KNOX COUNTY PERFORMANCE MEASURES FY 2012
AGENCY NAME: FED TAX I.D. MEASURES SUBMISSION DATE
REQUESTED AMOUNT
AGENCY MAILING CITY, STATE QUARTERLY REPORT SUBMISSION
ADDRESS: ZIP CODE: DATE (DUE 15TH FOLLOWING AWARDED AMOUNT
QUARTER END)
Project Contact SIGNATURE AND TITLE OF
Name: Total Project/Program Budget
APPROVER (BELOW)
PROGRAM/
Project Contact Grant award as a % of Total
PROJECT NAME
Phone and email:
Project/Program Budget
PROGRAM/
% of Grant Award spent to date
PROJECT
MISSION
Page ______ of ______
DATA
1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Cumulative
# RESULT/OUTCOME OUTCOME INDICATOR TYPE GOAL
July-Sept Oct-Dec Jan-Mar Apr-Jun Y-T-D
CONTROL COLLECTION
START
# QUARTERLY REPORT EXPLANATIONS - USE ADDITIONAL PAGES AS NECESSARY
Indicator Type
1 - Percent
2 - Average
3 - Median
4 - Ratio
5 - Total Count