Fillable 2017METROActMunicipalityAnnualReport April1,2017toMarch31,2018 LocalUnitName LocalUnitType CountyName LocalUnitCode StreetAddress City (Local Community Stabilization Authority)

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2017METROActMunicipalityAnnualReport April1,2017toMarch31,2018 LocalUnitName LocalUnitType CountyName LocalUnitCode StreetAddress City (Local Community Stabilization Authority)

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MetropolitanExtensionTelecommunicationsRights‐of‐WayOversightAct,Act48of2002
MCL484.3110Fee‐sharingpayments.
Sec.10.(5)Amunicipalityreceivingfundsundersections11and12withapopulationoflessthan10,000mayfile
andamunicipalityreceivingfundsundersections11and12withapopulationof10,000ormoreshallfileanannual
reportwiththeauthorityontheuseanddispositionofthefunds.Theauthorityshallprescribetheformofthereport
tobefiledunderthissubsection,whichreportshallbeinasimplifiedformat.
2017METROActMunicipalityAnnualReport
April1,2017toMarch31,2018
LocalUnitName
LocalUnitType
CountyName LocalUnitCode
StreetAddress
City
ZIPCode 2010Census
population
YourName
YourTitle
YourEmailAddress
YourPhoneNumber
Statement Amount
1 METROActfundscarriedforwardfrompreviousyear(s) $
2 METROActfundsreceivedthisyear
$
3 TotalMETROActfundsavailable(line1plusline2)
$
4 DescriptionofMETROActfundsused:

5 TotalMETROActfundsused
$
6 Carryforwardtonextyear(line3minusline5) $
Bysigningthisreport,youcertifythattheinformationincludedinthisdocumentistrue,accurate,and
completetothebestofyourknowledgeandbelief.

SignatureDate
Emailthecompletedreporttoadmin@lcsami.govnolaterthanApril29
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2017METROActMunicipalityAnnualReport April1,2017toMarch31,2018 LocalUnitName LocalUnitType CountyName LocalUnitCode StreetAddress City (Local Community Stabilization Authority)

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Completed 20 July 2020

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