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Financial lnformation <br />lnformation <br />Pass Th lnformation <br />Prosecutor Review <br />TotalAmount Sruff 522,o24.00 State Funds S Federal Funds SPercentCounFundsMatchiFunds S CFDA# <br />ln-Kind S <br />tn <br />urchased ?ls Equi ment being Who owns e I ment? <br />New Personnel bei ng hired?Contact HR hirin - reportin requtrements <br />Future impacts or liability to Kittitas County: <br />Budget Amendment Needed? <br />New Division Created? <br />Yes ! attach budget form No n why not <br />Revenue Code EXPENSE Code 116-61239245100r <br />to Pass Th h <br />Amount to Pass Th h 5 <br />Sub-Contract Approved Date <br />Has the Prosecutor reviewed this reement?Yes f " Yb'i-No <br />Cou Departments lm pacted <br />Submitted <br />Assignment of Track lnformation <br />Auditor Facilities Maintenance <br />lnformation Services Human Resource <br />Prosecutor Treasurer <br />natures Date: <br />rtmentDe <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office \1 tf <br />Who Signed the ant ap ication <br />Reviewer Date <br />Grant/Contract Review Page 2