Grant Expenditure Report Indiana Recycling And HHW Grant Programs
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Grant Expenditure Report Indiana Recycling And HHW Grant Programs Form. This is a Indiana form and can be use in Department Of Enviromental Management Statewide.
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Tags: Grant Expenditure Report Indiana Recycling And HHW Grant Programs, 51986, Indiana Statewide, Department Of Enviromental Management
Office of Pollution Prevention and Technical Assistance
RECYCLING & HHW GRANT PROGRAM
Grant Expenditure Report
402 West Washington Street, W041
P.O. Box 7095
Indiana Recycling & HHW Grant Programs
Indianapolis, IN 46207-7095
State Form 51986 (11-04)
Indiana Department of Environmental Management
Internet: http://www.in.gov/idem/resources/
grants_loans/recycling/
INSTRUCTIONS: Call your grant representative for assistance with this report. Use one sheet for each grant budget category. Designate a category to each sheet. For PEP grants budget categories are
Print Material (brochures, copying, publications, printing costs, etc.), Signage (billboard, informational signage, etc.), Advertising (TV/Cable, Radio, Newspaper), Promotional Education Items, or Other
(conferences/training, performers, subscriptions, booth rental, books, videos, etc.).
SECTION 1
GRANT INFORMATION
Name of Grantee:
Action Review Number (ARN):
SECTION 2
Grant Amount:
Grant State Date:
$
Grant End Date:
BUDGET CATEGORY EXPENDITURES
Budget Category:
Invoice
Date
Vendor
Description of expense or match
Check
Number
Total
Expense
Amount
Grant
Amount
Cash Match
Amount
In-kind
Amount
Subtotal:
TOTAL:
s
Total
Match:
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