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x � Cont'd from pg 2 . Application Evaluation Review Sheet r Martinez Industries Inc . d /b / a Applicant Name : jAppl . #406 ; Citrus Management Services Address : I P . O . Box 690365 , Vero Beach , FL 32969 Tract Number(s) : Field Number(s) : JAN in Indian River County Date : Revised August 24 , 2004 Land Use/Field : Acres : Citrus Groves 16 , 000 Best Management Practices Applied For: 3 . Precision Application Equipment (4 piece of equipment). Total BMP Costs: 58.76% Cost Share: Div by Total Eval Points: Div by Acres, times 100 = Applicant Score Applicant Cost: �y$43 , 980 $259843 80 2 . 02 $ 18 , 138 Ix Because of this years funding limits, we are not at this time able to offer the full 60% cost share that this applicant is eligible . We can offer only what is shown on this sheet . If other funds become available , this applicant will be offered the full 60% that they are eligible, for. .,. , , 777777 ( 'gnature) Date: (Checked By) I Date: %�-/244Z ; era IRSW D Board pprovqjo Date — � (Applicant Signatur Date Privacy Act Statement: The following statements are made in accordance with the Privacy Act of 1974 (SU . S. C. 522a). The authorities for requesting the information to be applied on this form are: 16 U . S . C . 590a-f (Soil and Water Conversation); 16U . S . C. 3801 et seq . (Food Security Acto of 1985, as ammended) , and the regulation promulgated theruder. The information requested is necessary for the evaluation of an application, development and implementation of a conservation plan as the basis for satisfying program eligibility and compliance requirements, and for providing technical education , or financial assist- ance under the previously mentioned authorities. Furnishing this information is voluntary; however, failure to fumish correct, complete information will result in the withholding or withdrawal of such technical , educational, or financial assistance. This information may be fumished to other USDA agencies, the Internal Revenue Service, the Department of Justice, or the other State or Federal law enforcement agencies, or in response to orders of a court, magistrate, or administrative tribunal. IRSWCD Page 3 (10-26-01 )