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OUNTY CODE: GOVERNMENTAL: CONSOLIDATED FISCAL REPORT For the Period: July 1, 2004 to June 30, 2005 Please check the box if the agency address changed from the prior reporting period. SCHOOL CODE (SED ONLY): FEDERAL EMPLOYER ID NUMBER (OMRDD Only): Person to Contact with Regard to Questions Concerning this Report: ( Name ) Telephone Number Title ( E-mail Address CHECK THE STATE AGENCY(IES): OMH OMRDD OASAS SED CHECK THE CFR SUBMISSION TYPE: FULL CF.

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