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[{"$nulls":11},"GRANT FINANCIAL REPORT"]
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[{"$nulls":10},"Monthly/Quarterly/Other Report:",null,"Grantee Name: "]
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[{"$nulls":12},"Current Period Reporting On:","mm/dd/yyyy - mm/dd/yyyy","Phone Number:"]
[{"$nulls":10},"Instructions: Send the completed and signed report to your LISC Program Officer. Enter the budget as it appears on the grant letter. "]
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[{"$nulls":10},"BUDGET DESCRIPTION                                ","TOTAL APPROVED BUDGET","PRIOR PERIOD'S CUMULATIVE EXPENSES","CURRENT PERIOD'S EXPENSES","CUMULATIVE TOTAL EXPENSES","BUDGET BALANCE"]
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[{"$nulls":10},"By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the expenditures, disbursements, and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise (U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812)"]
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[{"$nulls":10},"Signature of Authorized Certifying Official:",null,"Title:",null,null,"Date:"]
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[{"$nulls":10},"** SUBMIT THE REPORT BY THE 15TH OF THE FOLLOWING MONTH",{"$nulls":4},"Rev. June 2021"]

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[null,"Instructions: Send the completed and signed report to your LISC Program Officer. Enter the budget as it appears on the grant letter. "]
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[null,"BUDGET DESCRIPTION                                ","TOTAL APPROVED BUDGET","PRIOR PERIOD'S CUMULATIVE EXPENSES","CURRENT PERIOD'S EXPENSES","CUMULATIVE TOTAL EXPENSES","BUDGET BALANCE"]
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[null,"By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the expenditures, disbursements, and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise (U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812)"]
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[null,"Signature of Authorized Certifying Official:",null,"Title:",null,null,"Date:"]
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[null,"** SUBMIT THE REPORT BY THE 15TH OF THE FOLLOWING MONTH",{"$nulls":4},"Rev. June 2021"]