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. Washington State <br />� • Department of <br />►e&W commerce <br />COMMUNITY DEVELOPMENT BLOCK GRANT <br />REQUEST FOR AMENDMENT <br />ATTACHMENT 1-G (1) <br />1. Grantee Name <br />2. CDBG Contract Number <br />3. Request Number <br />Kittitas County <br />22-62210-008 <br />B <br />4. Type of Amendment (check all that apply) <br />® Time Extension ® Budget Revision ❑ Scope of Work ❑ Special Conditions <br />S. Explanation (attach additional page if response requires more space or for Supplemental Funds request) <br />Public Services through HopeSource to low- and moderate -income persons in Kittitas County for program year <br />2024. <br />6. Amendment Changes <br />Current End Date Change (# months) Revised End Date <br />Time Extension 6/30/2024 12 6/30/2025 <br />CDBG Budget Code Current Budget <br />' <br />Change (+/-) Revised Budget <br />21A— General Administration $7,000 <br />$3,500 $10,500 <br />05Z—Other Public Services $190,000 <br />$76,500 $266,500 <br />Totals $197,000 <br />$80,000 $ 277,000 <br />7. Submitted By (Chief Administrative Official) <br />Name Title <br />Signature Date <br />8. Action Taken (COMMERCE USE ONLY) APPROVED DISAPPROVED <br />Name Title <br />Signature Date <br />November 2022 <br />