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Standard Farm 270 <br />rCIMPUTATiin1V of AMOUNT OF RFTM$URSEMENT /ADVANCES REQUESTED <br />PROGRAMS/FUNCTIONS ACTIVITIES <br />(a} <br />Staff <br />(b} <br />Governance & <br />Finance Committee <br />PAGE 1 OF 2 PAGES <br />REQUEST FOR ADVANCE <br />OMB APPROVAL NO, 0348 -0004 <br />a. Total program outlays to day <br />$143,933.12 <br />$3,396.51 <br />$0 <br />$0 <br />OR REIMBURSEMENT <br />b. Less: Cumulative program income <br />l .Type of Payment <br />a. X" one or both boxes <br />BASIS OF REQUEST <br />(See instructions on back) <br />Requested <br />❑ ADVANCE ❑ REIMBURSEMENT <br />❑ CASH <br />b. ':Y" the applicable box <br />$1,875 <br />Electronic Transfer <br />❑ACCRUAL <br />d. Estimated net cash outlays for advance period <br />$311,066.88 <br />❑ FINAL ❑ PARTIAL <br />$7,500 <br />3. FEDERAL SPONSORING AGENCY AND <br />4. FEDERAL GRANT OR OTHER IDENTIFYING NUMBER <br />5. PARTIAL <br />ORGANIZATION ELEMENT TO WHICH THIS REPORT <br />ASSIGNED BY FEDERAL AGENCY <br />PAYMENT <br />IS SUBMITTED <br />see attached page <br />REQUEST NUMBER <br />Great Plains Region <br />99 -FC -60 -1187 � <br />FORTIES <br />REQUEST: <br />United States Bureau of Reclamation <br />see attached page <br />2 <br />6.EMPLOYER IDENTIFICATION NUMBER <br />-7.RECIPIENT'S <br />g, PERIOD COVERED BY THIS REQUEST <br />470769903 <br />IDENTIFYING <br />h. Federal payments previously requested <br />NUMBER: <br />FROM: 05/01/2007 <br />TO: 12131/07 <br />9. RECIPIENT ORGANIZATION <br />10. PAYEE (Where check is to be sent if dierenl that Item 9) <br />Nance: Nebraska Community Foundation <br />Nance: <br />Number <br />Number <br />and Street: 6501 Street, Suite 305 <br />and Street: <br />City, State <br />City, State <br />and ZIP Code: Lincoln, NE 68501 <br />and ZIP Code: <br />rCIMPUTATiin1V of AMOUNT OF RFTM$URSEMENT /ADVANCES REQUESTED <br />PROGRAMS/FUNCTIONS ACTIVITIES <br />(a} <br />Staff <br />(b} <br />Governance & <br />Finance Committee <br />(c} <br />Land Advisory <br />Cotmnittee <br />{d) <br />Water Advisory <br />Committee <br />TOTAL <br />a. Total program outlays to day <br />$143,933.12 <br />$3,396.51 <br />$0 <br />$0 <br />see attached page <br />b. Less: Cumulative program income <br />$192,500 <br />$45,000 <br />$1,875 <br />$1,250 <br />see attached page <br />c. Net program outlays (Line a minus line b) <br />$48,566.88 <br />$41,603.49 <br />$1,875 <br />$1,250 <br />see attached a e <br />d. Estimated net cash outlays for advance period <br />$311,066.88 <br />$176,603.49 <br />$7,500 <br />$5,000 <br />see attached page <br />a. Total (Sian of lines c & d) <br />$262,500 <br />$135,000 <br />$51625 <br />$3,750 <br />see attached page <br />f. Non - Federal share of amount of line a <br />$42 078.75 <br />$2164050 <br />$901.69 <br />$601.13 <br />see attached page <br />g. Federal share of amount on line a <br />$220,421.25 <br />$113,359.50 <br />$4,723.31 <br />$3,148.87 <br />see attached rage <br />h. Federal payments previously requested <br />see attached page <br />i. Federal share now requested (line g minus <br />line h <br />$220,421.25 <br />$113,359.50 <br />$4,723.31 <br />$3,148.87 <br />see attached page <br />j. Advances required by <br />month, when requested by <br />Federal grantor agency far <br />use in making <br />prescheduled advances <br />1st month <br />2nd month <br />COMPUTATION FOR ADVANCES ONLY <br />a. Estimated Federal cash outlays that will be made during period covered by the advance <br />b. Less: Esthnaied balance ofFedetal cash on hand as ofbE&!nuing of advance period <br />C. Amount requested (Line a minus line b S <br />AUTHORIZED FOR LOCAL REPRODUCTION (Continued on Reverse, <br />Prescribed by Office of Management and Budge: <br />Cir. No. A -102 and A -1 ]t <br />