Hello,? The information is below.? There are two forms attached that should be based on the CDC’s REACH program.??https://www
Hello,
The information is below. There are two forms attached that should be based on the CDC's REACH program. https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/index.htm
The financial accounting analysis should include:
· A 5-year proposed budget including major line items (see example template via link to the NIH grants page in syllabus)
· An analysis of budget line items, costs, sources of revenue, and deficits
· An analysis of the fiscal soundness and long-term viability of the public health initiative
398_fp4.docx
Program Director/Principal Investigator (Last, First, Middle): |
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DETAILED BUDGET FOR INITIAL BUDGET PERIODDIRECT COSTS ONLY |
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List PERSONNEL (Applicant organization only) Use Cal, Acad, or Summer to Enter Months Devoted to Project
Enter Dollar Amounts Requested (omit cents) for Salary Requested and Fringe Benefits
NAME |
ROLE ON PROJECT |
Cal. Mnths |
Acad. Mnths |
Summer Mnths |
INST.BASE SALARY |
SALARY REQUESTED |
FRINGE BENEFITS |
TOTAL |
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PD/PI |
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SUBTOTALS |
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CONSULTANT COSTS
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EQUIPMENT (Itemize)
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SUPPLIES (Itemize by category)
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TRAVEL
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INPATIENT CARE COSTS |
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OUTPATIENT CARE COSTS |
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ALTERATIONS AND RENOVATIONS (Itemize by category)
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OTHER EXPENSES (Itemize by category)
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CONSORTIUM/CONTRACTUAL COSTS |
DIRECT COSTS |
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SUBTOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD (Item 7a, Face Page) |
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CONSORTIUM/CONTRACTUAL COSTS |
FACILITIES AND ADMINISTRATIVE COSTS |
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TOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD |
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PHS 398 (Rev. 03/2020 Approved Through 02/28/2023) OMB No. 0925-0001 Page Form Page 4
398_fp5.docx
Program Director/Principal Investigator (Last, First, Middle): |
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BUDGET FOR ENTIRE PROPOSED PROJECT PERIOD DIRECT COSTS ONLY |
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BUDGET CATEGORY TOTALS |
INITIAL BUDGET PERIOD (from Form Page 4) |
2nd ADDITIONAL YEAR OF SUPPORT REQUESTED |
3rd ADDITIONAL YEAR OF SUPPORT REQUESTED |
4th ADDITIONAL YEAR OF SUPPORT REQUESTED |
5th ADDITIONAL YEAR OF SUPPORT REQUESTED |
PERSONNEL: Salary and fringe benefits. Applicant organization only. |
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CONSULTANT COSTS |
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EQUIPMENT |
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SUPPLIES |
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TRAVEL |
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INPATIENT CARE COSTS |
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OUTPATIENT CARE COSTS |
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ALTERATIONS AND RENOVATIONS |
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OTHER EXPENSES |
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DIRECT CONSORTIUM/ CONTRACTUAL COSTS |
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SUBTOTAL DIRECT COSTS (Sum = Item 8a, Face Page) |
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F&A CONSORTIUM/ CONTRACTUAL COSTS |
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TOTAL DIRECT COSTS |
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TOTAL DIRECT COSTS FOR ENTIRE PROPOSED PROJECT PERIOD |
$ |
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JUSTIFICATION. Follow the budget justification instructions exactly. Use continuation pages as needed.
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PHS 398 (Rev. 03/2020 Approved Through 02/28/2023) OMB No. 0925-0001 Page Form Page 5
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