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["REQUEST FOR TITLE III BUDGET REVISION: C1 or C2"]
[null,null,null,null,null,null,null,null,"Page 1 of 2"]
["Fiscal Year:",null,null,null,null,"Title: III-"]
[null,null,null,null,null,null,null,"(C1 or C2)"]
[]
["Agency Name:",null,null,null,null,null,"Site:"]
[]
["Agency Contact for Revision Questions:"]
[]
["Phone Number:",null,null,null,null,null,"Date of Request:"]
[]
[null,null,null,null,null,null,"Date of Last Revision:"]
[]
[]
["A.  Total FUNDS for site"]
[]
[null,"FUND CATEGORY",null,null,"CURRENT","REVISION","DIFFERENCE","% CHANGE"]
["a.","AgeOptions/Federal Funds",null,null,null,null,{"$f":"F23-E23","v":0},{"$f":"IF(G23=0,\"\",G23/E23)","v":""}]
["b.","Local Cash Match*",null,null,null,null,{"$f":"F24-E24","v":0},{"$f":"IF(G24=0,\"\",G24/E24)","v":""}]
["c.","Local Inkind Match*",null,null,null,null,{"$f":"F25-E25","v":0},{"$f":"IF(G25=0,\"\",G25/E25)","v":""}]
["d.","Project Income (Client Contributions)",null,null,null,null,{"$f":"F26-E26","v":0},{"$f":"IF(G26=0,\"\",G26/E26)","v":""}]
["e.","TOTAL",null,null,{"$f":"SUM(E23:E26)","v":0},{"$f":"SUM(F23:F26)","v":0},{"$f":"F27-E27","v":0},{"$f":"IF(G27=0,\"\",G27/E27)","v":""}]
["f.","Federal share of net cost",null,null,{"$f":"IF(E27=0,\"\",E23/(E27-E26))","v":""},{"$f":"IF(F27=0,\"\",F23/(F27-F26))","v":""},{"$error":"#VALUE!"},{"$f":"G28/E28","v":{"$error":"#VALUE!"}}]
["g.","Non-federal share of net cost",null,null,{"$f":"IF(E27=0,\"\",(E24+E25)/(E27-E26))","v":""},{"$f":"IF(F27=0,\"\",(F24+F25)/(F27-F26))","v":""},{"$error":"#VALUE!"},{"$f":"G29/E29","v":{"$error":"#VALUE!"}}]
[]
["B.  Total COSTS for site"]
[]
[null,"EXPENSE CATEGORY",null,null,"CURRENT","REVISION","DIFFERENCE","% CHANGE"]
["a.","Personnel/Fringe**",null,null,null,null,{"$f":"F34-E34","v":0},{"$f":"IF(G34=0,\"\",G34/E34)","v":""}]
["b.","Travel",null,null,null,null,0,{"$f":"IF(G35=0,\"\",G35/E35)","v":""}]
["c.","Equipment/Supplies***",null,null,null,null,0,""]
["d.","Other",null,null,null,null,0,""]
["f.","Food",null,null,null,null,0,""]
["g.","Delivery",null,null,null,null,0,""]
["h.","TOTAL",null,null,{"$f":"SUM(E34:E39)","v":0},{"$f":"SUM(F34:F39)","v":0},0,""]
[]
["C.  Revised FUNDS ALLOCATION for site"]
[null,"FUND CATEGORY",null,null,"Area Agency Funds","Local Cash Match","In-Kind Match","Project Income","TOTAL"]
["a.","Personnel /Fringe)",null,null,null,null,null,null,{"$f":"ROUND(E44+F44+G44+H44,0)","v":0}]
["b.","Travel",null,null,null,null,null,null,0]
["c.","Supplies/Equipment",null,null,null,null,null,null,0]
["d.","Food (C1 & C2 only)",null,null,null,null,null,null,0]
["f.","Delivery (C1 & C2 only)",null,null,null,null,null,null,0]
["g.","Other",null,null,null,null,null,null,0]
["h.","TOTAL",null,null,{"$f":"ROUND((E44+E45+E46+E47+E48+E49),0)","v":0},{"$f":"ROUND((F44+F45+F46+F47+F48+F49),0)","v":0},{"$f":"ROUND((G44+G45+G46+G47+G48+G49),0)","v":0},{"$f":"ROUND((H44+H45+H46+H47+H48+H49),0)","v":0},{"$f":"ROUND((I44+I45+I46+I47+I48+I49),0)","v":0}]
[]
[null,null,"Percent of Budget",null,{"$f":"IF(E50=0,\"\",E50/I50)","v":""},{"$f":"IF(F50=0,\"\",F50/I50)","v":""},{"$f":"IF(G50=0,\"\",G50/I50)","v":""},{"$f":"IF(H50=0,\"\",H50/I50)","v":""},{"$f":"IF(I50=0,\"\",I50/I50)","v":""}]
[null,null,"Match Percentage",null,{"$f":"(F50+G50)/(I50-H50)","v":{"$error":"#DIV/0!"}},{"$f":"IF(F51=0,\"\",F51/I51)","v":""},{"$f":"IF(G51=0,\"\",G51/I51)","v":""},{"$f":"IF(H51=0,\"\",H51/I51)","v":""},{"$f":"IF(I51=0,\"\",I51/I51)","v":""}]
["Instructions:"]
["* Agencies may not reduce the amount of match from the original grant/contract."]
["** Any change in number of positions or salary scale must be identified and explained on Page 2."]
["*** List any equipment changes requested and provide an explanation for changes on page 2."]
[]
["Rev 10-05-2019"]

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[]
[null,null,null,"REQUEST FOR TITLE III BUDGET REVISION: C1 or C2      ",null,null,null,null,"Page 2 of 2"]
[]
[null,null,null,"Agency:",{"$f":"IF(Page1!C11=0,\"\",Page1!C11)","v":""}]
[null,null,null,"Site: ",{"$f":"IF(Page1!H11=0,\"\",Page1!H11)","v":""}]
[]
["A.  CURRENT COSTS for site"]
[null,"AgeOptions/\nFederal Funds","# of Meals","# of Clients","Total Unit Cost","AAA Unit Rate","AAA Food & Delivery Unit Rate"]
["a.",{"$f":"Page1!E23","v":0},null,null,{"$f":"IF(C9=0,\"\",Page1!E27/C9)","v":""},{"$f":"B9/C9","v":{"$error":"#DIV/0!"}}]
[]
["B.  REQUESTED REVISION for site"]
[null,"AgeOptions/\nFederal Funds","# of Meals","# of Clients","Total Unit Cost","AAA Unit Rate","AAA Food & Delivery Unit Rate"]
["a.",{"$f":"Page1!F23","v":0},null,null,{"$f":"IF(C13=0,\"\",Page1!F27/C13)","v":""},{"$f":"B13/C13","v":{"$error":"#DIV/0!"}},{"$f":"IF(C13=0,\"\",(Page1!E47+Page1!E48)/C13)","v":""}]
[]
["C.  EXPLANATION OF REQUESTED REVISION for site"]
["1.  Please provide an explanation for any changes in unit rate."]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["2.  Please provide rationale for any changes in resources and/or expenses categories."]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["D. This section is for AgeOptions use only."]
[]
["1. Meal, client and unit rate variances"]
[null,"AgeOptions/\nFederal Funds","# of Meals","# of Clients","Total Unit Cost","AAA Unit Rate","AAA Food & Delivery Unit Rate"]
[null,{"$f":"B13-B9","v":0},0,0,{"$error":"#VALUE!"},{"$error":"#DIV/0!"},{"$error":"#VALUE!"}]
[]
["2. Ratio of meal revision to F&D revision"]
["SITE","Current meals","Revised meals","% change in meals","Current F&D","Revised F&D","% change in F&D"]
["a.",{"$f":"C9","v":0},{"$f":"C13","v":0},{"$f":"-(1-(C53/B53))","v":{"$error":"#DIV/0!"}},{"$f":"SUM(Page1!E38:'Page1'!E39)","v":0},{"$f":"SUM(Page1!F38:'Page1'!F39)","v":0},{"$f":"-(1-(F53/E53))","v":{"$error":"#DIV/0!"}}]
[]
[{"$f":"Page1!A59","v":"Rev 10-05-2019"}]

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[]
[null,null,null,"Reimbursement Schedule"]
["Program:","Title III-",{"$f":"IF(Page1!H8=0,\"\",Page1!H8)","v":""},null,null,"Areas to enter are highlighted in yellow."]
[]
[null,"Fiscal Year:",{"$f":"IF(Page1!C8=0,\"\",Page1!C8)","v":""}]
[null,"Agency:",{"$f":"IF(Page1!C11=0,\"\",Page1!C11)","v":""}]
[null,"Submitted by:"]
[null,"Date Submitted:",{"$f":"IF(Page1!H15=0,\"\",Page1!H15)","v":""}]
[]
[null,"Month","AgeOptions Reimbursements received ","Estimation of Expenditures for the month","Total AgeOptions reimbursement (Sum of column a and b)","Pending available funding, Agencies will receive this reimbursment within 3 days of AgeOptions receipt of the funds","Program Income  received","Estimation of Program Income which will be collected & expended","Total Project Income (Sum of column e and f)"]
[]
[null,null,"a ","b","c","d","e","f","g"]
[1,"October",null,null,{"$f":"+D13+C13","v":0},"October",null,null,{"$f":"+H13+G13","v":0}]
[2,"November",null,null,0,"November",null,null,0]
[3,"December",null,null,0,"December",null,null,0]
[4,"January",null,null,0,"January",null,null,0]
[5,"February",null,null,0,"February",null,null,0]
[6,"March",null,null,0,"March",null,null,0]
[7,"April",null,null,0,"April",null,null,0]
[8,"May ",null,null,0,"May ",null,null,0]
[9,"June",null,null,0,"June",null,null,0]
[10,"July",null,null,0,"July",null,null,0]
[11,"August",null,null,0,"August",null,null,0]
[12,"September",null,null,0,"September",null,null,0]
[13,"Total",{"$f":"SUM(C13:C24)","v":0},{"$f":"SUM(D13:D24)","v":0},{"$f":"SUM(E13:E24)","v":0},null,{"$f":"SUM(G13:G24)","v":0},{"$f":"SUM(H13:H24)","v":0},{"$f":"SUM(I13:I24)","v":0}]
[14,"NGA level",null,null,{"$f":"Page1!F23","v":0},null,null,null,{"$f":"Page1!F26","v":0}]
[15,"Difference (should be $0)",null,null,{"$f":"+E26-E25","v":0},null,null,null,{"$f":"+I26-I25","v":0}]
[null,"This report should be sent to reports@ageoptions.org along with Budget Revision."]
[null,"I certify that this report is the best estimate of our AgeOptions Expenditures ",null,null,null,null,null,"          Check this box if you "]
[null,"and estimated Project Income collected.",null,null,null,null,null,"would like to suppress paper"]
[null,"A signed copy may be scanned or faxed and sent to AgeOptions.",null,null,null,null,null,"and receive email notification "]
[null,null,null,null,null,null,null,"of payments."]
[]
[null,"Signature",null,null,null,"Date"]
[]
[null,"Name (printed)",null,null,null,"Title"]
[]
[]
[null,"Prepared by",null,null,null,"Phone number of preparer"]
[]
[null,"Send payment email notification to:"]
[null,"Email notifications will be sent to this email address only if box is checked (see above)."]
[]
[null,{"$f":"Page1!A59","v":"Rev 10-05-2019"}]