HomeMy WebLinkAboutBudget_Amendment_Form_-_EMTK:\users\shared goodies\forms\Copy of Budget Amendment Request Form (Apr 2003)
FINANCE DEPT. ONLY
Finance Committee approval required?
YES _____ NO _____
If so, date approved: _______________
City of Waterloo
Line-Item Budget Amendment Request Form
The Finance Committee of the City Council and/or Finance Dept. is hereby requested to authorize the following line-item budget
amendment for FYE submitted by the Department:
EXPENSES/REVENUE
DECREASE EXPENDITURES (INCREASE REVENUE)INCREASE EXPENDITURES (DECREASE REVENUE)
Fund Dept Activity Acct #Acct Name Proj Code Amount Fund Dept Activity Acct #Acct Name Proj Code Amount
TOTAL TOTAL
This amendment is being requested because:
Prior Committee Actions (Dates):
(Signature Dept. Head or Designee)Date (Signature Finance Dept. Review)Date
Date Posted (Finance Dept.)
Completed forms should be routed directly to the Finance Dept.
2025 Fire
10 12 1410 3873 Reimbursement for Services 2,358.00 10 12 1410 2116 Medical & Laboratory Equip 2,358.00
2,358.00 2,358.00
WFR has conducted an in house EMT school and the revenue collected from that class will be deposited
into 010-12-1410-3873. Once deposited, we would like to use these funds to purchase medical training
aids for future continuing education and EMT classes.
Jason Hernandez 4/25/25
Docusign Envelope ID: 7D7EBCA0-A6A7-4D22-9B9C-D5F92B0F6811
May 5, 2025