ARM 34.3.104. APPLICATION FOR ASSISTANCE

(1) If the total estimated expenditures necessary to respond to the emergency are greater than the estimated resources available for the emergency, the board or council may request the governor to declare an emergency and to initiate action to provide state financial assistance in accordance with such declaration. The application should be made on the following form: The Honorable Ted Schwinden Governor of Montana State Capitol Helena, Montana 59620 Dear Governor Schwinden: Pursuant to our authority as__________________________________________________ of________________________________________________, Montana, we request that an emergency be declared immediately to provide supplemental disaster relief in accordance with the provisions of Title 10, chapter 3, part 3, MCA. 1. SITUATION A. (Date and description of conditions causing disaster) B. (Description of damages to public sector) C. (Description of damages to private sector) D. (Description of economic impact) 2. OFFICIAL ACTION A. The County Disaster Committee has determined by a majority vote that an emergency does exist. Attached is a copy of the signed resolution. B. This __________________________has levied the emergency two mill levy authorized by Section 10-3-405, MCA. (Attach copy of resolution imposing the levy.) C. (Other action taken) 3. DAMAGE ESTIMATES A. Debris Clearance $ B. Protective Measures C. Road Systems D. Water Control Facilities E. Public Buildings and Related Equipment F. Public Utilities G. Public Facilities Under Construction H. Other Damages (Not in Above Categories) TOTAL ESTIMATED DAMAGES $ 4. LOCAL RESOURCES Names of funds or accounts involved: ESTIMATED Cash balance including reserves as of June 30, 19 $ Receipts from two mill emergency levy Receipts from maximum permissive levy and other anticipated revenues SUB TOTAL $ Less regular operating budget including reserve budgeted for year per Sec. 7-6-2319, MCA. BALANCE AVAILABLE TO RESPOND TO EMERGENCY $ 5. ASSISTANCE REQUIRED Total damage estimate (from No. 3) $ Less estimated resources available from No. 4) ESTIMATED ASSISTANCE REQUIRED $ Date (Title of Board or Council) By: Chairman Member Member