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• ii_ENE F:. •1, <br />401441Iilli Raveruo SN.r log pro'wles feeeiat hinds directly to local <br />-1p •[!courage. c[hten part.cipahon ;r. determining your goveinme <br />d(rgknfnation In the use of these funds may be ant to <br />.:. USISOHlee of Revenue Sharing, Wash., D.C. 20226. <br />PLANNED USE RE;POS <br />and state govemments. :Toth reporlof.ynur :government's ptatt'13 published <br />nt's decision on holy the,rnoney will %be spent. Note:. Any complaltta of <br />PLANNtD EX rLHDITURES <br />IC) OPERATING <br />',(A) CATEGORIES l6 CAPITAL MAINTENANCE • <br />1. tLCC SAFETY $ $ <br />3,ENYIRONMENTAL • <br />'PRGtsci3ON 1$ $ <br />•:-•• S: pue lc <br />• ...TitANSPORTATION $ <br />. rA.AECREAT ION <br />;a LIeRARtES <br />• <br />T SOCIAL SERVICES <br />FOR AGED OR POOR $ <br />':: II.FINANCIAL <br />; 'ADMINISTRATION <br />$ <br />'.; q„ TIPURPOSE AND <br />LGOVT. $ <br />t0;61A&CArlON <br />SE'DFYELOPMENT <br />•1E,NOWING S COM- <br />'MtPaTr CE.ELOPMENT $ <br />• <br />MIC <br />VELOI.MENT $ <br />..4.0TNER (Specify,. <br />'puts <br />THE GOVERNMENT <br />OF LITTLE ':CfafADA' CITY <br />:. <br />ANTICIPATING A GENERAL 'REVENUE 14 r 116 <br />SHARING PAYMENT OF ' <br />FOR THE SEVENTH ENTITLEMENT PERIOD. JULY .1 ,.4976 THROUGH <br />:c•_ = -- '5(d 31. 1:1?6, PLANS TO SPEND. THESE FUNDS FOR THE PURPOSES <br />SHOWS <br />yy . ACCOUNT NO. :.24 2 062 <br />• <br />• <br />004 <br />LITTLE: CANADA. :C.ITY.... <br />CTT'Y CLERK< <br />515 LITTLE :CANADA'.ROAD <br />LITTLE :CANADA...IINN. •5.5:1 :1T. • <br />915 <br />(0) Submit proposals foc folding conaidalallon *1: <br />3 <br />w A copy of this report and .. 'A <br />supporting documents are open IOr pu01i0.sofuUity D <br />(E) ASSURANCES (Refer to Matrix-goo E) I assure the Secretary of the Treasury <br />that the non - discrimination and other: attlutery requirements listed In Part E of <br />the instructions accompanying this report will be.rnmphed with. by this redolent <br />government with respect to the entitlement funds reported hereon.,.: <br />.Signature DI CNA! Executive Officer. <br />Name & Title = piease Print <br />II 1!s <br />' Date <br />INIINHZ1'A`,i <br />414. AUDIT (refer to ins9L.C.On F: <br />E;:Aif, your General Revenue S^ <br />yes D no <br />It if `yes'. flow often? <br />it Y11S PACE Ott t.1 12.I; :PUHL..[SIIED .(SEE :INSTRUCTION <br />cquir:.i the lower hell „ thus '.tbridc" '. publisher!; . - <br />my (GRS) funds audited? <br />ovary year C every 2 rears L_J less than every 2 ye <br />G4Vit RFGHTS (refer to instruc'.or. H) <br />a "Does your government Inc the "EEOC Slate and Local <br />( 4ernment Information" form IEE0.4) with she U S Equal <br />Irtipfayment Opportunity Commission? Yes <br />N "yea ", whet was the dare of the last report% <br />M". Gnawer the loeowng question. <br />Haw many persons were on your government's payroll on <br />s <br />(G) PUBLIC PARTICIPATION (refer to, lnitrucdon G)In planning for the use m'. <br />ORS funds. does your government : <br />7[ Hold special pub11C h hat <br />earings on Raysnue'SIng? <br />[1'rake local opfnfon polls ?,'• • <br />Soacn requests for funding of AF9iec s using revenue onetime. funds tram <br />outside your government admlhstfatidn?• - <br />Discuss revenue ehuing's; reputar public meetings?. . • <br />El Appoint advisory groups of Iocat.cdfieritt "" • <br />No <br />_.,m, 31, 1076? <br />PUELN:ATION (Refer to instruction I) <br />C. : Ypper pan of this report was puo- <br />r.:?raallakt in the following newspaper on b <br />• :'"tMEtited.date at a cost of -or <br />. <br />: (4) PERSON COMPLETING THIS REPr[ RT [PLEASE PRINT) <br />: 1 <br />DO.NOT WRITE IN THIS SPACE,:.': <br />FOR REVENUE SHARING USE ONLY:' • <br />1 i 2 3 4 <br />8 .9 <br />•10 <br />11 <br />12 <br />13 14 `15 16 '.17 1S <br />2 1 <br />2 2 <br />2 3 <br />2 4 <br />Name of Newspaper Dale; Pubsehad:,: • <br />Name <br />Title <br />BEFORE JUNE 2[, 1.176 by <br />(Area code) Tetephona Number <br />1HE OFFICE OF REVENUE "SHARING <br />240.1 E STREET, N.W: • <br />WASHINGTON. D.C. 2022d: <br />000016915 <br />