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r <br /> EXHIBIT A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPI ICATION <br /> d.) Agency Operating Budget <br /> Please show all sources and amounts of funding for your entire current fiscal year. What is your <br /> agency's fiscal Year? Example: July 1, 2016 through June 30, 2017. Submit operating budget in <br /> your own format. <br /> Do not Include funds that have been applied for but not yet awarded: If the total revenue is not <br /> the same amount as the budget for any fiscal year, please attach a statement explaining the deficit <br /> or surplus. <br /> It is required that your Excel budget worksheet be embedded on the next page. You must <br /> also submit an electronic copy,of the MS Excel file with your application, as a separate file. <br /> w A�s'r. 414C210n40 4 4.9n•77 AAA D n r n 7 4 o f 7 7 <br />