Community Support Agency Grant Program
PERFORMANCE MEASURES REPORTING FORM
Provide an update on your agency's Performance Measures, as provided in your Proposed Performance
Measures Form. Include the goal for the fiscal year, progress to date, and any explanatory comments if
necessary. Submit a mid-year update (with information for the period July-December) by January 15,
along with the agency’s Mid-Year Financial Reporting Form and Third Quarter Payment Request form.
Submit an end-of-year update (with information for the period January-June) by July 15, along with the
agency’s End of Year Financial Reporting Form and Final Payment Request form.
Agency Name: ________________________________________________________________________
Contact Person: __________________________________
Phone: _________________ Email: ___________________
_________________________ ___ _________________________________ ___________
Signature of Authorized Official Typed Name of Authorized Official Date
Submit this form in hardcopy or electronic format to your agency's CSAG contact (refer to your grant
award letter to determine your agency's CSAG contact).
City of Newport News
Department of Budget & Evaluation
2400 Washington Avenue, 9th Floor
Newport News, VA 23607
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