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[]
[]
["(A)",null,"District/Agency Name",{"$nulls":20},"  FLORIDA DEPARTMENT OF EDUCATION",{"$nulls":24},"(F)",null,"Agency Number"]
[]
["(B)",null,"Program Name",{"$nulls":21}," PROJECT DISBURSEMENT REPORT",{"$nulls":23},"(G)",null,"Grant Number"]
[]
["(C)",null,"Effective Approval Date",{"$nulls":45},"(H)",null,"Project Code"]
[]
["(D)",null,"Termination Date",{"$nulls":24},"  Interim Report",{"$nulls":8},"Final Report",{"$nulls":11},"(I)",null,"Agency Project Number"]
[]
["(E)",null,"Total Project Dollars",{"$nulls":20},"Adult Education & Family Literacy Act of 1998",{"$nulls":24},"(J)",null,"Contact Person                                          ",{"$nulls":11},"Phone (      )",null,null,"(  )"]
[]
[{"$nulls":33}," "]
[null,null,null,"(1)",{"$nulls":6},"(2)",{"$nulls":12},"(3)",{"$nulls":13},"(4)",{"$nulls":8},"(5)",{"$nulls":8},"(6)",{"$nulls":9},"(7)"]
["     Account or",{"$nulls":6},"     Account or ",{"$nulls":13},"   Name of ",{"$nulls":13},"    Budget ",{"$nulls":6}," Total Disbursed to Date",{"$nulls":9},"      Undisbursed",{"$nulls":7},"       Current Disbursement"]
["      Func. No.",{"$nulls":6},"      Object No.",{"$nulls":13},"   Account",{"$nulls":13},"   Amount",{"$nulls":6}," As of ____/____/____",null,null,"      /       /   ",{"$nulls":8}," Balance",{"$nulls":5},"                Reported"]
["LEADERSHIP",{"$nulls":51},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
["(8)  TOTAL LEADERSHIP",{"$nulls":32},0,{"$nulls":8},0,{"$nulls":9},0]
[]
[]
["PROGRAMS OF INSTRUCTION     0-8"]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[]
[]
[{"$nulls":52},0]
["(9)  TOTAL PROGRAM OF INSTRUCTIONS       0-8",{"$nulls":32},0,{"$nulls":8},0,{"$nulls":9},0]
["(9a)",null,"CORRECTIONS (including institutionalized adults)"]
[]
["DOE 499"]
["Rev 08/22/12"]
[]
[]
["PROJECT BUDGET SUMMARY AND DISBURSEMENT REPORT"]
["Adult Education & Family Literacy Act of 1998"]
[]
[]
[]
[null,null,null,"(1)",{"$nulls":6},"(2)",{"$nulls":12},"(3)",{"$nulls":13},"(4)",{"$nulls":8},"(5)",{"$nulls":8},"(6)",{"$nulls":9},"(7)"]
["     Account or",{"$nulls":6},"     Account or ",{"$nulls":13},"   Name of ",{"$nulls":13},"    Budget ",{"$nulls":6}," Total Disbursed to Date",{"$nulls":9},"      Undisbursed",{"$nulls":7},"       Current Disbursement"]
["      Func. No.",{"$nulls":6},"      Object No.",{"$nulls":13},"   Account",{"$nulls":13},"   Amount",{"$nulls":6}," As of ____/____/____",null,null,"      /       /   ",{"$nulls":8}," Balance",{"$nulls":5},"                Reported"]
["PROGRAMS OF INSTRUCTION 9-12 (Not Applicable for EL/Civics Education)"]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
[{"$nulls":52},0]
["(10)   PROGRAM OF INSTRUCTION        9-12",{"$nulls":32},0,{"$nulls":8},0,{"$nulls":9},0]
[null,null,"(10a)",{"$nulls":4},"CORRECTIONS (including institutionalized adults)"]
[]
[]
[]
[" (11)",null,"  TOTAL LEADERSHIP AND PROGRAMS OF INSTRUCTION (rows 8, 9 & 10)",{"$nulls":39},0,{"$nulls":9},0]
[]
[]
[]
[]
[]
["(12)  CERTIFICATION: (Complete on last page only)"]
[]
["I hereby certify that I have reviewed this budget summary/disbursement report and that all items shown above are in accordance with applicable law and regulation and have "]
["been classified properly according to this district's/agency's current chart of accounts.  All records necessary to substantiate these items are available for review by state and "]
["federal monitoring staff.  I further certify that as a disbursement report, all disbursements: were obligated for after the project approval date and prior to the termination date; have "]
["not been reported previously; and were not used for matching funds on this or any special project.  Further, that all inventory items included have been entered properly on the"]
["inventory records required by Florida Statutes."]
[]
[]
["DOE 499",{"$nulls":6},"Report Number",{"$nulls":9},"Certified Correct ",{"$nulls":7}," ",{"$nulls":18},"  Date",null,null,"___/___/___",{"$nulls":8},"DOE",null,null,"Audited by: ___________"]
["Rev 08/22/12",{"$nulls":6},"Page   ",{"$nulls":4},"   of",{"$nulls":9},"             Finance Officer or Authorized Representative",{"$nulls":33},"USE",null,null,"Date: ___/___/___",null,"     /      /"]
[{"$nulls":56}," "]
[]
[]
[{"$nulls":18},"                     PROJECT DISBURSEMENT REPORT"]
[{"$nulls":28},"             INSTRUCTIONS"]
["PROJECT DISBURSEMENT REPORT"]
[null,"Complete Items (A) through (I).  Mark (X), in the box provided below the title, to indicate that this is an interim or a final report (a final report is that report which closes out the project)."]
[{"$nulls":5},"Federal Programs:",{"$nulls":7},"Submit two copies by the 20th of each month following the month of disbursement to: Comptroller's Office, Florida Department of Education, 944 Ralph Turlington "]
[{"$nulls":13},"Building, Tallahassee, Florida 32399-0400, (850) 487-2460, Suncom 277-2460."]
[{"$nulls":5},"State Programs:",{"$nulls":7},"Do not submit monthly disbursement reports unless instructed to do so by the Comptroller's Office or the state grant program."]
[]
[null,null,"Columns"]
["(1)",null,"-","(2)",null,"School District Applicants:",{"$nulls":10},"Use the four digit function and three digit object numbers as required in Financial and Program Cost Accounting and Reporting for Florida Schools.  The"]
[{"$nulls":16},"first two digits of each function and object number must be the same as those required in exhibits I and II.  Examples are: 5000 - 100: 6100 - 200: 5000 -"]
[{"$nulls":16},"310; 6300 - 640."]
[]
[null,null,"(2)",null,null,"Community College",{"$nulls":10},"Use the five digit object codes as described in the Accounting Manual for Florida's Public Community Colleges.   The first two digits of "]
[{"$nulls":5},"Applicants:",{"$nulls":10},"each object code must be the same as those required in the expenditure chart of accounts.  Examples are: Salaries/Benefits - 50000: Travel - 60000;"]
[{"$nulls":16},"Professional  Fees - 65000; Furniture and Equipment - 71000."]
[]
[null,null,"(2)",null,null,"University/State Agency",{"$nulls":10},"Use the six digit object codes as described in the State of Florida Automated Management Accounting Subsystem.  The first two digits of each object  "]
[{"$nulls":5},"Applicants:",{"$nulls":10},"code must be the same as those required in the expenditure object classifications.  Examples are: Salaries/Benefits - 10000; Other Personal Services - "]
[{"$nulls":16},"130000; Travel - 260000; Operating Capital Outlay - 510000"]
[]
[null,null,"(2)",null,null,"Other Agency Applicants:",{"$nulls":10},"Use the object codes/account codes as described in the agency's expenditure chart of accounts."]
[]
[null,null,"(3)",null,null,"School District Applicants:",{"$nulls":10},"Use the account titles provided in exhibits I and II for the required function and object numbers."]
[]
[null,null,"(3)",null,null,"Community College Applicants:",{"$nulls":10},"Use the account titles for the required object codes."]
[]
[null,null,"(3)",null,null,"University/State Agency",{"$nulls":10},"Use the account titles for the required object codes."]
[{"$nulls":5},"Applicants:"]
[]
[null,null,"(3)",null,null,"Other Agency Applicants:",{"$nulls":10},"Use the account titles for the required object codes in the agency's accounting system."]
[]
[null,null,"(4)",null,null,"For each account name, indicate the budget amount requested for funding under this project."]
[]
[null,null,"(5)",null,null,"Complete by reporting total project disbursements as of the date indicated at the top of the column."]
[]
[null,null,"(6)",null,null,"Complete by subtracting Column (5) from Column (4)."]
[]
[null,null,"(7)",null,null,"Complete by reporting all current disbursements.  Enter the difference between the amount shown in Column (5) on the previous disbursement report and Column (5) of this report."]
[]
[null,null,"Rows"]
[null,null,"(8)"," ",null,"Complete by reporting current disbursements for Leadership projects."]
[]
[null,null,"(9)",null,null,"Complete by reporting current disbursements for Programs of Instruction 0-8"]
[null,null,"(9a)",null,null,"Complete by reporting total of expenditures in Row 9 that are related to Corrections and institutionalized adults."]
[]
[null,null,"(10)",null,null,"Complete by reporting current disbursements for Programs of Instruction 9-12"]
[null,null,"(10a)",null,null,"Complete by reporting total of expenditures in Row 10 that are related to Corrections and institutionalized adults."]
[null,null," "]
[null,null,"(11)",null,null,"Must represent the complete project status (rows 8, 9, & 10)."]
[]
[]
[null,null,"(12)",null,null,"The Finance Office or authorized representative must certify and date the project disbursement report on the last page."]
[]
[]
[]
[]
[null,null,"DOE 499"]
[null,null,"Rev 08/22/12"]

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