Lost Wages Claimant Summary & Admin Costs_3 weeks.xlsx
XLSX spreadsheet 22 KB Posted
- Attached to
- Other Needs Assistance - Lost Wages
- Opportunity number
- DHS-20-ONA-050-00-99
- Issued by
-
Federal Emergency Management Agency
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Lost Wages Claimant Summary & Admin Costs_3 weeks
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Text version
State submission
Box 1: Claimant Summary - [INSTERT STATE/TERRITORY NAME] Number of eligible claimants
| (actual or estimated) | Total benefit |
| ($400/claimant) | Federal Share |
| ($300/claimant) | Non-Federal Share |
($100/claimant)
| Week ending 8/1/20 | ||||
| Regular Unemployment | $0 | $0 | $0 | |
| Unemployment Compensation for Federal Employees (UCFE) | $0 | $0 | $0 | |
| Unemployment Compensation for Ex-Service members (UCX) | $0 | $0 | $0 | |
| Pandemic Emergency Unemployment Compensation | $0 | $0 | $0 | |
| Pandemic Unemployment Assistance | $0 | $0 | $0 | |
| Extended Benefits | $0 | $0 | $0 | |
| Short-Time Compensation | $0 | $0 | $0 | |
| Trade Readjustment Allowance | $0 | $0 | $0 | |
| Payments under the Self-Employment Assistance program | $0 | $0 | $0 | |
| SUBTOTAL | 0 | $0 | $0 | $0 |
| Week ending 8/8/20 | ||||
| Regular Unemployment | $0 | $0 | $0 | |
| Unemployment Compensation for Federal Employees (UCFE) | $0 | $0 | $0 | |
| Unemployment Compensation for Ex-Service members (UCX) | $0 | $0 | $0 | |
| Pandemic Emergency Unemployment Compensation | $0 | $0 | $0 | |
| Pandemic Unemployment Assistance | $0 | $0 | $0 | |
| Extended Benefits | $0 | $0 | $0 | |
| Short-Time Compensation | $0 | $0 | $0 | |
| Trade Readjustment Allowance | $0 | $0 | $0 | |
| Payments under the Self-Employment Assistance program | $0 | $0 | $0 | |
| SUBTOTAL | 0 | $0 | $0 | $0 |
| Week ending 8/15/20 | ||||
| Regular Unemployment | $0 | $0 | $0 | |
| Unemployment Compensation for Federal Employees (UCFE) | $0 | $0 | $0 | |
| Unemployment Compensation for Ex-Service members (UCX) | $0 | $0 | $0 | |
| Pandemic Emergency Unemployment Compensation | $0 | $0 | $0 | |
| Pandemic Unemployment Assistance | $0 | $0 | $0 | |
| Extended Benefits | $0 | $0 | $0 | |
| Short-Time Compensation | $0 | $0 | $0 | |
| Trade Readjustment Allowance | $0 | $0 | $0 | |
| Payments under the Self-Employment Assistance program | $0 | $0 | $0 | |
| SUBTOTAL | 0 | $0 | $0 | $0 |
| TOTAL (3 weeks of Lost Wages benefit payments, fed-share) | 0 | $0 | $0 | $0 |
| Box 2: Administrative Costs | ||
| Instructions to State/Territory: In the box to the right, enter the total estimated administrative costs associated with dispersing three weeks of Lost Wages Assistance benefit payments. The number should match the administrative costs on the SF-424A. (The Federal and Non-Federal Share will automatically calculate) | Total Admin Costs | |
| (Fed + Non-Fed) | Federal Share | |
| (75%) | Non-Federal Share |
(25%) $0 $0
Calculations
Award Calculations- [INSTERT STATE/TERRITORY NAME]
| Lost Wages Benefit Payments | |||
| Total Benefits | |||
| ($400/claimant) | Federal Share | ||
| ($300/claimant) | Non-federal share |
($100/claimant)
| Number of eligible claimants for week ending 8/1/20 | 0 | $0 | $0 | $0 |
| Number of eligible claimants for week ending 8/8/20 | 0 | $0 | $0 | $0 |
| Number of eligible claimants for week ending 8/15/20 | 0 | $0 | $0 | $0 |
| Lost Wages benefit payments subtotal | 0 | $0 | $0 | $0 |
Lost Wages Administrative Costs Reviewer instructions for Admin Costs:
1) Confirm that the state/territory entered their admin costs, as reflected in the SF-424A, into "Box 2" of the "State submission" tab.
2) Compare the "FEMA-calculated administrative costs" to the "State-submitted administrative costs", and enter the lesser of the two amounts in the bright green box.
| Total Admin Costs | Federal Share | Non-federal share | ||
| FEMA-calculated administrative costs | 1.00% | $0 | $0 | $0 |
| State-submitted administrative costs | ERROR:#DIV/0! | $0 | $0 | $0 |
| Lost Wages administrative costs (lesser of the two) | $0 | $0 |
| Total Award: Lost Wages Benefits + Administrative Costs | ||||||
| Total Award | ||||||
| (Benefits + Admin Costs) | Federal Share | Non-federal share | ||||
| Lost Wages benefit payments for 3-week period | ||||||
| (weeks ending 8/1, 8/8, and 8/15) | $0 | $0 | $0 | |||
| Lost Wages administrative costs (lesser of the two) | $0 | $0 | $0 | |||
| TOTAL | $0 | $0 | $0 |
Table for Award Letter The table below is formatted so that it may be copied and pasted into the award letter template.
All reviewers should double check that $$ figures copy and paste into the award letter accurately.
| Total | |
| Lost Wages Payments for the week ending 8/1/20 | $0 |
| Lost Wages Payments for the week ending 8/8/20 | $0 |
| Lost Wages Payments for the week ending 8/15/20 | $0 |
| Administrative Costs | $0 |
| Total | $0 |
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