Planning - Application for Regional Community Grants or Glaxo Inc. Special Projects Grants

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1. Other sources of funds for this project: (TO BE SOLICITED DURING 1994) Funding Source Total Amount Amount Already Notification Sought Committed Date Orange County $6000 ± $5000 (matching funds) Town of Chapel Hill Town of Carrboro Town of Hillsborough Irivate organizations and indi-viduals $6-10,000 TOTALS: = $40,000 12. Applicant agency's overall annual operating budget: $ 53,982,206 Overall Operating Budget Breakdown: (SEE ATTACHED SUMMARY SHEETS) Total Income $ from Individuals $ from Corporations $ from Foundations $ from Local Government $ from State Government $ from Federal Government $ from Earned Income $ from Other Expense $ for Program Services $ for Fundraising $ for Management/General $ for Payments to Affiliates Difference: 3. Percentage of this project to overall annual operating budget: 0.07 4. Timetable for the project: July 1994 - to October 1995 Month/Year Month/Year .5. Proposed timetable for payment of funds requested from Greater Triangle Community Foundation: (Fall grants available after January 15 or later and Spring grant available after July 15 or later; Foundation checks are written on the 15th and last day of each month): Date Amount 7-15-95 $6000 Tax Status (check one): Tax-exempt charitable organization [501(c)(3)] x Governmental tax-exempt unit Other nonprofit (specify status) Unincorporated association Affiliated with tax-exempt organization Other (specify) Please attach a copy of your organization's tax status determination letter. A tax exempt identification number is not sufficient (not applicable to government agencies and religious organizations). $5000 in matching grant funds were received in October 1993 from the State Historic Preservation Office, Survey and tPlanning Grant for manuscript preparation.