OFFICE OF REFUGEE RESETTLEMENT CASH AND MEDICAL ASSISTANCE PROGRAM ORR-2 QUARTERLY REPORT ON EXPENDITURES AND OBLIGATIONS |
OMB 0970-0407 Expires XX/XX/XXXX |
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1 Federal Agency and Organization Element to Which Report is Submitted | 2. Grant Document/Award Number | 3. EIN | ||||||||||||||||||||
4. Grantee Recipient Organization Name and Address | Grantee Name 2 | |||||||||||||||||||||
Address Line 1 | Address Line 2 | |||||||||||||||||||||
City | State | Zip Code | Zip Ext. | |||||||||||||||||||
5a. Project/Grant Period Start Date: |
5b. Project/Grant Period End Date: |
6a. Reporting Period Start Date: |
6b. Reporting Period End Date: |
7. Final Report? (Yes or No) |
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Cash and Medical Assistance Program Components (Column A) |
Total Cumulative Expenditures (Column B) |
Total Cumulative Unliquidated Obligations (Column C) |
Total Expenditures and Unliquidated Obligations (Column D) |
Federal Funds Authorized (Column E) |
Unobligated Balance (Column F) |
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1. Refugee Cash Assistance (RCA) | (a) RCA Recipient Costs | |||||||||||||||||||||
(b) RCA Administration | ||||||||||||||||||||||
(c) Subtotal | ||||||||||||||||||||||
2. Refugee Medical Assistance (RMA) | (a) RMA Recipient Costs | |||||||||||||||||||||
(b) RMA Administration | ||||||||||||||||||||||
(c) Medical Screening | ||||||||||||||||||||||
(d) Medical Screening Administration | ||||||||||||||||||||||
(e) Subtotal | ||||||||||||||||||||||
3. Unaccompanied Refugee Minors (URM) | (a) Services for URMs | |||||||||||||||||||||
(b) URM Program Administration | ||||||||||||||||||||||
(c) Subtotal | ||||||||||||||||||||||
4. Administration - Planning and Coordination | ||||||||||||||||||||||
5. Total Administration | ||||||||||||||||||||||
6. Total | ||||||||||||||||||||||
7. Remarks: | ||||||||||||||||||||||
Certification: I certify that, to the best of my knowledge, all expenditures and obligations are for the purpose set forth in the award documents. | ||||||||||||||||||||||
8. Name and Title of Approving Official | 9. Telephone Number | |||||||||||||||||||||
10. Email Address | ||||||||||||||||||||||
11. Signature of Approving Official | 12. Date Report Submitted | |||||||||||||||||||||
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |