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Distribution of
Electronics Management Funds Questionnaire
November 2014
Please take a few moments to answer the following questions. When complete, please attach this form and required documents
to an e-mail message and send to: electronic_recycling@ncdenr.gov If you have questions regarding fund distribution or
reporting, contact Ethan Brown at (919) 707-8249 or Ellen Lorscheider (919) 707-8245.
Buncombe
2. Finance Director Contact Information - Please provide contact information for your finance director.
Name: Donna Clark
Telephone Number: 828-250-4137
Fax Number:
FY 13-14
Beginning Balance
+ Revenues
16,215.13
- Expenditures
41,556.9
Ending Balance
-25,341.77
6. For the 2015 funds, describe how you intend to spend and utilize the funds.
Funds will be used to support our program to recycle and manage discarded computer equipment, televisions and other
electronic devices.
7. As part of the eligibility requirements, please send copies of the following documents:
1) A copy of the electronics recycler/vendor R2 or e-Steward certificate.
2) Copies of all invoices or weigh sheets showing tonnage of electronics materials received and shipped by the
government program during 2014 including the vendor utilized.
3) A copy of the current Electronics Management Plan for your county/city.
When complete, please attach this form and the required documents to an e-mail message and send to:
electronic_recycling@ncdenr.gov
NC DENR - Electronics Management Program