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And a Budget Form have been prepared for use with the application. Health departments shall submit their budget using the included template in accordance with the instructions on the template and as specified herein. Please do not alter the form; however, you may re-label the line items to reflect your request. A few blank spaces have been provided for additional budget line items as needed. The budget form is used to calculate the health department s total Oral Health award request. A. All l.

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