Directions for completing Budget Expense Summary

1.  Indicate the Log Number of your project.

2.  Indicate the closing date in the Report Date Ending space.

3. Check the appropriate Type of Report box (interim claim, final claim)

4. Fill in the Administering Organization, Report Preparer (print your name), your phone number and email (if available).

4.  Indicate the amount budgeted for each item within each category in Column A.

5.  Indicate how much was spent for each budget item within each category in column B. (Note: please use running totals rather than reporting information for each reporting period separately.)

6.  Indicate the amount of Match you budgeted for each item within each category in column C.

7.  Indicate how much match has been received for each item within each category in column D. (Note: please use running totals rather than reporting information for each reporting period separately.)

8.  Total Columns A,B,C,D.

9.  Indicate the Balance of your grant funds, and the Match to be received in the light shaded boxes at the bottom.  (Disregard blackened boxes).  Show a minus or brackets for negative balances and explain on your Project Report Form.

10.  Indicate the Funds Received to Date.

11. Indicate the Total Disbursements. (This should be equivalent to the total for column B.)

12. Indicate the Cash Balance (Funds Received to Date-Total Disbursements). This is likely to be a negative number

13. Indicate the amount to be reimbursed within the Amount Requested box.

14. Sign and date the form

15. Submit three copies of the Budget Expense Summary form along with three copies of the Periodic Report Summary Form.