Wisconsin Environmental Education Board

Budget Expense Summary Form

(Rev 04/2006)

 

Project Log # _____________                                                                       Type of Report
Report Date Ending _______________                                            □ Interim Claim               □ Final Claim

 

Administering Organization

 

Report Preparer

 

Phone

(      )

Email

Budget Category

(A) Amount Budgeted

(B) Amount Expended

(C) Match

Budgeted

(D) Match Received

Salary/Honoraria

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fringe Benefits

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Travel

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Materials/Supplies

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

Total

 

 

 

 

Balance

 

(A-B)

 

(C-D)

Cash Summary

AMOUNT REQUESTED

 

 

For WEEB Use Only

AMOUNT APPROVED

Funds Rec’d to Date

 

 

 

Disbursements to Date

Cash Balance

CERTIFICATION I CERTIFY that all revenue and disbursements reported herein are properly substantiated and reconciled with the financial transactions of this organization’s general ledger, and have not been claimed under any other state or federal program, and do not replace or supplant existing funding from other sources.

Signature

 

 

Date