budgetary Information form(s), and any additional information that is required to: <br />COPS Universal Hiring Program <br />U. S. Department of Justice <br />1100 Vermont Avenue, N.W. <br />Washington, DC 20530 <br />Note Fax copies trill NOT be accepted <br />