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Budget Contribution Request

  1. The instructions detailed are for any outside agency that is requesting funding assistance from Goochland County. These instructions must be complied with in order for the funding request to be considered by the Goochland County Board of Supervisors in the upcoming fiscal year budget. Upon completing the Application for Funds, you will be required to sign a statement certifying to the accuracy of the information submitted and agreeing to allow Goochland County Officials to review your books and records upon request, if they should so request. Goochland County shall publish its intent to provide funding to your organizations in the local newspaper. The records that your organization submits to Goochland County regarding your finding request will be open for public inspection.

  2. Type of Organization

  3. I hereby certify that to the best of my knowledge and belief that the information with this request is accurate. The Organization also agrees to allow Goochland County to review the books and records of this agency should they so desire.

  4. By submitting this form I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature.

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  6. This field is not part of the form submission.