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Approved by Office oI ..anagement and PAGE OF <br /> REQUEST FOR ADVANCE Budget. No. 80-R0183 <br /> PAG <br /> I. <br /> �''"''"'" " <br /> ' '" 2. BASIS OF REQUEST <br /> OR REIMBURSEMENT <br /> TYPE OF (2 ADVANCE 0 REIMTaURSG 0 CASH <br /> MEN <br /> PAYMENT b. -X" A.4P4I4r1144 boo <br /> (See instructions on back) REQUESTED <br /> FINAL <br /> 3. FEDERAL SPONSORING AGENCY AND ORGANI}'IONAL ELEMENT TO a. FEDERAL GRANT OR OTHER 0 PARTIAL` PARTIAL PA❑YMENTRUAL REQUEST <br /> WHICN THIS REPORT IS SUBMITTED IDENTIFYING NUMBER ASSIGNED NUMBER FOR THIS REQUEST <br /> NY FEDERAL AGENCY <br /> DRUG ENFORCEMENT ADMINISTRATION 97-39 <br /> a. EMPLOYER IDENTIFICATION I. RECIPIENTS ACCOUNT NUMBER B. PERIOD COVERED BY THIS REQUEST <br /> NUMBER OR IDENTIFYING NUMBER <br /> FROM Ie,eatA.4r.Pw) TO ISA.da..I+w) <br /> N/A N/A January 1, 1997 I December 31, 1997 <br /> S. RECIPIENT ORGANIZATION 10. PAYEE(Whore eAeeA is to M peat 4 <br /> dib«cal tAaw Supe,!) <br /> • <br /> N.,. N/A <br /> Nemo , Hawaii County of Hawaii Police Dept. <br /> C/O DEA <br /> :i si« N.�,a« 300• Ala Moans Boulevard, Room 3129 <br /> watreet , Honolulu, Hawaii 96850 <br /> •s31.10.JtaCU,,.awe <br /> wd SIP <br /> a,.ZIP Cod*: <br /> 11. COMPUTATION OF AMOUNT OF REIMBURSEMENTS/ADVANCES REQUESTED <br /> (a) (b) (e) <br /> PROGRAMS/FUNCTIONS/ACTIVITIES► <br /> TOTAL <br /> a. Total program (As of data) <br /> outlays to date -4 195,000 $ $ $ 195,000 <br /> b. Less:Cumulative program income <br /> c. Net program outlays (Lin. a mints <br /> line b) 195,000 <br /> 195,000 <br /> d. Estimated net cash outlays for advance <br /> period <br /> e. Total (Sum o/linea e&d) 195,000 195,000 <br /> f. Non•Fed eraI share of amount on line e <br /> 4. Federal share of amount on Ilne a 195,000 195,000 <br /> h. Federal payments previously requested <br /> I. Federal share now requested (Lin. p <br /> minty line h) 195,000 195,000 <br /> J. Advances required by 1st month 195,000 195,000 <br /> month, when request- <br /> ed by Federal grantor <br /> agency for use in mak- <br /> 2nd month <br /> ing prescheduled ad- <br /> vances <br /> 3rd month <br /> 12. ALTERNATE COMPUTATION FOR ADVANCES ONLY <br /> a. Estimated Federal cash outlays that will be made during period covered by the advance <br /> S <br /> b. Less:Estimated balance of Federal cash on hand as of beginning of advance period <br /> c. Amount requested (Line a minus lin.b) I <br /> 13. CERTIFICATION <br /> SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL. DATE REQUEST <br /> I certify that to the best of my knowledge �'AA q�- SUBMITTED <br /> and belief the data above are correct and yyL([J&.2. /�S C •. n 1)- <br /> that all outlays were made In accordance l Few G�+I-Gla. Apfll 15, 1997 <br /> with the grant Conditions or Other agree. TYPED OR PRINTED NAME AND TITLE <br /> ment and that payment is due and has not TELEPHONE (AREA <br /> COOS NUMBER. <br /> been previously requested. Wayne G. Carvalho EXTENSION) <br /> Police Chief 808-961-2244 <br /> This space for agency use <br /> 2,:-102 <br /> STANDARD FORM 270(7-76) <br /> Prescribed by Orrice of M Budget <br /> Cir.No.A-110 <br />