3414 Special Procedures 2546 22 Remarks. 15 Date Received: OBJECT CLASS K Funds Available Date: Budget Officer: Copy Hour Clerical Tech Hour Manger or Supervisor Total Amount Claimed By Financial Institution Amount 16 Disallowance (See Attached) 17 Net to Financial Institution 19 Signat

lic Law 9S-620 (12 U.S.C. 3401.3422) Request Pursuant To: (arectate 0400 SECTION 22 Remarks IS Dos Recited: 0.25 1100 17.00 How Oedcal Tech Hour Manger or Superstar To - tal A mou iClaimed By I- inarnial Institution 16 oran...... Arsacht 17 -N et to Financial Institution 0.00 OBJECT CL

enrollment form. Do not proceed with compliance: If cost will exceed Moll without prior approval of 0.25 11.00 17.00 Copy Hour Clerical Tech Hour Manger or Supervisor Budget Officer liatir0 FtlICIAIRL Fax any request to (305) 530-7670 12 Signature of Financial Institution Official: 13 Date Signed

ollment form. DO not proceed with compliance: If cost will exceed 5500 without prior approval el to 0.25 11.00 17.00 Copy Hour Clerical Tech Hour Manger or Supervisor Budget Officer Lazar* Felicia's.. Paz any request to (305)530-7679 12 Signature of Financial Institution Official: 13 Date Signed:

enrollment form. Do not proceed with compliance: If cost will exceed 5500 without prior approval of 0.25 11.00 17.00 Copy Hour Clerical Tech Hour Manger or Supervisor Budget OM/. 'Fax any request to 005)530.7679 12 Signature of Financial Institution Official: 13 Dat Signed: Total AmountClaimed

Er enrollment form. Do pot proceed with compliance: If cost will exceed 6500 without prior approvalof 0.25 11.00 17.00 Cow Hour Clerical Tech Hour Manger or Supervisor Budget Officer. Loam Feliciano. Fax any request to (305)530-7679 12 Signature of Financial Institution Oficial: 13 Date Signed: T