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Fiscal Note For Proposed Rules - West Virginia

Fiscal Note For Proposed Rules Form. This is a West Virginia form and can be used in Administrative Law For Government Secretary Of State .
 Fillable pdf Last Modified 9/8/2006
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APPENDIX B FISCAL NOTE FOR PROPOSED RULES Rule Title: Type of Rule: Agency: Address: ____________________________________________________________ _____ Legislative _____Interpretive _____Procedural ____________________________________________________________ ____________________________________________________________ _____________________________________________________________ ____________________________________________________________ Phone Number: _______________________ Email: _______________________________ Fiscal Note Summary Summarize in a clear and concise manner what impact this measure will have on costs and revenues of state government. Fiscal Note Detail Show over-all effect in Item 1 and 2 and, in Item 3, give an explanation of Breakdown by fiscal year, including long-range effect. FISCAL YEAR Effect of Proposal 1. Estimated Total Cost Personal Services Current Expenses Repairs & Alterations Assets Other 2. Estimated Total Revenues Current Increase/Decrease (use "-") Next Increase/Decrease (use "-") Fiscal Year (Upon Full Implementation) Rule Title: ____________________________________________________________ American LegalNet, Inc. www.USCourtForms.com American LegalNet, Inc. www.USCourtForms.com PRINT THIS COPY, THEN CLICK HERE TO RESET.
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