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•:,F' ('• /!n^t 1 �•Io/l . <br /> • <br /> Grant # Agency <br /> (or "Appli,:ation") (Grantor) Name of Program or Project <br />• <br /> (1 • <br /> •1 <br /> (4) , <br /> (5) ' <br /> (6) <br /> (7) , <br /> (8) <br /> (9) . <br /> (10) ' <br /> Total Required <br /> Local Share <br /> Total Program Total Grant (Total Cost minus <br /> or Project Cost Amounts Awarded Total Grants) <br /> (1) $ 1 1 <br /> (2) $ $ $ <br /> (3) $ . $ I . <br /> $ $ $ <br /> $ $ $ <br /> $ , S I <br /> :7) $ , $ $ <br /> (8) $ , $ $ <br /> (9) $ $ $ . <br />'11 (10) $ $ $ <br /> Calendar Year or <br /> Fiscal Year Certified . Certified Difference- <br /> that Levy is Levy in Levy in 1977/1978 minus <br /> to Fund or Reimburse 1977/1978 1970/1971 1970/1971 <br /> (1) $ $ $ <br /> (2) $ $ S <br /> (3) $ , $ $ <br /> (4) $ $ S <br /> (5) , $ $ S <br /> (6) $ $ 1 <br /> (,-, $ $ S <br /> $ $ $ <br /> $ $ n <br /> (10) $ , $ S <br /> Total Special Levy (enter here and on page 1, line C) S . <br /> (4) <br />