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DocuSign Envelope ID: 4B292955- 9A36- 47C6- BDDE- 4E9CDOBA074D <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 (CDBGlHOMEletc.) <br />• Private Foundation Grants <br />• Other Revenue <br />• Expenditures <br />o Compensation <br />o Rent & Utilities <br />o Supplies & Equipment <br />o Travel & Training <br />o Other Expenses <br />iii. Does your agency budget show a Surplus or Deficit? Yes. <br />Is there a significant change? Yes /No No. <br />Please provide a brief explanation for Surplus or Deficit, and significant changes. <br />The deficit of $2,656 is just 1 % of the agency's total revenues and not significant. <br />iv. What is your agency's fiscal year? July 1, 2018 — June 30, 2019 <br />(Example: July 1, 2018 through June 30, 2097) <br />Agency Information 1/19/2018 2:38:17 PM Page 13 of 26 <br />