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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":4},"(5)",{"$nulls":13},"(6)",{"$nulls":8},"(7)",{"$nulls":4},"(8)"]
["     Account or",{"$nulls":6},"     Account or ",{"$nulls":13},"   Name of ",{"$nulls":13},"    Budget ",{"$nulls":6},"Amended Budget",{"$nulls":9}," 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},"Amount",{"$nulls":9}," As of ____/____/____",null,null,"      /       /   ",{"$nulls":8}," Balance",{"$nulls":5},"                Reported"]
["LEADERSHIP"]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
["(9)  TOTAL LEADERSHIP",{"$nulls":32},0,{"$nulls":8},0,{"$nulls":9},0,{"$nulls":9},0,{"$nulls":7},0]
[]
[]
["PROGRAMS OF INSTRUCTION     0-8 "]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
["(10)  TOTAL PROGRAMS OF INSTRUCTION       0-8",{"$nulls":32},0,{"$nulls":8},0,{"$nulls":9},0,{"$nulls":9},0,{"$nulls":7},0]
["(10a)",null,"Institutionalized adults"]
[]
["DOE 499"]
["Rev 04/10"]
[]
[]
["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":4},"(5)",{"$nulls":13},"(6)",{"$nulls":8},"(7)",{"$nulls":4},"(8)"]
["     Account or",{"$nulls":6},"     Account or ",{"$nulls":13},"   Name of ",{"$nulls":13},"    Budget ",{"$nulls":6},"Amended Budget",{"$nulls":9}," 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},"Amount",{"$nulls":9}," As of ____/____/____",null,null,"      /       /   ",{"$nulls":8}," Balance",{"$nulls":5},"                Reported"]
["PROGRAMS OF INSTRUCTION 9-12 (Not Applicable for EL/Civics Education)"]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
[{"$nulls":62},0]
["(11)   PROGRAMS OF INSTRUCTION 9-12 (Not Applicable for EL/Civics Education)",{"$nulls":32},0,{"$nulls":8},0,{"$nulls":9},0,{"$nulls":9},0,{"$nulls":7},0]
[null,null,"(11a)",{"$nulls":4},"Institutionalized adults"]
[]
[]
[]
[" (12)",null,"  TOTAL LEADERSHIP AND PROGRAMS OF INSTRUCTION (rows 9, 10, & 11)",{"$nulls":30},0,{"$nulls":8},0,{"$nulls":9},0,{"$nulls":9},0,{"$nulls":7},0]
[" (13)",null,"  FEDERAL PROGRAM INCOME"]
[]
[]
[]
[]
["(14)  CERTIFICATION: (Complete on last page only)"]
[]
["I hereby certify that I have reviewed this budget summary/disbursement report and that all items shown above are in accordance with applicable law and regulation and have "]
["been classified properly according to this district's/agency's current chart of accounts.  All records necessary to substantiate these items are available for review by state and "]
["federal monitoring staff.  I further certify that as a disbursement report, all disbursements: were obligated after the project approval date and prior to the termination date; have "]
["not been reported previously; and were not used for matching funds on this or any special project.  Further, that all inventory items included have been entered properly on the"]
["inventory records required by Florida Statutes."]
[]
[]
["DOE 499",{"$nulls":6},"Report Number",{"$nulls":9},"Certified Correct ",{"$nulls":7}," ",{"$nulls":18},"  Date",null,null,"___/___/___",{"$nulls":8},"DOE",null,null,"Audited by: ___________"]
["Rev 04/10",{"$nulls":6},"Page   ",{"$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:",{"$nulls":7},"Submit an original and one copy by the due date specified on the DOE200 to: Comptroller's Office, Florida Department of Education, 325 West Gaines, Room 914  "]
[{"$nulls":13},"Tallahassee, Florida 32399-0400, (850) 245-0401."]
[{"$nulls":5},"State Programs:",{"$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:",{"$nulls":10},"Use the account titles for the required object codes in the agency's accounting system."]
[]
[null,null,"(4)",null,null,"For each account name, indicate the budget amount requested for funding under this project."]
[]
[null,null,"(5)",null,null,"For each account name indicate the total amended budget amount if different from original awarded budget amount."]
[]
[null,null,"(6)",null,null,"Complete by reporting total project disbursements as of the date indicated at the top of the column."]
[]
[null,null,"(7)",null,null,"Complete by subtracting Column (6) from Column (4) or (5) whichever is applicable."]
[]
[null,null,"(8)",null,null,"Complete by reporting all current disbursements.  Enter the difference between the amount shown in Column (6) on the previous disbursement report and Column (6) of this report."]
[]
[null,null,"Rows"]
[null,null,"(9)"," ",null,"Complete by reporting current disbursements for Leadership projects."]
[]
[null,null,"(10)",null,null,"Complete by reporting current disbursements for Programs of Instruction 0-8"]
[null,null,"(10a)",null,null,"Complete by reporting total of expenditures in Row 10 that are related to institutionalized adults."]
[]
[null,null,"(11)",null,null,"Complete by reporting current disbursements for Programs of Instruction 9-12 (Not Applicable for EL/Civics Education)."]
[null,null,"(11a)",null,null,"Complete by reporting total of expenditures in Row 11 that are related to institutionalized adults (Not Applicable for EL/Civics Education)."]
[null,null," "]
[null,null,"(12)",null,null,"Must represent the complete project status (rows 9, 10, & 11)."]
[]
[null,null,"(13)",null,null,"In Column 4, report as federal program income only proceeds from the sale of equipment and income from user fees or other tangible personal property.  In Column 6, complete by"]
[{"$nulls":5}," reporting total expenditures from program income as of the date indicated at the top of Column 6.  In Column 8, complete by subtracting Row 12, Column 6 on the previous expenditure "]
[{"$nulls":5},"report and Row 12, Column 6 of this report. A transfer of expenditures shall be made by a reduction of Line 12, Column 6 and 9 and an increase of Line 12 Columns 6 and 9.  A footnote "]
[{"$nulls":5},"should be added to indicate the source of the income. "]
[]
[null,null,"(14)",null,null,"The Finance Officer or authorized representative must certify and date the project disbursement report on the last page."]
[]
[null,null,"DOE 499"]
[null,null,"Rev 04/10"]