Pursuant to the provisions of Section 14-a of the Correction Law, I, the undersigned, Clerk of the governing body of the County or City of _____, State of New York,

HEREBY CERTIFY that on (month, day, year)

the governing body of said County or City appropriated or otherwise made available for the operation of the probation services the sum of $ ____ for the purpose or purposes specified in the attached budget of proposed expenditures for the _____ probation department.

I FURTHER CERTIFY that said sum was appropriated or otherwise made available for the period beginning _____, 19_ and ending _____, 19 _; that it constitutes the entire amount required for the purpose or purposes specified, and that the said governing body desires to and hereby does make application for State aid reimbursement in the amount of $ ____ to the County or City pursuant to the provisions of Section 14-a of the Correction Law.

It is understood that if this application is approved by the New York State Department of Correction and undertaken, State aid can be granted only on money expended by the sponsoring municipality in accordance with the law of New York State and the rules and regulations of the Department of Correction.

It is further understood that facilities and services provided shall be open to all regardless of race, creed or color.

It is further understood that these probation services will be operated in compliance with all laws and the Constitution of the State of New York and all ordinances, rules, regulations, resolutions and codes of the subdivi-sions, departments and commissions of the State, which may be pertinent thereto.

In accepting State aid the governing body of _____ County or City hereby AGREES:

(1) to conform to the attached budget as approved by the State Commissioner of Correction.

(2) to abide by the decision of the State Commissioner of Correction as to the propriety of all expenditures.

Dated at ______, N.Y., this ____ day of ______, 19_

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Return to Division of Probation, State Department of Correction,

The Alfred E. Smith State Office Building, Albany, New York