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9129122, 10:52 AM <br />Verification of ln-kind <br />Contributions <br />LTAC Grant Funding <br />Past Actual 3 <br />$000 <br />Past Actual 2 <br />$000 <br />Past Actual 2 <br />$000 <br />$000 <br />Past Actual 1 <br />$ 0.00 <br />Past Actual 1 <br />$ 0.00 <br />$000 <br />Projected <br />$ 5,000.00 <br />Projected <br />$ 300.00 <br />$ 500 00 <br />LTAC Clerk Review <br />For any claimed in-kind contributions valued at $500 or more and related to marketing/advertising, you must <br />submit verifying documentation which assures the coniribution will be provided. <br />9l Project Budget Overview <br />Please complete budget for this projecVproposal. lf your agency operates independently of this project application it <br />may not be necessary to submit the entire agency budget. You must submit a budget which specifically pertains to <br />the projecUevent for which you are requesting funding and adheres to the basic budget format shown below. <br />The budget must include anticipated revenues, expendiiures, and any potential profit or loss. For projects/events which <br />are ongoing for more than one (1) year, please also submit actuals from the previous three (3) years of operations <br />(need not be consecutive) for the projecUproposal if applicable. <br />For any claimed in-kind contributions valued at $500 or rnore and related to marketing/advertising, you must <br />submit verifying documentation which assures the contribution will be provided. For instance, if you are claiming <br />in-kind contributions in the form of advertising match, a binding contract itemizing the matching value and obligating <br />each party must be provided. <br />ATTENTION: ln an effort to allow an adequate level of flexibility for allapplicants, not allfields in the budget portion are <br />required to be filled before this form is submitted. Froviding all applicable data is your responsibility, failure to do <br />so will potentially jeopardize your application's chance for review. <br />Budget Year <br />Edit if necessary 2020 2021 2022 2023 <br />Revenues From Consolidated Lodging Tax Grant <br />,, <br />:l <br />:. <br />.': <br />! <br />ii <br />']. <br />l <br />a,: <br />::: <br />la <br />lr <br />7: <br />,, <br />il <br />i <br />t <br />I <br />,:, <br />t <br />.t <br />{.t <br />q <br />1,1 <br />:!fl <br />ti <br />a* <br />r, <br />!ti <br />All Other Revenues <br />Account Name <br />Sponshorship <br />Registrations <br />Past Actual 3 <br />$000 <br />$ 0.00 <br />ln-Kind Contributions (except volunteerism) <br />lf-app-16-03.co.kittitas.wa.us/Forms/form/submission/historyi77548/85643?hideHeader=true 11t13