Community Support Agency Grant Program
MID-YEAR FINANCIAL REPORTING FORM
Provide a summary of your agency’s financial activity for the first half of the fiscal year (July through
December). Submit this form by January 15, along with the Mid Year Performance Measures Reporting
Form, the Third Quarter Payment Request form, and an independent audit of your agency’s last
completed fiscal year.
Agency Name: ________________________________________________________________________
Contact Person: __________________________________
Phone: _________________ Email: ___________________
1
st
Half Fiscal Year
(July-December)
Comments (if necessary)
Revenues:
Expenditures:
Compensation:
Non-Compensation:
Total Expenditures:
Cash Balance:
Current Accounts and Notes Payable:
_________________________ ___ _________________________________ ___________
Signature of Authorized Official Typed Name of Authorized Official Date
Send this form in hardcopy or electronic format to:
City of Newport News
Department of Budget & Evaluation
2400 Washington Avenue, 9th Floor
Newport News, VA 23607
(757) 926-8733
budget@nnva.gov
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