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A TRUE COPY <br /> CERTIFICATION ON LAST PAGE <br /> REQUEST FOR WAIVER OF CALCULATED AC XIM[TM J . K . BARTON , CLERK <br /> [ ] Recipient has no previous DEM/DCA contract history. Complete Estimated Expenses chart and <br /> Explanation of Circumstances below. <br /> [ j Recipient has exceptional circumstances that require an advance greater than the Maximum Advance <br /> calculated above. <br /> Complete estimated expenses chart and Explanation of Circumstances below. Attach additional pages if <br /> needed. <br /> ESTIMATED EXPENSES <br /> BUDGET CATEGORY 200.-200. Anticipated Expenditures for First Three Months <br /> of Contract <br /> ADMINISTRATIVE COSTS <br /> (Include Secondary Administration.) <br /> PROGRAM EXPENSES <br /> TOTAL, EXPENSES <br /> Explanation of Circumstances: <br /> 23 <br />