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If logged in, you will be able to save your progress of this form. You can find any saved forms under the My Applications drop down in the menu bar at the top of the window, then select Form Center.
Select the category that best represents the program for which you are requesting funds. You can check more than one if you feel they apply.
1. Copy of the most recent IRS Form 990 -OR-
2. Copy of most recent audit/financial review -OR-
3. Most recent fiscal year profit/loss statement
You only need to complete one of the below templates. They are the same template, just in different file formats for convenience.
I hereby approve the submission and content of this application and agree that any funds awarded pursuant to this application will be subject to review by the County and will be administered in conformity with the purposes stated. I further agree that all financial records will be open and available to County officials upon request.
(Board President) Your typed name above will act as your electronic signature for this completed form, please review before submitting to ensure all information is accurate.
This field is not part of the form submission.
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