Exhibit 12 Sample Annual Funding Allocation | MAN1425
Fiscal Year: |
20XX (July 1, 20XX - June 30, 20XX) |
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Human Service Providers |
Historical Usage* |
Suggested Allocation |
Adjustments ** |
NEW Fiscal Year ALLOCATION |
Comments |
Totals |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
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* Historical usage comes directly from previous fiscal years expenditures. |
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** Adjustments are requested changes to the suggested allocations and must net a zero total balance unless funds are being removed or added by Aging Services. Any amount other than $0.00 in the adjustments column must be justified in the comments section. |
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Comments: |
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Signature: |
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Date: |
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