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DocuSign Envelope ID: 913F749B-B9E8-4103-AF9D-A4296D01069E t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Section VI.Financial Data <br /> Operating Budget for Entire Agency <br /> AGENCY NAME: Ligo Dojo of Budo Karate <br /> Actual Estimated Projected Percent <br /> AGENCY REVENUE 2014-15 2015-16 - 2016-17 Change <br /> Private Donations <br /> Agency Generated Revenue(fees) 5 66,600 $ 73,920 5 75,000 1% <br /> Local Government Grants: <br /> Orange County $ 3,600 $ 5,600 $ 5,600 0% <br /> Town of Chapel Hill $ 2,000 $ - $ 2,000 <br /> Town of Carrboro $ 2,000 5 2,000 5 2,000 0% <br /> Other Local: OC JCP $ 19,000 $ 19,000 $ 19,000 0% <br /> Other Local: 0 <br /> Other Local: <br /> If more than 3 sources,please <br /> provide a separate list. <br /> Non-Local Government Grants <br /> Triangle United Way 0 <br /> State Government 0 <br /> Federal Government 0 <br /> Other Grants: <br /> Other Grants: <br /> Miscella neousfOther Revenue $ 2,000 $ 2,000 $ 7,000 250% <br /> Reese Est 3 gest Iiiiscellanous sources: <br /> Well Fargo $ 4,000.00 <br /> Individual gift 5 3,000,00 <br /> strowd roses/wells fargo $ 2,000.00 <br /> Total Agency Revenue $ 95,200 $ 102,520 $ 110,600 8% <br /> AGENCY EXPENSES <br /> Compensation 5 26,000 $ 32,000 $ 37,000 16% <br /> Rent S.Utilities $ 36,200 $ 37,020 $ 40,500 9% <br /> Supplies&Equipment $ 2,000 $ 2,500 $ 3,000 20% <br /> Travel&Training $ 5,000 $ 5,000 $ 4,100 <br /> Other Expenses: $ 26,000 $ 26,000 $ 26,000 0% <br /> Reese fist 3 largest"Rther apenses": <br /> Insurance $ 2,000.00 <br /> Loan repayment $ 24,000.00 <br /> Total Agency Expenses $ 95,200 $ 102,520 $ 110,600 8% <br /> SURPLUS/(DEFICIT)FOR PERIOD: I$ - I $ - I $ - I 0 <br /> Main Application 1/25/2015 10:16:09 AM Page 20 of 20 <br />