January 20, 2022

Hello,? The information is below.? There are two forms attached that should be based on the CDC’s REACH program.??https://www

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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):

DETAILED BUDGET FOR INITIAL BUDGET PERIOD DIRECT COSTS ONLY	FROM	THROUGH

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
	PD/PI






SUBTOTALS
CONSULTANT COSTS
EQUIPMENT (Itemize)
SUPPLIES (Itemize by category)
TRAVEL
INPATIENT CARE COSTS
OUTPATIENT CARE COSTS
ALTERATIONS AND RENOVATIONS (Itemize by category)
OTHER EXPENSES (Itemize by category)
CONSORTIUM/CONTRACTUAL COSTS	DIRECT COSTS
SUBTOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD (Item 7a, Face Page)	$
CONSORTIUM/CONTRACTUAL COSTS	FACILITIES AND ADMINISTRATIVE COSTS
TOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD	$

Program Director/Principal Investigator (Last, First, Middle):

BUDGET FOR ENTIRE PROPOSED PROJECT PERIOD DIRECT COSTS ONLY
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.
CONSULTANT COSTS
EQUIPMENT
SUPPLIES
TRAVEL
INPATIENT CARE COSTS
OUTPATIENT CARE COSTS
ALTERATIONS AND RENOVATIONS
OTHER EXPENSES
DIRECT CONSORTIUM/ CONTRACTUAL COSTS
SUBTOTAL DIRECT COSTS (Sum = Item 8a, Face Page)
F&A CONSORTIUM/ CONTRACTUAL COSTS
TOTAL DIRECT COSTS
TOTAL DIRECT COSTS FOR ENTIRE PROPOSED PROJECT PERIOD	$
JUSTIFICATION. Follow the budget justification instructions exactly. Use continuation pages as needed.

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