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~. ~ ~ - 7 <br />To assist the COPS Office in forecasting future hiring, how many new officers would you tike to have award- <br />ed by the COPS Office in each of the following calendar years? Do not includt officers currently funded by the <br />COPS Office or included in yotrr request above. By completing this section, you will automatically bt 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 th[ extraordinary local fsscal hardship upon wieich you are <br />basing your request for a waiver. (Set "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 the best of my knowledge. 1 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 lauw <br />,~ , <br />Law Enforcement Executive's Signa ~ ~~~~ Date: 4/ 1 F~97 <br />(signature of person named on ~ front of this form) <br />Government Executive's Signature: 1~ ~ LQ Q~w~t ~.. ~ a.u~n Date: y (S a <br />(signature of person named on the 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 />Notes Fax copies urill NOT be accepted <br />