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Generallnfonnation: Which COPS hiring grants are you currently receiving? LJ FAST LJ AHEAD LJ Universal Hiring Program Sworn force strength: (;7 (including funded vacancies) as of March 1, 1997. To assist the COPS Office in forecasting future hiring, how many new officers would you like to have awarded 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 futflre~ant awards from the COPS Office. Full-Time Part-TIme 1998: 4 0 1999: 0 0 2000: 0 0 Are you requesting a waiver of the local match requirement based upon severe fiscal distress (bankruptcy, recovery from natural disaster)? LJ Yes ~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. Attached is a budget worksheet. Please fill out this form. You must submit it with your grant application. This updated information will provide us with the most current figures available upon which to base your department's award. Please fill out the budget worksheet based on the salary and benefits of one entry-level officer. The COPS Office then will determine the amount of your grant based on the number of officers awarded. A COPS Universal Hiring Program grant award supports one or more new officer position(s) in your law enforcement agency. You are required to dedicate either these new officers, or an equal number of current sworn officers, to community policing activities. I certify that the information provided on this Jrmn is true and accurate to the best of my knowl£dge. I acknawl£dge tha. the Assurances and Certifications submitted in connection with the applicant's prior COPS AHEAD or COPS FAST application Temain in jóTœ. 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 of 1994 and other requirements of FedeTm w. ~ \'\\bn iliiliL Law Enforcement Executive's Signature: ~!?4i1'\¡ \ ç:.¡..~ DateS I ~ "g (signature of person named on the front of this Jrmn) Government Executive's Signature: 1. / ./~. , Date: 5/19/98 (signature of p~n named on 1be front of this Jrmn) Mail this completed application, two copies and any additional information to: COPS Universal Hiring Program, U. S. Department of Justice, noo Vermont Avenue, NW, Washington, DC 20530. (For overnight delivery, please use 20005 as zip code.) Note: Fax copies will NOT be accepted.