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Health and WellnessTrust Fund Commission <br />Grant Application Budget <br />Applicant Agency: <br />Contact Person for Budget: Maria Hitt <br />Contact Phone: 919 -968 -2022 Ext 291 <br />Fax: 919- 968 -2013 <br />e -mail: mhitt@co.orange.nc.us <br />Federal Tax I.D. or 501(c)(3): 56- 6000327 <br />Arect Expenses: <br />ialaryMages /Benefits <br />;ontracted Staff <br />Other (Please clarify bek <br />Subtotal: <br />Other Than Personnel <br />Support (OTPS) <br />Supplies /Material <br />Communication Costs <br />(telephone, postage, freh <br />Occupancy Costs (rent, <br />utilities, repairs, mainten <br />Media (Advertising and <br />Promotions) <br />Capital Outlay (furniture, <br />equipment, data process <br />1. Year 1 starting on or about 111/2003 and ending 12/3112003 <br />2. Year 1 starting on or about 1/1/2004 and ending 12131/2004 <br />3. Year 3 starting on or about 1/112005 and ending 12/31/2005 <br />1/1/2003— <br />$4,000.00 $ <br />$49,382.00 $1 <br />.001 $51,272.00 $24,800.00 1 $53,257.00 $2 <br />Total <br />.00 $141,911.00 $26,400.00 <br />$0.00 $0.00 <br />.00 $12,000.00 $40,000.00 <br />.001 $153,911.00 $66,400.00 <br />4,000.00 1,000.00 <br />4,000.00 1,000.00 <br />.4,000.00 1,000.00 <br />12,000.00 3,000.00 <br />1,217.00 500.00 <br />982.00 500.00 <br />982.00 500.00 <br />3,181.00 1,500.00 <br />9,600.00 <br />9,600.00 <br />9,600.00 <br />0.00 28,800.00 <br />1,000.00 500.00 <br />500.00 <br />500.00 <br />2,000.00. 500.00 <br />non no . <br />5.000.00 0.00 <br />CD <br />