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DocuSign Envelope ID: C4A8ABA9- 961E- 4297- 82F0- 5B1739260CFF <br />h) Agency Budget <br />i. Is your agency currently receiving and/or requesting other (non -Human Services) <br />local (Town of Carrboro, Town of Chapel Hill, Orange County) government <br />funding? (Yes/No) No <br />If yes, please list below: <br />Include all programs that have funding requestslawardsltotais from Carrboro, ChaQel hf /11. <br />and Orange Cogn!y governments (other than Human Services). DO NOT include federal <br />funding sources, such as CDBG and HOME, <br />Program - <br />FY17 -18 <br />FY18 -19 <br />I Source - — - <br />Award <br />Request <br />Ex: Affordable Rental <br />a <br />$20.000 <br />Carrboro - Affordabl Housi <br />Rehabilitation <br />Ex: Agency Administration <br />$15,000 <br />$15,0010 <br />Carrboro - Other <br />Ex. Total <br />$15,000 <br />$35,000 <br />Carrboro Total Fundina <br />*Add rows or attach additional page, if needed. <br />ii. Submit your agency's budget. You may complete the provided template (separate <br />xis file) or you may submit your own budget file (as long as it contains the same <br />information, and in a similar format, as requested in the provided template). <br />Agency Budgets are required to define budget amounts for the previous program <br />year, current program year, and next program year for the following categories: <br />• Revenues <br />Q Private Donations <br />0 Program Generated Revenue <br />Q Local Government Grants <br />• Carrboro Human Services <br />• Carrboro Other <br />• Chapel Hill Human Services <br />• Chapel Hill Other (DO NOT include CDBG funding here) <br />Agency Information 2/1212018 7:53:03 PM Page 13 of 28 <br />