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DocuSign Envelope ID: CB0C1343-06EB-4BE7-9AF6-62EE77BD69FE 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 <br /> in your own format. <br /> Do not include funds that have been applied for but not yet awarded: If the total revenue is <br /> not the same amount as the budget for any fiscal year, please attach a statement explaining the <br /> deficit or surplus. <br /> It is required that your Excel budget worksheet be embedded on the next page. You <br /> must also submit an electronic copy of the MS Excel file with your application, as a <br /> separate file. <br /> • Agency fiscal year is July 1, 2016 to June 30, 2017 <br /> • FY15 represents the first six months of Planned Parenthood South Atlantic's <br /> operations. On January 1, 2015, Planned Parenthood Health Systems (PPHS) and <br /> Planned Parenthood of Central North Carolina(PPCNC) merged to become <br /> Planned Parenthood South Atlantic. Prior to that, PPHS and PPCNC operated as <br /> separate organizations with separate budgets. <br /> Main Application 1/21/2016 18:35:26 a1/p1 Page 2 3 of 2 " <br />