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k - <br />STATE LIBRARY <br />of NORTH CAROLINA <br />021 <br />AVERAGE MAINTENANCE OF EFFORT REPORT AND DECLARATION <br />State Fiscal Year 2016 - 2017 <br />(Submit one form only) <br />Please submit this average summary form for the library system in addition to the individual <br />Maintenance of Effort forms from your local funding entities. This sheet shows the library system's <br />average appropriation from all of its local funding sources from the last three years. Please place the <br />total of all Maintenance of Effort forms for FY 2016-2017 in the FY 2016-2017 box. <br />In order to meet Maintenance of Effort, the total appropriation for FY 2016-2017 must equal or <br />exceed the average figure of the last three fiscal years. <br />This summary form requires only the library director's signature. <br />The other Maintenance of Effort forms for each funding entity must be completed and signed as usual. <br />Lee- Cout,4.- L;6(�r,- <br />Name of Library <br />AVERAGE <br />County and/or City Appropriations <br />Budgeted and Available for Expenditure <br />FY 2013-2014 <br />FY 2014-2015 <br />FY 2015-2016 <br />(Excluding capital outlay and <br />State Aid appropriations) <br />$ 13 a <br />Signed: <br />Library Director <br />Submit application to: <br />State Aid <br />Library Development Section <br />State Library of North Carolina <br />4640 Mail Service Center <br />Raleigh, NC 27699-4600 <br />SL/LD <br />Rev. 06/16 <br />TOTAL <br />County and/or City Appropriations <br />Budgeted and Available for Expenditure <br />FY 2016-2017 <br />(Excluding capital outlay and <br />State Aid appropriations) <br />$ 55 <br />Date: <br />Deadline for submission of FY <br />July 1, 2016 - June 30, 2017 <br />application is: <br />Postmarked on or before <br />Natural and September 15, 2016 <br />Cultural Resources <br />