Exemption Details

Project to be Funded (Title or Description):

Entity Requesting:

State Agency:

Campus Receiving Funds:


Public or Private:

Agreement No.(if available):

Exemption Request:

Date of Request:

Date of Final Action:

Approved or Denied:

Rationale for Approval or Denial:

Approved Terms/ Language, if approved:

Type of Exemption:

Date of Exemption Termination:

Notes & Errata:

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