PWS_Attachment_12-Budget_Data_Capture_Report_template.pdf

CORE RM DATA CAPTURE

PROGRAM NAME:

Program Fiscal Year:

State Fiscal Year:

HIGHER HEADQUARTERS:

Current Program Year:

Target Graduates:

Current Enrollment:

Budget Operating Dates:

Federal Funds (75%):

State Match (25%):

Potential Grow Back:

Additional State funds above the 25% (Provide source and $ amount):

Petty Cash Accounts:

Discretionary or Restricted Funds Account:

In-Kind Assistance:

Travel Funds (100% FED) (aka Appendix 3):

Travel Funds Obligated YTD:

Travel Funds Disbursed YTD:

Program Income earned:

Food Program reimbursement total:

501 (c) (3) funds (Foundation) total budget:

Number of staff paid with Cooperative Agreement funds:

Number of staff paid with or reimbursed by funds from other sources:

Target Graduation for the last two classes Class #: Target Graduation: Total Graduation:

Class #: Target Graduation: Total Graduation:

Funds from other sources - NOTE: A copy of all pertinent documentation for Grant administration must be available for the evaluation.

Non-YCP Grant (if more than one provide information on additional sheet):

Grant Name:

Grant Renewal Date:

Grant Awarded By:

Grant Amount Funded:

Grant Amount Remaining:

Grant Custodian:

Prior Year:

Date CA was closed out:

Close out Modification amount:

Budget Operating Dates:

Target Graduates:

Number of Graduated Cadets:

Federal Funds (75%):

State Match (25%):

Actual Grow Back:

Potential Grow Back:

Petty Cash Accounts:

In-kind Assistance:

Travel Funds (100% FED) (aka Appendix 3):

Travel Funds Obligated YTD:

Travel Funds Disbursed YTD:

Program Income earned:

Food Program reimbursement total:

501 (c) (3) funds (Foundation) total budget:

Number of staff paid with Cooperative Agreement funds:

Number of staff paid with or reimbursed by funds from other sources:

Target Graduation for the last two classes Class #: Target Graduation: Total Graduation:

Class #: Target Graduation: Total Graduation:

Funds from other sources - NOTE: A copy of all pertinent documentation for Grant administration must be available for the evaluation.

Non-YCP Grant (if more than one provide information on additional sheet):

Grant Name:

Grant Renewal Date:

Grant Awarded By:

Grant Amount Funded:

Close out Modification amount:

Budget Operating Dates:

Target Graduates:

Number of Graduated Cadets:

Federal Funds (75%):

State Match (25%):

Potential or Actual Grow Back:

Petty Cash accounts:

In-kind Assistance:

Travel Funds (100% FED) (aka Appendix 3):

Travel Funds Obligated YTD:

Travel Funds Disbursed YTD:

Program Income earned:

Food Program reimbursement total:

501 (c) (3) funds (Foundation) total budget:

Funds from other sources - NOTE: A copy of all pertinent documentation for Grant administration must be available for the evaluation.

Non-YCP Grant (if more than one provide information on additional sheet):

Grant Name:

Grant Renewal Date:

Grant Awarded By:

Grant Amount Funded:

Close out Modification amount:

Budget Operating Dates:

Target Graduates:

Number of Graduated Cadets:

Federal Funds (75%):

State Match (25%):

In-kind Assistance:

Travel Funds (100% FED) (aka Appendix 3):

Travel Funds Obligated YTD:

Travel Funds Disbursed YTD:

Program Income earned:

Food Program reimbursement total:

501 (c) (3) funds (Foundation) total budget:

Funds from other sources - NOTE: A copy of all pertinent documentation for Grant administration must be available for the evaluation.

Non-YCP Grant (if more than one provide information on additional sheet):

Grant Name:

Grant Renewal Date:

Grant Awarded By:

Grant Amount Funded:

Close out Modification amount:

Budget Operating Dates:

Target Graduates:

Number of Graduated Cadets:

Federal Funds (75%):

State Match (25%):

In-kind Assistance:

Travel Funds (100% FED) (aka Appendix 3):

Travel Funds Obligated YTD:

Travel Funds Disbursed YTD:

Program Income earned:

Food Program reimbursement total:

501 (c) (3) funds (Foundation) total budget:

Funds from other sources - NOTE: A copy of all pertinent documentation for Grant administration must be available for the evaluation.

Non-YCP Grant (if more than one provide information on additional sheet):

Grant Name:

Grant Renewal Date:

Grant Awarded By:

Grant Amount Funded:

Close out Modification amount:

Budget Operating Dates:

Target Graduates:

Number of Graduated Cadets:

Federal Funds (75%):

State Match (25%):

In-kind Assistance:

Travel Funds (100% FED) (aka Appendix 3):

Travel Funds Obligated YTD:

Travel Funds Disbursed YTD:

Program Income earned:

Food Program reimbursement total:

501 (c) (3) funds (Foundation) total budget:

Funds from other sources - NOTE: A copy of all pertinent documentation for Grant administration must be available for the evaluation.

Non-YCP Grant (if more than one provide information on additional sheet):

Grant Name:

Grant Renewal Date:

Grant Awarded By:

Grant Amount Funded:

TRAINING:

Youth ChalleNGe Budget Officer:

FUNCTIONAL EDUCATION: Date attended:

RMIC: Date attended:

AFCOS: Date attended:

FISCAL LAW: Date attended:

COOPERATIVE AGREEMENT: Date attended:

Was training voluntary or required by higher headquarters?

MIL/ CIV EDUCATION:

TIME IN POSITION:

Federal Program Manager:

FUNCTIONAL EDUCATION: Date attended:

RMIC: Date attended:

AFCOS: Date attended:

FISCAL LAW: Date attended:

COOPERATIVE AGREEMENT: Date attended:

Was training voluntary or required by higher headquarters?

Grants Officer Representative:

RMIC: Date attended:

AFCOS: Date attended:

FISCAL LAW: Date attended:

COOPERATIVE AGREEMENT: Date attended:

Was training voluntary or required by higher headquarters?

Grantee (State) Program Manager:

RMIC: Date attended:

AFCOS: Date attended:

FISCAL LAW: Date attended:

COOPERATIVE AGREEMENT: Date attended:

Was training voluntary or required by higher headquarters?