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Name of the Participating Jurisdiction Federal Fiscal Year(yyyy) <br /> 7.Site Preparation, <br /> 1.Project No. 2.Date of 3.Cash 4.Foregone Taxes, 5.Appraised 6.Required Construction Materials, 8.Bond 9.Total <br /> or Other ID Contribution (non-Federal sources) Fees,Charges Land/Real Property Infrastructure Donated labor Financing Match <br /> (mm/dd/yyyy) <br /> page 2 of 4 pages form HUD-40107-A(12/a4) <br />