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INDIAN RIVER COUNTY NONPROFIT / QUASI AGENCY REQUEST FOR FUNDING <br />A. Program Cover Page <br />Agency: Veterans Council of Indian River Telephone: 7722051995 <br />County, Inc <br />Contact Person: Patricia Geyer -Patton Fax: <br />Title: Finance, grants, budgets E -Mail: patriciaigeyer@gmail.com <br />Address: PO Box 1354, Vero Beach, FL 32961 <br />Website Address: veteran scouncilirc.org <br />Program Title: Transportation Services for Veterans <br />I Agree - By checking the "I Agree" box and entering your name below, you certify that information contained in <br />this application accurately reflects the activities of this agency and that the expenditures or portions thereof for <br />which County funds are being requested are not reimbursed by any other source. <br />Name: Stephen Hume Title: Stephen Hume, Treasurer <br />rsneT aescripuon OT the vrogram Tor wnicn Tunaing is requestea: <br />The Program provides transportation for veterans and caregivers from Indian River County to and from <br />medical appointments locally and to the Veterans Administration Medical Center in West Palm Beach, FL at <br />no charge to the veteran. <br />summary Keport <br />Amount requested from Indian River County for 2022/2023: $94,000.00 <br />Total Proposed Program budget for 2022/2023: $94,000.00 <br />Percent of total Program budget: 100% <br />Current Funding (2021/2022) $94,000.00 <br />Dollar increase / (decrease) in request: $0.00 <br />Percent increase / decrease in request: 0% <br />f request increased 5% or more, briefly explain why: <br />N/A <br />The Organization's Board of Directors has approved this application on (date): 03/30/2022 <br />Name of President/Chair of the Board: Fr. Dave Newhart <br />Name of Exec. Director/CEO: Jim Romanek <br />224 <br />is <br />is <br />is <br />