Exhibit D_Budget Information_SF424A-V1.0 (1).pdf

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Attached to
Virginia Rural Health Transformation Program (RHTP) Earn to Learn Initiative
Solicitation number
RFA-128140
Issued by
Virginia

About this file

This is a Standard Form 424A Budget Summary document for a non-construction grant program administered under OMB Number 4040-0006, with an expiration date of June 30, 2028. The form is designed to capture comprehensive budget information for federal grant applications, including estimated unobligated funds, new or revised budgets, and both federal and non-federal funding sources. The document is structured to accommodate multiple grant programs, functions, or activities, with each line item referencing an Assistance Listing Number and corresponding budget allocations across federal and non-federal categories.

The budget categories detailed in the form encompass Personnel, Fringe Benefits, Travel, Equipment, Supplies, Contractual costs, Construction, and Other expenses, with provisions for calculating total direct charges and indirect charges. The form includes sections for forecasted cash needs broken down by quarterly periods within the first year, non-federal resource documentation by source type (applicant, state, or other sources), and budget estimates for future funding periods across multiple years. Supporting sections address program income, authorized local reproduction capabilities, and remarks or additional budget information, providing applicants with a standardized framework for presenting comprehensive financial plans aligned with federal grant requirements and OMB circulars. The form structure permits clear delineation between federal and non-federal contributions across all budget categories and funding periods.

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SECTION A - BUDGET SUMMARY

BUDGET INFORMATION - Non-Construction Programs OMB Number: 4040-0006 Expiration Date: 06/30/2028

Grant Program Function or

Activity

(a)

Assistance Listing Number

(b)

Estimated Unobligated Funds New or Revised Budget

Federal (c)

Non-Federal (d)

Federal (e)

Non-Federal (f)

Total (g)

5. Totals

4.

3.

2.

1. $ $ $ $

Standard Form 424A (Rev. 7- 97) Prescribed by OMB (Circular A -102) Page 1

SECTION B - BUDGET CATEGORIES

7. Program Income

d. Equipment

e. Supplies

f. Contractual

g. Construction

h. Other

j. Indirect Charges

k. TOTALS (sum of 6i and 6j)

i. Total Direct Charges (sum of 6a-6h)

(1)

Authorized for Local Reproduction Prescribed by OMB (Circular A -102) Page 1A

Standard Form 424A (Rev. 7- 97)

GRANT PROGRAM, FUNCTION OR ACTIVITY

(2) (3) (4) (5)

Total6. Object Class Categories

a. Personnel

b. Fringe Benefits

c. Travel

SECTION D - FORECASTED CASH NEEDS

14. Non-Federal

SECTION C - NON-FEDERAL RESOURCES

(a) Grant Program (b) Applicant (d) Other Sources(c) State (e)TOTALS

$8.

9.

10.

11.

12. TOTAL (sum of lines 8-11)

15. TOTAL (sum of lines 13 and 14)

13. Federal

Total for 1st Year 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter

FUTURE FUNDING PERIODS (YEARS)

SECTION F - OTHER BUDGET INFORMATION

SECTION E - BUDGET ESTIMATES OF FEDERAL FUNDS NEEDED FOR BALANCE OF THE PROJECT

Authorized for Local Reproduction

$16.

17.

18.

19.

20. TOTAL (sum of lines 16 - 19)

21. Direct Charges: 22. Indirect Charges:

23. Remarks:

(a) Grant Program (b)First (c) Second (d) Third (e) Fourth

Standard Form 424A (Rev. 7- 97) Prescribed by OMB (Circular A -102) Page 2

File details come from the government source that posted it. Updated .