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DocuSign Envelope ID: EBOFBDBE -FD15- 4428- 899B- 19A867F94OCC <br />h) Agency Budget <br />L 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 ail programs that have funding requests/awards/totals from Carrboro, Chapel Herr, <br />and Qran-ge Coun€ governments (other than Human Services). DO NOT include federal <br />funding sources, such as CDBG and HOME. <br />Program <br />FY17 -18 <br />Award <br />FYI 8-19 <br />Request <br />Source <br />Ex: Affordable Rental <br />Rehabilitation <br />0 <br />$20,000 <br />Carrboro - Affordable Housing <br />Ex: Agency Administration <br />$15,000 <br />$15,000 <br />Carrboro — Other — <br />Ex. Total <br />$15,000 <br />$35,000 <br />Carrboro Total Funding <br />*Add rows or attach additional page, if needed. <br />ii. Submit your agency's budget. You may complete the provided template (separate <br />As 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 />o Private Donations <br />* Program Generated Revenue <br />o 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 />Arurmrrr lnfnrmation 112.,419ti1R R-.E'id-nn AAA P n 1-1 r -�, I I o f '9 ri <br />