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Below each special item is a list of information required by the Division for approval of the Special Item(s) of Revenue. Submission of all supporting documentation is required with the budget. Special Item of revenue resolutions are not required. Use this checklist in the preparation of your budget. This sheet must be signed by the Chief Financial Officer and submitted to the Division with the supporting documentation. Special Item of revenue & Required Supporting Documentation Name of Municipality:________________________ County:__________________________ Non-Cash Surplus: Certified Analysis of Non-Cash Surplus Increase in Fees & Rates: Current Fund & Utilities: Examples: Uniform Construction Code Fees, Recreation Fees, Alcoholic Beverage License Fees, Local Fire Inspection Fees, Water Rates, Sewer Rates and Solid Waste Rates Certified Adopted Old Fee/Rate Ordinance Certified Adopted New Fee/Rate Ordinance Certified Calculation by Chief Financial Officer Supporting Fee Requested Host Community Fees: Executed Contract Certified Calculation by Chief Financial Officer Supporting Fee Requested Cable TV Franchise Fees: Copy of Check or Certification of Chief Financial Officer as to Receipt and Day of Deposit Grants: Federal, State and County Examples: Federal Emergency Management Grant, Clean Community Grant, DEPE Matching Fund Grant, Highway Safety Grant, Public Health Priority Grant, Municipal Alliance Grant Executed Agreement or Notice of Grant Obligation Sale of Municipal Property/Asset: Sale in Current Year: Executed Agreement Certification of Chief Financial Officer Property/ Asset sold is unencumbered and not pledged To any outstanding debt pursuant to N.J.S.A. 40A:12-17 Payment in Lieu of Taxes (PILOTS): If Additional or new from prior years cash realization, require executed agreement & calculation certified by Chief Financial Officer. Interfunds: If cash amount stated at year end is insufficient to liquidate interfund, show proof of cash available to liquidate interfund. Miscellaneous Not Listed Above: Supporting Documentation Required Certification of Chief Financial Officer: I hereby certify that I have reviewed this checklist and have submitted the documentation required for approval by the Division. _____________________________________________________ Signature, Chief Financial Officer License# _______________________________________________ Printed Name, Chief Financial Officer _____________ Date Q†›œ´ñABY€„…¸ˆ‰±²âãý o ‡ ä å é ë Ì î w ‚  # D E F o p q ò ó )Vˆ®ÃÆýùùéãàÝÚãàÝàÝàÝàãàãàéãàãàãàãàãàÝùÝàÝÚÔÔ 6CJ]CJCJCJ 5CJ\j5CJU\mHnHu5\CJ1+Q†›œ³´ðñAZ„…¹î T`‰²ãúúøöúôôôôïôåàÛÕÛÏÏÏÏÊÊÊ & F„Ð^„Єh^„h & F & F &d PÆÿ $a$$a$ë Åþþãüý $ U n o ˆ º ã ä 9 j Ÿ ¸ é ê ë 6 i ” ¸ Ë ù÷òòòù÷ííù÷èùùùùè÷âÝÝÝ××ׄÐ^„Ð & F „h^„h & F & F & F„Ð^„ÐË Ì ï v w ƒ   # E F p q ò ó )VWXˆ®¯°¾ÃÄÅýøøýøøýøøýýýöýôôýýýòííèèýý$a$$a$ & F ÅÆù„h^„h(1h°Ð/ °à=!°Z"°Z#õ$õ%°°° iD@ñÿD Normal$CJOJQJ^J_HaJmH sH tH 8@8 Heading 1$$@&a$5\<@< Heading 2$$@&a$ 5CJ\6@6 Heading 3$@& 6CJ]<@< Heading 4$$@&a$ 6CJ]<A@òÿ¡< Default Paragraph Font0B@ò0 Body Text$a$CJ.P@. 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