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APPLICATION FOR GRANT FUNDING <br />OFFIC )F THE GOVERNOR, CRIMINAL,, ACE DIVISION <br />SCHEDULE A <br />PERSONNEL <br />(Refer to page 25 of the 9999 Plan.) <br />1. DIRECT SALARIES <br />% or <br />$ Rate <br />(2) <br />(3) <br />(4) <br />Title or Position' <br />% of <br />Time' <br />CJD Funds <br />Cash Match <br />In -kind <br />Match <br />(VOLUNTEERS) <br />TOTAL' <br />Juvenile Officer /Juvenile <br />(A ) Ganq Officer <br />100 <br />$ 16,982 <br />$ 13,017 <br />$ 0 <br />$ 29,999 <br />(B) <br />Insurance (Life & Health) <br />@ <br />(C) <br />Workers' Compensation <br />@ 2.58° <br />0 <br />774 <br />` 0 . <br />(D) <br />Unemployment Insurance' <br />@ 1.5% <br />0 <br />135 <br />0 <br />(E) <br />Other (Explain) <br />(F) <br />(G) <br />TOTAL FRINGE BENEFITS <br />$ 0 1 <br />$ 9,327 <br />0 <br />(H) <br />(1) Volunteers <br />;r <br />TOTAL DIRECT SALARIES <br />$ 16,982 <br />$ 13,017 <br />$ 0 <br />$ 29,999 <br />2. FRINGE BENEFITS <br />All applicants must submit a staff organizational chart for their project that shows both grant -paid and non grant -paid <br />personnel. If a staff member is paid partially from CJD funds, then attach a note explaining from what sources the remainder <br />of the salary is paid. <br />' Include only one position per line. Attach a description of each position that lists the name of the employing agency, the <br />duties or responsibilities, and the required qualifications (degree, license, etc.) for each position. <br />Express as a percent of total time. Must be at least 25 %. (40 hours per week equals 100 %) <br />3. Should reflect employee's gross salary attributable to the project. If applying for continuation funding, justify <br />any salary increase over the previous year. <br />4. Un=Int an ce is calculated on the first $9,000 of each salary. <br />Financial Officer Initials CJD -6 Issued: September, 1997 <br />% or <br />$ Rate <br />CJD Funds <br />Cash Match <br />In -kind <br />Match <br />TOTAL <br />FICA& Medicare <br />@7.65° <br />$ 0 <br />$ 2,295 <br />to .. <br />$ 2,295 <br />Retirement <br />@ 9.41° <br />0 <br />29823 <br />0 <br />2,823 <br />Insurance (Life & Health) <br />@ <br />Workers' Compensation <br />@ 2.58° <br />0 <br />774 <br />` 0 . <br />774 <br />Unemployment Insurance' <br />@ 1.5% <br />0 <br />135 <br />0 <br />135 <br />Other (Explain) <br />TOTAL FRINGE BENEFITS <br />$ 0 1 <br />$ 9,327 <br />0 <br />$ 99327 <br />All applicants must submit a staff organizational chart for their project that shows both grant -paid and non grant -paid <br />personnel. If a staff member is paid partially from CJD funds, then attach a note explaining from what sources the remainder <br />of the salary is paid. <br />' Include only one position per line. Attach a description of each position that lists the name of the employing agency, the <br />duties or responsibilities, and the required qualifications (degree, license, etc.) for each position. <br />Express as a percent of total time. Must be at least 25 %. (40 hours per week equals 100 %) <br />3. Should reflect employee's gross salary attributable to the project. If applying for continuation funding, justify <br />any salary increase over the previous year. <br />4. Un=Int an ce is calculated on the first $9,000 of each salary. <br />Financial Officer Initials CJD -6 Issued: September, 1997 <br />