Virginia department of planning and budget



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Other sources of support. Identify other funding sources, along with the amount, intended to be used in addition to the state appropriation? What percentage is the requested state grant of the total amount of support you anticipate for this purpose?




  1. Consequences of not funding. Describe the impact on services, products, customers, goals, or objectives if this request is not funded.




  1. Expected Outcome. Indicate how you will measure the success of the effort if this proposal were to be funded, giving the specific outcome you expect.


D. State Appropriations
Include in the table, by state fiscal year and amount, all state appropriations your agency has received since FY 2002. Differentiate in the table between state funds received as a nonstate agency grant and those your organization receives as a subgrantee of another state agency or through a state grant-in-aid program authorized by law. If your organization receives state funding other than as a nonstate agency grant, indicate the agency(ies) from which you receive the funds.
E. Matching Funds
Provide in the table the amount and a description of the proposed matching funds. Identify the source of the proposed matching funds and when they will be available. The state appropriation will be available on July 1 or shortly thereafter. The matching funds should be on hand and available on the same date. If the proposed match includes in-kind contributions, please describe in detail. After the last entry, provide a grand total.

DPB FORM NSA-1
(July 2005)


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