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DocuSign Envelope ID: D068E7B0- D869- 43F4- B35C- 428F10E3BDC1 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />■ Orange County Other (DO NOT Include HOME funding here) <br />• Other Government Grants <br />• Triangle United Way <br />• State Government <br />• Federal Government (CDBG /HOME /etc.) <br />• Private Foundation Grants <br />• Other Revenue <br />• Expenditures <br />o Compensation <br />o Rent & Utilities <br />• Supplies & Equipment <br />• Travel & Training <br />• Other Expenses <br />iii. Does your agency budget show a Surplus or Deficit? <br />There is a small deficit for FY17. <br />Is there a significant change? Yes /No No <br />Please provide a brief explanation for Surplus or Deficit, and significant changes. <br />The board has reviewed the deficit, which was caused by some initiatives that <br />were unpaid. As the deficit was a low percentage of the budget, and we have <br />reserve funds, the board was comfortable with it. <br />iv. What is your agency's fiscal year? June 30 <br />(Example: July 1, 2016 through June 30, 2017) <br />Agency Information 1/22/2018 4:11:17 PM <br />