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MICHIGAN CAMPUS COMPACT

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					MICHIGAN CAMPUS COMPACT Venture Grant Cycle #37 STATEMENT OF FINAL EXPENSES Grantee Name(s): ______________________________________________________________ Project Name: _________________________________________________________________ Project Institution: _____________________________________________________________ Period Covered by Report: February 1, 2009 to January 31, 2010
Please provide line item names in the space below and their corresponding awarded, expended, and balance dollar amounts in columns 1-3. Grant Detail: 1 Award Total (Budget) 2 Cumulative Expenses (Actual) 3 Award Balance (1– 2)

Grant Subtotal: Matching Requirement Detail:

Matching Subtotal: TOTAL:

I certify that to the best of knowledge, the information presented above is accurate and adheres to all grant guidelines and expectations. Grant Recipient: ___________________________________ Signature and Date ___________________________________ Name & Title (printed) Authorized Institutional Fiscal Officer: _________________________________________ Signature and Date _________________________________________ Name & Title (printed)

This form, along with a check for any unexpended funds, should be returned by February 28, 2010 to: Michigan Campus Compact 1048 Pierpont, Suite 3 Lansing, MI 48911