READ ALONGSIDE THE SOURCE
Okaloosa County BOCC — January 7, 2014 — LETF Application — reading text
Part 1 of 1. These parts divide the reading text for browsing; they are not the source document's page numbers.
Machine-extracted text — 102-LETF Application.pdf
Machine-extracted OCR text · Review label: Machine produced / unreviewed
Compare this copy with the preserved source. Review labels describe the recorded status of this file; they do not guarantee that the text is error-free. Spacing and line breaks are retained, with long lines wrapped to fit the screen.
OKALOOSA COUNTY LETF APPLICATION
PROGRAM INFORMATION
Program Title:
Name/ Title of Contact:
Address: Phone:
City • Zip Code: Fax:
Total Program Budget: E-mail:
New Renewal Amount
Program is: P
Requested:
If renewal, circle number of years this program has been funded thru LETF? 1 2 3 4 or more
APPLICANT AGENCY INFORMATION
Applicant Agency Legal Name:
Program Name:
Main Administrative Address:
City & State: Zip Code:
Telephone Number: Fax Number:
Website:
CEO/Executive Director:
Office Phone Number: E-mail Address:
Federal Identification Number:
LETF CATEGORY (Place an “X” to the left of one program area for which you Intend to Apply):
1. Crime Prevention
2. Drug Abuse Prevention/Education
3. Safe Neighborhood
4. School Resource Officer
5. Other Law Enforcement Purpose (specify below)
1
PROPOSED PROGRAM INFORMATION
1. Program Summary (1-3 sentences): Provide an overview of program services.
2. Program Purpose (1-3 sentences): Please identify the services, target population and how many will be served while
completing the following statement.
The purpose of this program is…
3. Proposed use of LETF proceeds: Please identify the proposed use(s) of LETF proceeds and specify how it fulfills the
statutorily authorized uses set forth in Section 932.7055, Florida Statutes. These proceeds shall not be utilized to meet
normal operating needs of the applicant agency/organization.
4. Has your agency received funding from LETF within the last three (3) years? (If yes, identify the source
of that funding, when it was received and the dollar amount that the agency has received).
5. Have you applied for funding for this program from any other entity or agency? (If yes, identify the
source from which the funding was sought, the dollar amount requested from the source and provide the outcome of
that application).
2
Upon completing this application in its entirety, please read the following statement and affix your
signature accordingly.
I have read, fully understand and agree to be bound by Okaloosa County’s Operating Procedures
for Law Enforcement Trust Fund and applicable state statutes. I have completed this application
fully and accurately and have not misrepresented any information contained herein. I certify that
the requested funds will be used for the purposes set forth in this application and in conformity with
Florida law.
I agree to submit proper supporting documentation within sixty (60) days of expending the LETF
proceeds, which establishes that such proceeds were expended for the purposes they were approved
and in conformity with Florida law. I further agree that should I fail to provide such documentation
within the specified time period, I will be responsible for reimbursing Okaloosa County for the
amounts received.
Signature of Applicant Date of Application
Print Name of Applicant
OFFICIAL USE ONLY
I, Larry R. Ashley, do hereby certify that the aforementioned request for LETF proceeds is in compliance with
Section 932.7055, Florida Statutes.
____________________________
Sheriff Larry R. Ashley
Board of County Commissioners: Approved/Disapproved
Date: _________ Amount approved: $________
3