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<br />LXL=-:,'~ -: ~ <br /> <br />BUDGET FORM <br /> <br />All costs related to the program activities describeci in the proposal must be included on the Budget Form, A <br />budget narrative must be attached on a separate sheet of paper for all line items marked with an * asterisk. <br /> <br />Administrative <br /> <br />Prol.!ram <br /> <br />Total WIA <br /> <br />MatchlIn <br />Kind <br /> <br />Personnel <br />Salaries* <br /> <br />l <br />! <br />, <br />! <br /> <br />$74,105 <br /> <br />$74,105 <br /> <br />$72,568 <br /> <br />] <br /> <br />~ <br /> <br />,). <br /> <br />Use separate sheet if necessary, <br />Benefits* <br />I. <br /> <br />$0 <br /> <br />$0 <br /> <br />$70,268 <br /> <br />~ <br /> <br />o <br />,), <br /> <br /> <br />$74,105 <br /> <br />$142,836 <br /> <br />$58,400 <br /> <br />$58,400 <br /> <br />$28,000 <br /> <br />$7,600 <br />$35,600 <br /> <br />GRAND TOTAL <br />(T alaI Personnel + Total <br />o eratin Ex enses) <br />*See Budget Form Instructions <br /> <br />$0 <br /> <br />$132,505 <br /> <br />$132,505 <br /> <br />$178,436 <br /> <br />Note: Audit Requirements <br />States, local governments and non-profit institutions who receive $500,000 or more in federal funds in a <br />fiscal year shall meet the audit requirements of the OMB Circular A-133, "Audits of States, and Local <br />Governments and Non-Profit Institutions," <br /> <br />31 <br /> <br />