Fiscal Note For Proposed Rules
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Fiscal Note For Proposed Rules Form. This is a West Virginia form and can be use in For Government Secretary Of State.
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Tags: Fiscal Note For Proposed Rules, West Virginia Secretary Of State, For Government
APPENDIX B
FISCAL NOTE FOR PROPOSED RULES
Rule Title:
____________________________________________________________
Type of Rule:
_____ Legislative
Agency:
____________________________________________________________
Address:
____________________________________________________________
_____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
Current
Increase/Decrease
(use “-“)
Effect of Proposal
Next
Increase/Decrease
(use “-“)
Fiscal Year
(Upon Full Implementation)
1. Estimated Total Cost
Personal Services
Current Expenses
Repairs & Alterations
Assets
Other
2. Estimated Total
Revenues
Rule Title:
____________________________________________________________
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