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STATE AGENCY REQUEST FOR FUNDING FROM INDIAN RIVER COUNTY <br /> FISCAL YEAR 2015/2016 <br /> Lf <br /> A. Program Cover Page <br /> Agency: Public Defender Office, 19th Telephone: 772-337-5665 r <br /> Contact Person: Patricia Armold Fax: 772-337-5668 <br /> Title: Administrative Director E-Mail: Patricia.Armold@pd19.org <br /> Address: 1664 SE Walton Road, Suite 203 <br /> Port St. Lucie, Fl 34952 <br /> Website Address: <br /> Patricia.Armoid@pd19.org <br /> Program Title: Indigent Defense <br /> I certify that information contained in this application accurately reflects the activities of this agency and <br /> that the expenditures or portions thereof for which County funds are being requested are not reimbursed <br /> by any o source. <br /> Patricia Armold, Administrative Director <br /> Siena ure Print name and title <br /> Brief description of the Program for which funding is requested: • <br /> Funding is requested for the Public Defenders Office and a portion of the <br /> Administrative Office and costs for the purpose of representing persons <br /> declared indigent and facing possible incarceration in criminal and <br /> certain civil matters in accordance with Florida Statutes. <br /> Summary Report <br /> Amount requested from Indian River County for 2015/2016: $85,973.00 <br /> Total Proposed Program budget for 2015/2016 $ <br /> Percent of total Program budget: <br /> Current Funding (2014/2015) $ <br /> • Dollar increase/(decrease) in request: $ <br /> Percent increase/decrease in request: <br /> If request increased 5% or more, briefly explain why: <br /> The Organization's Board of Directors has approved this application on (date): <br /> Name of President/Chair of the Board Signature <br /> • <br /> Name of Exec. Director/CEO Signature <br /> 106 <br />