Purpose for How Was Value Was Contribution Obtained Description of Which Determined? (i.e., Who Made This With or Supported By State or Date of Contributed Contribution Real or Approximate Actual, appraisal, fair Value Federal Funds? (If so, indicate Contribution Item(s) or Service Was Made Value of Contribution market value) Determination? source) Name of Contributing Organization/Agency/Business/Individual: Address of Above Contributor: Phone #: Printed Name of Contributor’s Authorized Signee: Title: Signature of Authorized Signee: Date: APPENDIX M - FINANCIAL MANAGEMENT AND CAPACITY FORM If the applicant is a unit of government responsible for the operation of the museum, complete the attachment as the museum.
Date of Contribution Description of Contributed Item(s) or Service Purpose for Which Contribution Was Made Real or Approximate Value of Contribution How Was Value Determined? (i.e., Actual, appraisal, fair market value) Who Made This Value Determination? Was Contribution Obtained With or Supported By State or Federal Funds? (If so, indicate source) Name of Contributing Organization/Agency/Business/Individual: Address of Above Contributor: Phone #: Printed Name of Contributor’s Authorized Signee: Title: Signature of Authorized Signee: Date: APPENDIX M - FINANCIAL MANAGEMENT AND CAPACITY FORM If the applicant is a unit of government responsible for the operation of the museum, complete the attachment as the museum.
2014-15_MGP_APPLICATION-FORMS.docx