UC Campuses only

							                                                   UC Campus Name
                                                  Optional address here




                                   Intercampus Request for Reimbursement

Request #             1

Date:            ########

To:              Sea Grant Fiscal Team at UCSD



Subject:         Awarding Agency         U-04-SC-005                           Allocation               $69,500.00

                 Award/Project Number              R/SF-nn                     Award Balance            $64,000.00

                 Period of Performance        03/01/07-06/30/08                Carry Forward       Yes         No



                                         Our Campus                                  Your Campus

Fund Number                                12345A                                              18332A

Principal Investigator                  Henry James                                         Russell Moll

Department                            Marine Sciences                                   California Sea Grant



Below is the summary of expenditures & payments for the period from 03/01/07 through 09/30/07:


                                                       AMOUNT

Total Cumulative Expenditures                        $5,500.00

Less: Payments Received                              $0.00
Less: Billed but unpaid                              $0.00
Current Expenditures                                 $5,500.00


Total Amount Due                                      #######

Please prepare the necessary financial journal crediting our Financial Control Account 1195__0 and
referencing our Fund Number

This financial report is a      NOT       FINAL




If you have any questions, please contact Nancy Smith at (123) 456-7891, 1234@uci.edu.


Signature of Authorized Official                     Position Title

I certify that the above costs were incurred in the performance of work
required under the grant and are consistent with the amounts evidenced
by supporting documents and expenditures and are in compliance with
the terms and conditions of the award. Additionally, I certify that that all
travel expense payments conform to Exhibit B of the Conditions of
Award.