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Population served as of 1990 u.S. Census: 28. 741 and square nùles covered: 17.2 (E:D::lude the papulation and square miles primarily seroed by other law enforcement agencÍð within your jurisdiction. For example, sheriffs' departmerrts must exclude papulations and areas covered by a city police department for which the sheriffs' department has no primary law enforcement authority.) Current authorized sworn force strength: 69 (Indicate if your department does not have an authorized strength.) !\ctual sworn force strength as of March I, 1997: 67 (Include funded vacancies.) To assist the COPS Office in forecasting future hiring, how many new officers would you like to have awaIded by the COPS Office in each of the following calendar years? Do not include officers currently funded by the COPS Office or those included in your request above. By completing this section, you will automatically be considered for future grant awards from the COPS Office. Full-TIme Part-TIme 1998: 4 0 1999: 0 () 2000: 0 0 Are you requesting a waiver of the local match requirement based upon severe fiscal distress? L1 Yes G:J No If "yes," attach a one-page, typewritten description of the extraordinary local fiscal hardship upon which you are basing your request for a waiver. (See "Guidelines for Waivers of Local Match" in the Application Instructions.) I certify that the information provided on this form is true and accurate to the best of my knowledge. I understand that prior to any grant award, the applicant must comply with all application and program requirements of the Public Safety Partnership and Community Policing Act O~hEr requi, Is derallow. ~ Law Enforcement Executive's Signature: p~,,^ 4\ rf¥^,- Date:.s \~ $, (signature of person named on the front of this form) Government Executive's Signature: f'- ~ .d.'óL;k; Date: 5/19/98 (signa ure of rson name n thefront of this form) Please return 1 original and 2 copies of this form, the Community Policing Information Worksheet, the Budget Information forms, and any additional information that is required to: COPS Universal Hiring Program u. S. Department of Justice 1100 Vermont Avenue, NW Washington, DC 20530 (For overnight delivery, please use 20005 as the zip code.) Note: Fax copies will NOT be accepted. 3 I.-