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Financial lnformation <br />B lnformation <br />Pass Th lnformation <br />Prosecutor Review <br />TotalAmount State Funds Federal Funds 5 <br />CouPerce Funds Matchi Funds CFDA# <br />ln-Kind S <br />tn <br />ent bei hased?lsE ut Who owns I <br />New Personnel bei hired ?Contact HR hiring - re uirementsnre <br />Future impacts or liability to Kittitas County: <br />Budget Amendment Needed? <br />New Division Created? <br />Yes ! attach budgetform No [] why not - already budgeted <br />Reven ue Code 116-6 L5.02.1.3J4.OJ.1O.2 <br />Agency to Pass Through <br />Amount to Pass Through s <br />Sub-Contract Approved Date <br />Has the Prosecutor reviewed this ?Yes No zrs- [ <br />Co De rtments lm <br />Submitted <br />Signature:Date <br />artment <br />Assignment of Track lnformation <br />Auditor Facilities M aintenance <br />lnformation Services Human Resource <br />Prosecutor Treasurer <br />Auditor's Office <br />Human Resource <br />Prosecutor's Office -L1'(/IL !{1r <br />Who S ed the ant a lication u /l <br />Reviewer Date <br />Grant/Contract Review Page 2