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1/31/79 AC 150/5900-1B
<br />Appendix 1
<br />EXHIBIT 5. REQUEST FOR ADVANCE OR REIMBURSEMENT
<br />DEPARTMEMT OF TRAHWORTATON _fEOERAL AVIATION ADMINISTRATION o..e No aonmo
<br />REQUEST FOR ADVANCE
<br />OR REIMBURSEMENT
<br />x hp. el Pardon Raµee,e.
<br />a.lM Aum.. 6 1_ F.nal
<br />,A Pan.ai
<br />9. Hama °I b,anae o,Favaa,.°°
<br />Element
<br />Federal Aviation Admin.
<br />4 Boos al Re°°n
<br />Cann
<br />;X Aet.u.a e..ma„urt,
<br />7. Omits Ramon. No. e. Ida
<br />Ha.
<br />(Optloral)
<br />3 Federal Gan, No. or Onto, ldenttly.n9
<br />N" (Use Project No.
<br />on Grant Agreement)
<br />5. nan.al Payment Roane„ X°
<br />P a P...ed C°ue..d 11.tem1, Day Teal
<br />FROM TO
<br />)0. Name of Payee ul d.ne.m. Roo Item 91
<br />II. COMPUTATION OF AMOUNT REOUESTEO
<br />a. Tdal program outlays to dale as of
<br />b. less' Cumulative program mcane . ,
<br />E. Net prostate outlays.
<br />d. Estimated net cash outlays for advance panW. -
<br />e. Total of lines c and d..,
<br />1 Nan -Federal share at amount el Lune e . ...
<br />g, Fedeal share of amount on Llnee, .. ,.
<br />h. Federal paymmis prevmusly re9uestea
<br />I Federal share now repuested . . .. .
<br />I, Manlhty advance teyrrenanls
<br />ill let m,nd ....
<br />121 Ld month. ..
<br />13) 3Mmon0
<br />12. REMARKS(Rooth add.,.anrd eFene .(nateeaervI
<br />PARER YIN — FUNCTIONS — ACTIVIT.ES 1) 121
<br />Contractual Administrative
<br />5 11 750 15250
<br />0 0
<br />11,750 250
<br />1),750 250
<br />23,500 500
<br />4,700 100
<br />18,800 400
<br />9,400 200
<br />9,400 200
<br />In
<br />2
<br />TOTAL
<br />412.000
<br />0
<br />12 , 000
<br />12,000
<br />24,000
<br />4,800
<br />19,200
<br />9,600
<br />9,600
<br />la. I e..,Ily,ha„o tin Last atm, snow/act, and F.I.af IF. de,e.a° .,.d above., donee ,od the all outlays ware made., °,,.,done. HMF gran, con d.,.ane
<br />and that Isaym.n„° due end had net b..n P.e+mu,ly•....sr.d,
<br />ken.
<br />H9nm.a of Au,Mn,ad 0/twat
<br />RAt Farm 5100-g1 le-0L 00PERRI/AS PRA roam 5100-6
<br />59007
<br />FOR AGENCY USE ONLY
<br />TELEPHONE
<br />Area Code !Number
<br />W,. Rop°n Is %anomid
<br />Ice',
<br />27
<br />
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