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DocuSign Envelope ID:6CD4A528-52AE-410E-B18B-BA619068A9AB t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <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 /> July 1, 2016—June 30, 2017 <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 /> Main Application 5/24/2016 9:47:14 AM 0 I:°' g 21 of 23 <br />