Certification of Cash Match and Program Income Worksheet.docx

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Option Year WBCs
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OWBO-WKPLN-2020-1
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Certification of Cash Match and Program Income Worksheet

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CERTIFICATION OF CASH MATCH

AND PROGRAM INCOME

Women’s Business Center (Name And Location):

Host Organization Name:

Point of Contact (phone and email):

Date Submitted:

Project Period:

CASH

As the duly authorized officer/representative of the above applicant or grantee, I hereby certify that Women’s Business Center (WBC) program budget for the funding cycle indicated above contains or will contain actual cash dollars in the amount of: $ from sources other than the federal government (Please provide expected or committed sources on the attached page).

PROGRAM INCOME

Program income collected for eligible WBC grant activities must be accounted for in a separate manner and can be used to match WBC federal funds or further expand the WBC program service delivery.

Please provide the amount of the expected Program Income
$

Program Income expected to be earned from this current award that will be applied as match. Include this amount on the SF-424A, Section B, block 6, Column (4)

Please provide the amount of the expected Program Income
$

Please provide the balance of program income on hand at the beginning of this project period that will be applied as

Signature of Project Director

Signature of Authorized Organizational Representative

Source of Match
Expected or Committed
Amount

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