Crisis Center ICDVVA Monthly Billing Sheet
Main Street Grant year: 2003/04
Anywhere, Idaho 83000 Grant period: July 1 2003 thru June 30, 2004
Phone: 208-555-1234 Fax 208-555-5678 Grant No. KC163000
E-mail: current e-mail address
Original Balance Requested Ending
Expense Category Sub Category Funding Source Amount Forward Amount Balance
Administrative Salary Domestic Violence $5,000.00 $5,000.00
Legal Aid Legal Assistance Domestic Violence $2,500.00 $2,500.00
TOTAL STATE D.V. $7,500.00 $0.00 $7,500.00
Salaries & Benefits Salaries & Witholdings VOCA $25,000.00 $25,000.00
Travel Client Mileage VOCA $1,000.00 $1,000.00
Training Grantee Training VOCA $600.00 $600.00
Supplies Supplies VOCA $1,200.00 $1,200.00
Rent Rent VOCA $4,800.00 $4,800.00
Utilities Telephone VOCA $2,400.00 $2,400.00
Legal Aid Legal Assistance VOCA $7,500.00 $7,500.00
Other Other (fingerprinting) VOCA $500.00 $500.00
Three Days in June Training VOCA $600.00 $600.00
TOTAL VOCA $43,600.00 $0.00 $43,600.00
Administrative Supplies Family Violence $300.00 $300.00
Rent Family Violence $1,200.00 $1,200.00
Internet Family Violence $300.00 $300.00
Audit Family Violence $1,200.00 $1,200.00
Board Liability Insurance Family Violence $1,500.00 $1,500.00
Salaries & Witholdings Family Violence $6,000.00 $6,000.00
Insurance & E.A.P. Family Violence $700.00 $700.00
Salaries & Benefits Salaries & Witholdings Family Violence $8,000.00 $8,000.00
TOTAL FAMILY VIOLENCE $19,200.00 $0.00 $19,200.00
GRANT TOTAL: $70,300.00 $0.00 $70,300.00
Total Drawdown Request: $0.00
Program Director:
(Signature) (Date)
Breakdown of Expense Categories 7/1/02 -7/15/02
Jeff Lerwill Administrative: Rent Family Violence
Shaffer Insurance/Cafeteria Plan $12.00 Salaries & Benefits Family Violence
Blue Cross Sal. & Ben.: Insurance Family Violence
Broker's National $115.80 Sal. & Ben.: Insurance Family Violence
TOTAL $127.80 Family Violence
Gross Payroll: Margie, Alana, & Stefanie $1,428.01 Salaries & Benefits Family Violence
Employer contributions - withholdings $99.79 Salaries & Benefits Family Violence
TOTAL: $1,527.80 Family Violence
TOTAL: $0.00