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14 <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 officers currently funded by the <br /> COPS Office or included in your request above. 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: A <br /> 1999: R <br /> 2000: 12 <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 you are <br /> basing your request for a waiver. (See "Guidelines for Waivers of Non-Federal Matching Contributions for COP: <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 applica 'on and program requirements of the Public Safe. <br /> Partnership and Community Policing Act of 1 4.an of r i is of federal lain <br /> Law Enforcement Executive's Signa I �/L�'� Date: 4/1 s147 <br /> (signature of person named on t' front of this form) 1 <br /> Government Executive's Signature: U j cQ ci AM L.1/AMA11 _ Date: `i <br /> (signature of person named on the front of this)orm) <br /> Please return I original and 2 copies of this form, the Community Policing 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 /> noo Vermont Avenue,N.W. <br /> Washington,DC 20530 <br /> Note:Fax copies will NOT be accepted <br />