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� - <br /> ILLINOIS DEPARTMENT OF HUMAN SERVICES <br /> APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM <br /> BUDGET SECTION,Equipment and Patient Care(12 Month Budget) . <br /> APPLICANT AGP,NCY: Citv of Decatur 'I'1N: rIN 37-6001308 <br /> PROGRAM: Tide V—Delin uenc Prevention Pro r�m FOR TI IG PER10D: Jul TI IROUGf I June • <br /> � UIPMENT Itemize SOURCES OF FUNDS IDHS Components(specify) <br /> Q �- ----- � -- ----- <br /> Total for the Applicant and Requested from <br /> Pro ram Other IDHS <br /> Copy machine --- <br /> X <br /> - ---- --- -------- <br /> -- - <br /> 500 <br /> -- . _ - -- -- <br /> - ----- -- — --- —-- <br /> Fax machine --� X <br /> X --- -X -- ------ <br /> --225 225- --- ----- - -- ------- --- <br /> - ---- -- -- --- - — <br /> Phone 400 400- ----_ ---_ X -- X ------ X <br /> TOTAL, E ui ment 1,125. 1,125. I <br /> PATIENT CARE (Itemize) SOURCES OF FUNDS IDHS Components(specify) � <br /> Total for the Applicant and Requested from <br /> Pro ram Other IDHS <br /> Not applicable _ -- -------- -- ----- --- -- --- -- <br /> TOTAL, Patient Care <br /> USE ADDITIONAL SHEETS IF NECESSARY Budget Section,Page 5 <br /> 120 <br />