Reporting Period: July 1, 2017 Through June 30, 2018

¨ NEW ¨AMENDED

Reporting Period: July 1, 2017 through June 30, 2018

PLANS are due no later than Friday, June 16, 2017. Recipients will receive an approval from the USAAV Council if the plan is accepted. Please refer to the updated Beer Tax Guidelines located on the USAAV web page: www.usaav.utah.gov.

Name of Municipality (City or Town—not the PD or SO):
/ Name of County:
Name and Title of Contact Person Preparing Plan (Print):
/ Mailing Address (Street, City, Zip Code):
Contact’s Phone Number:
/ Contact’s Fax Number:
/ Contact’s E-mail Address:

COMPLETE ONLY THE CATEGORIES WHERE BEER TAX FUNDS WILL BE APPLIED.

1 / Prevention Programs (programs must be evidence-based or evidence-informed, see Guidelines for additional information). Are you coordinating with the Local Substance Abuse Authority (LSAA) in your area (LSAAs are listed at the end of the Guidelines)? ¨Yes ¨No
¨ Keepin’ It Real ¨Guiding Good Choices ¨Prime for Life ¨ Communities that Care (CTC) ¨ LifeSkills Training ¨Parenting Wisely ¨ Too Good for Drugs ¨ Other(s)______
Description of how funds will be used to support the above Prevention Program(s):
2 / Treatment of Offenders with Alcohol and/or Substance Abuse Problems (25% of funding to counties must be spent in Treatment and/or Confinement categories, see FY 2017 Distribution spreadsheet): Are you coordinating with the Local Substance Abuse Authority (LSAA) in your area (LSAAs are listed at the end of the Guidelines)? ¨Yes ¨No
¨ Recovery support services (e.g., Alcoholics Anonymous) ¨ Jail- based treatment ¨ Medication for alcohol or substance abuse dependency ¨ Outpatient programs ¨Residential programs ¨ Screening and assessment programs ¨ Other(s) ______
Description of how funds will be used to support the above Treatment Program(s):
3 / Law Enforcement related to Alcohol and/or Substance Abuse:
¨ Overtime DUI shifts, checkpoints, saturation patrols ¨ Alcohol and/or Substance Abuse related equipment (e.g., BodyCameras, breathalyzers, etc) ¨ K-9 Purchase and Training ¨ Alcohol and/or Substance Abuse training (not to include Taskforce training) ¨ Other(s) ______
Description of how funds will be used to specifically support above Law Enforcement selection(s):
4 / Prosecution:
¨ Prosecution of offenders who have committed Alcohol and/or Substance Abuse related offenses ¨ Other ______
Description of how funds will be used to specifically support above Prosecution selection(s):
5 / Confinement (25% of funding to counties must be spent in Treatment and/or Confinement categories, see FY 2017 Distribution spreadsheet):
¨ Confinement costs for Alcohol and/or Substance abuse offenders ¨ Other ______
Description of how funds will be used to specifically support above Confinement selection(s):
Chief Executive Officer (print name and title)
/ CEO Telephone
/ CEO E-mail Address
As chief executive officer, I do hereby attest the Beer Tax Funds will be spent according to the Plan details listed above and accounting for these monies will be separate from other funds (separate account/code, restricted line item, etc.). Additionally, the Beer Tax Funds will not be used to supplant any current funding for alcohol and/or substance abuse-related projects or programs.
______
Signature of Chief Executive Officer / ______
Date CEO Signed

CEO MUST SIGN THE FORM OR IT WILL BE RETURNED

Please send completed PLAN to: Utah Commission on Criminal and Juvenile Justice – ATTN: Krystal Hazlett, Utah State Capitol Complex – Senate Building, Suite 330, P.O. Box 142330, Salt Lake City, UT 84114-2330 Email: Telephone: (801) 538-1088, Fax: (801) 538-1024.