SF-424A - Bureau of Primary Health Care



OMB No.: 0915-0285 Expiration Date: 09/30/2016 DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration FORM SF-424A: BUDGET INFORMATIONFOR HRSA USE ONLYGrant NumberApplication Tracking NumberBudget InformationSection A – Budget SummaryGrant Program Function or ActivityCFDA NumberEstimated Unobligated FundsNew or Revised BudgetFederalNon-FederalFederalNon-FederalTotalwill auto-calculate in EHBCommunity Health Centers 93.224N/AN/AHealth Care for the Homeless 93.224N/AN/AMigrant Health Centers93.224N/AN/APublic Housing93.224N/AN/ATotal will auto-calculate in EHBSection B – Budget CategoriesObject Class CategoriesFederalNon-FederalTotalwill auto-calculate in EHBPersonnelFringe BenefitsTravelEquipmentSuppliesContractualConstructionOtherTotal Direct Charges will auto-calculate in EHBIndirect ChargesTotal will auto-calculate in EHBSection C – Non-Federal Resources Grant Program Function or ActivityApplicantStateLocalOtherProgram IncomeTotalwill auto-calculate in EHBCommunity Health Centers Health Care for the Homeless Migrant Health CentersPublic HousingTotal will auto-calculate in EHBSection D – Forecasted Cash Needs (optional)1st Quarter2nd Quarter3rd Quarter4th QuarterTotal 1st Yearwill auto-calculate in EHBFederalNon-FederalTotal will auto-calculate in EHBSection E – Budget Estimates of Federal Funds Needed for Balance of ProjectGrant ProgramFuture Funding Periods (Years)FirstSecondThirdFourthCommunity Health Centers N/AN/AN/AHealth Care for the Homeless N/AN/AN/AMigrant Health CentersN/AN/AN/APublic HousingN/AN/AN/ATotal will auto-calculate in EHBN/AN/AN/ASection F – Other Budget InformationDirect ChargesIndirect ChargesRemarksPublic Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 0915-0285. Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 10-29, Rockville, Maryland, 20857 ................
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