1St Page Project Report Template VBPD Grantee Financial Report

							VBPD Grantee Financial Report                                                                         (Rev. 6/05)                          Page 1

Grantee:
Project Title:
Project Coordinator:                                                            VBPD Program Mgr:
Project Period:
FIN:                                                                            Fiscal ID:                                                                          Grant ID:
Grant/Match Ratio:
EXPENDITURE                                                     Approved Budget
CATEGORY                                                      DD Grant               Match                                Instructions to Complete Financial Report Form
PERSONNEL (Salaries, Wages, Fringe)
CONSULTATION (Volunteers, Subcontracts)                                                                                Complete Section I. - fill in report period, final report?, begin
TRAVEL                                                                                                                    balances, match expend by category for report period.
RENTAL (Space, Equipment)                                                                                              Complete Section II. List individual Grant Payments.
SUPPLIES (Printing, Postage, Materials)                                                                                Complete Section III. Poverty Areas Expenditures, if applicable.
OTHER                                                                                                                  Complete Section IV. Signatures.
TOTALS                                                                  -                    -

Section I. Expenditures This Period (Monthly or Quarterly)
Report Period        from:                   thru:                                                                           Amount Requested for Reimbursement:
FINAL REPORT?        NO                      YES                                                                                                     -
                                                                                                                       Expenditures This Report
                                                                                         Begin Balance                         Period                              End Balance
EXPENDITURE                                                                         DD Grant               Match          DD Grant           Match           DD Grant            Match
CATEGORY                                                                                          A                                    B                                  C
PERSONNEL (Salaries, Wages, Fringe)                                                           -                    -               -                                  -                    -
CONSULTATION (Volunteers, Subcontracts)                                                       -                    -               -                                  -                    -
TRAVEL                                                                                        -                    -               -                                  -                    -
RENTAL (Space, Equipment)                                                                     -                    -               -                                  -                    -
SUPPLIES (Printing, Postage, Materials)                                                       -                    -               -                                  -                    -
OTHER                                                                                         -                    -               -                                  -                    -
TOTALS                                                                                        -                    -              -                 -                 -                    -

A = Balance as of last financial report or last budget amendment; or if 1st financial report -- approved budget.
B = Grant and Match expenditures you are reporting for THIS REPORT PERIOD.
C = A - B (Begin Balance less Expenditures this Period = End Balance)
VBPD Grantee Financial Report                                                            (Rev. 6/05)                Page 2

Grant ID:                                                                             Report Period:
Fiscal ID:                                                                                1/0/1900        thru           1/0/1900

Section II. List each DD Grant Payment for this Report Period by Expenditure Category (in yellow shaded areas)
                                                                                          Check #/
             Vendor/Payee                             Description of Goods/Services     Voucher #/ ET   Date Paid   Amount Paid
PERSONNEL




                      Subtotal for Personnel                                                                                  -
CONSULTATION



                    Subtotal for Consultation                                                                                 -
TRAVEL



                          Subtotal for Travel                                                                                 -
RENTAL



                          Subtotal for Rental                                                                                 -
SUPPLIES



                        Subtotal for Supplies                                                                                 -
OTHER



                            Subtotal for Other                                                                                -


                                       TOTAL GRANT EXPENDITURES FOR REPORT PERIOD:                                            -
VBPD Grantee Financial Report                                                               (Rev. 6/05)                                                      Page 3


Section III. Poverty Area Expenditures This Period
                                  This section must be completed if your grant program serves designated Poverty Areas.

Based on the above grant expenditures reported THIS PERIOD, fill-in the amount of grant funds expended
for each Poverty Area location.
                 Poverty Area Location*                               Grant Funds Expended                                           Amount Requested:

                                                                                                                                $                        -




TOTAL FUNDS EXPENDED IN POVERTY AREA(S) THIS PERIOD                                                  -
* See DD Grant Program Proposal & Administration Manual, Appendix A "Designated Poverty Areas".


Section IV. Signatures

The grantee certifies that all expenditures being claimed for reimbursement were incurred during the grant period and are for budget activities
approved under the grant application or subsequent amendments. Supporting documentation for all expenditures claimed and reported
is on file and available for review or audit.


Project Coordinator                                                                                       Authorized Official:




PROJECT COORDINATOR SIGNATURE                                                      DATE                   AUTHORIZED OFFICIAL SIGNATURE                               DATE




VBPD APPROVAL                                                                      DATE                   DRS APPROVAL (FISCAL AGENT)                                 DATE