"Application to Establish or Deactivate a Fund" - Mississippi

Application to Establish or Deactivate a Fund is a legal document that was released by the Mississippi Department of Finance and Administration - a government authority operating within Mississippi.

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APPLICATION TO ESTABLISH OR DEACTIVATE A FUND
Agency: ____________________________________________________________ Business Area #: ________
Address: ____________________________________________________________
Date: ____________
Official Name of Fund: _______________________________________________________________________
Purpose and Description:
__________________________________________________________________________________________
Source of Revenue: _________________________________________________________________________
Legal Authority: ____________________________________________________________________________
For all funds, will fund retain interest? __ Yes __ No If yes, legal authority: ____________________________
For Bond Fund only, please specify fund that retains interest: _______________________________________
Legal Authority for Bond Fund interest: _________________________________________________________
Requested Fund Number (10 digits):
___________________________________
Fund Application/Functional Area (6 digits):
___________________________________
Program Number/Functional Area (8 digits):
___________________________________
Cost Center (10 digits):
___________________________________
(Please use your Cost Center Spreadsheet if there are additional fund/cost center combinations)
Contact for questions: __________________________
___________________________________________
Phone Number: __________________________
Signature of Agency Head
FOR DFA USE ONLY
Class:
_____________________________________________
Category:
_____________________________________________
Budgetary Function:
_____________________________________________
CAFR Function:
_____________________________________________
Fund Balance Account:
_____________________________________________
Government-Wide Indicator:
_____________________________________________
Unbudgeted Fund Indicator:
_____________________________________________
GAAP Fund Type:
_____________________________________________
DFA/OFM Signature _______________________________________________
Date ____________________________
APPLICATION TO ESTABLISH OR DEACTIVATE A FUND
Agency: ____________________________________________________________ Business Area #: ________
Address: ____________________________________________________________
Date: ____________
Official Name of Fund: _______________________________________________________________________
Purpose and Description:
__________________________________________________________________________________________
Source of Revenue: _________________________________________________________________________
Legal Authority: ____________________________________________________________________________
For all funds, will fund retain interest? __ Yes __ No If yes, legal authority: ____________________________
For Bond Fund only, please specify fund that retains interest: _______________________________________
Legal Authority for Bond Fund interest: _________________________________________________________
Requested Fund Number (10 digits):
___________________________________
Fund Application/Functional Area (6 digits):
___________________________________
Program Number/Functional Area (8 digits):
___________________________________
Cost Center (10 digits):
___________________________________
(Please use your Cost Center Spreadsheet if there are additional fund/cost center combinations)
Contact for questions: __________________________
___________________________________________
Phone Number: __________________________
Signature of Agency Head
FOR DFA USE ONLY
Class:
_____________________________________________
Category:
_____________________________________________
Budgetary Function:
_____________________________________________
CAFR Function:
_____________________________________________
Fund Balance Account:
_____________________________________________
Government-Wide Indicator:
_____________________________________________
Unbudgeted Fund Indicator:
_____________________________________________
GAAP Fund Type:
_____________________________________________
DFA/OFM Signature _______________________________________________
Date ____________________________