HomeMy WebLinkAboutQuarter Report 3rdEXHIBIT C 3rd QUARTER REPORT
Organization:
Contact person:
Mailing Address:
Phone Number/Email:
1. LTAC Funds received from the County 3rd QTR:
Due by October 31st to afmcknight@co.jefferson.wa.us
ORGANIZATION Total
Amount
Awarded
by JeffCo
Total
Received
From
JeffCo
Overspent
(+)
Underspent
(-) of LTAC
funds
Refund
Required
TOTAL
1st QTR
LTAC
FUNDS
SPENT
TOTAL 2nd
QTR
LTAC
FUNDS
SPENT
TOTAL
3rd QTR
LTAC
FUNDS
SPENT
2. LTAC funds spent by your organization 3rd QTR (include 200 word limit regarding activities and funds spent
with and itemized statement:
3. LTAC funds balance remaining 3rd QTR:
4. Please attach your organization’s report for all revenue, marketing, services, programs and activities for
the quarter of July through September (3rd) quarter.
This report and any attachments may be subject to disclosure as a public record under the Public Records Act, RCW
Chapter 42.56. A minimum of six years, you must maintain documented proof of payments made, contracts executed
and other expenditures authorized under your Agreement with Jefferson County. Upon reasonable notice, you must be
able to provide access to County or State representatives to audit those records.