Attachment 5
Budget Format
NOTE: Applicants: (1) must use this form for the budget; (2) cannot request a total two-year budget that exceeds
$1,000,000; and (3) must indicate resident/family sample size at baseline below in the space provided for that information.
Complete one budget for each year of the contract and one summary budget for both years together.
RFA title:_____________________________________________________________________________
RFA number:__________________________________________________________________________
Resident/family sample size at baseline: ____________________________________________________
Contract Year: [ ] Year 1
[ ] Year 2
CATEGORY OF EXPENSE
1. Personal Services (personnel
or staff)
a) Salary
b) Fringe
Subtotal
2. Non-personal Services
a) Contractual services
b) Travel
c) Equipment
d) Space/property and
utilities
e) Operating expense
f) Other
Subtotal
TOTAL
[ ] Summary budget years 1 and 2
Summary Budget
Months 1 – 24
GRANT
MATCH
FUNDS
FUNDS
MATCH
%
OTHER
FUNDS
TOTAL
Attachment 5, Cont’d.
Personal Services Detail
POSITION TITLE
ANNUALIZED
SALARY PER
POSITION
SALARY
STANDARD PERCENT
WORK
OF
WEEK
EFFORT
(HOURS)
FUNDED
NUMBER
OF
MONTHS
FUNDED
Subtotal
FRINGE – TYPE/DESCRIPTION
PERSONAL SERVICES TOTAL
TOTAL
SALARY
CHARGED
TO GRANT
Attachment 5, Cont’d.
Non-Personal Services Detail
CONTRACTUAL SERVICES – TYPE/DESCRIPTION
TOTAL
1.
2.
3.
4.
5.
6.
7.
8.
TOTAL
TRAVEL – TYPE/DESCRIPTION
TOTAL
1.
2.
3.
4.
5.
6.
7.
8.
TOTAL
Attachment 5, Cont’d.
Non-Personal Services Detail
MOVABLE CAPITAL (EQUIPMENT) – TYPE/DESCRIPTION
(CANNOT EXCEED $5,000)
TOTAL
1.
2.
3.
4.
5.
6.
7.
8.
TOTAL
SPACE/PROPERTY EXPENSES: RENT – TYPE/DESCRIPTION
TOTAL
1.
2.
3.
TOTAL
SPACE/PROPERTY EXPENSES: OWN – TYPE/DESCRIPTION
1.
2.
3.
TOTAL
TOTAL
Attachment 5, Cont’d.
Non-Personal Services Detail
UTILITY EXPENSES - TYPE/DESCRIPTION
TOTAL
1.
2.
3.
TOTAL
OPERATING EXPENSES - TYPE/DESCRIPTION
TOTAL
1.
2.
3.
4.
5.
6.
7.
8.
TOTAL
OTHER – TYPE/DESCRIPTION
TOTAL
1.
2.
3.
4.
5.
TOTAL