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DocuSign Envelope ID: 8FFCF3D9- 3AF5 -4C83- 9829- AC9D4975107C <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />• Orange County Human Services <br />• Orange County Other (DO NOT Include HOME funding here) <br />o Other Government Grants <br />• Triangle United Way <br />• State Government <br />• Federal Government (CDBG /HOME /etc.) <br />• Private Foundation Grants <br />o 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? Yes <br />Is there a significant change? <br />Yes; we stopped reporting the museum's use of supplemental reserve funding as revenue on our <br />budgets to show more clearly the museum's dire financial state. <br />iv. What is your agency's fiscal year? July 1, 2018 - June 30, 2019 <br />(Example: July 1, 2016 through June 30, 2017) <br />Agency Information 1/23/2018 12:14:22 PM _ <br />