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DocuSign Envelope ID: 80124B29- E4DA- 4BOD- A879- D287FCF3F3CA <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? We balance our budget <br />annually. <br />Is there a significant change? Yes /No Yes <br />Please provide a brief explanation for Surplus or Deficit, and significant changes. <br />Our FY runs Jan 1 — Dec 31. For RSC 's 2017 budget year, we show a surplus of <br />$5,618.00 because we receive $11,340 from Orange County Social Justice Funds in <br />June 2017 to cover rent and utilities from July, 2017 — June, 2018. <br />The significant change is that our budget has grown; this is for two reasons. Due to <br />our move to own location, we now incur rent, utilities and insurance expenses. Our <br />need for more interpreters in various languages (Arabic, Burmese, Chin, Karen, <br />Kinyarwanda, Rohingya and Swahili) has also resulted in budget growth. <br />iv. What is your agency's fiscal year? January 1, 2018 — December 31, <br />2018 <br />(Example: July 1, 2016 through June 30, 2017) <br />Agency Information 1/18/2018 1:56:21 PM Page 14 of 26 <br />