1. Financial Report

 

A. Provide the following information regarding the program or project for which you received funds.

 

SUPPORT/REVENUE                                               BUDGETED               ACTUAL

 

Total Anticipated Support/Revenue

Actual Support/Revenue

  1. This grant

 

 

  2. Fundraising events

 

 

  3. Gifts/bequests

 

 

  4. Miscellaneous contributions

 

 

  5. Foundation/corporate grant support

 

 

  6. United Way

 

 

  7. Grants/contracts: govt. agencies

 

 

  8. Program service fees

 

 

  9. Membership dues

 

 

10. Investment income/transactions

 

 

11. Sales: services, products, crafts

 

 

12. Miscellaneous revenue

 

 

13. Subtotal Direct Support/Revenue

 

 

14. General & Management Income (prorated)

 

 

15. Total Support/Revenue

 

 

 

 

EXPENSES                                                                 BUDGETED                     ACTUAL

 

Total Anticipated Expenses

Total Actual Expenses

16. Salaries of provider staff

 

 

17. Fringe benefits

 

 

18. Professional fees (contract, consultant)

 

 

19. Supplies (consumable)

 

 

20. Printing and postage

 

 

21. Occupancy

 

 

22. Phone and fax

 

 

23. Travel and meetings

 

 

24. Training

 

 

25. Evaluation

 

 

26. Equipment purchases

 

 

27. Miscellaneous expenses

 

 

28. Subtotal Direct Expenses

 

 

29. General & Management Expenses (prorated)

 

 

30. Total Expenses

 

 

 

31. Surplus (Deficit)

 

 

 

 

B. Explain any variances between budgeted and actual figures that are larger than 10%.