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Revised May 2023 Page 6 of 7 Current Fiscal Year Next Fiscal Year General Revenue_________________ General Revenue________________ Federal Funds___________________ Federal Funds___________________ Cash Funds_____________________ Cash Funds_____________________ Special Revenue_________________ Special Revenue_________________ Other (Identify)__________________ Other (Identify)__________________ Total__________________________ Total__________________________ (b) What is the additional cost of the state rule? Current Fiscal Year Next Fiscal Year General Revenue_________________ General Revenue________________ Federal Funds___________________ Federal Funds___________________ Cash Funds_____________________ Cash Funds_____________________ Special Revenue_________________ Special Revenue_________________ Other (Identify)__________________ Other (Identify)__________________ Total__________________________ Total__________________________ 5. What is the total estimated cost by fiscal year to any private individual, private entity, or private business subject to the proposed, amended, or repealed rule? Please identify those subject to the rule, and explain how they are affected. Current Fiscal Year Next Fiscal Year $__________________ $_________________ 6. What is the total estimated cost by fiscal year to a state, county, or municipal government to implement this rule? Is this the cost of the program or grant? Please explain how the government is affected. Current Fiscal Year

Next Fiscal Year $__________________

$__________________ $5046.14 $11908.86 0 0 0 $ 16,995.00 0 0 0 0 0 $ 0.00 $190,000.00 $ 190,000.00 0.00 0.00 195,046.14 0.00 The total one-time cost implement both Federal and State mandates equals$206,995.00. Costs associated with SNAP Alien Eligibility updates resulting from Public Law 119-21 total $16,995.00, with applicable Federal grants allocating divisible costs of $5,046.14 State and $11,908.86 Federal. Costs associated with updates resulting from State legislation total $190,000.00, payable only by the State.