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<tbody>
<tr class="odd">
<td colspan="6" rowspan="2"><h5 id="section"></h5>
<p><strong>FEDERAL CASH TRANSACTIONS REPORT</strong></p>
<p>(See instructions on the back. If report is for more than one grant
or</p>
<p>assistance agreement, attach completed Standard Form 272A.)</p></td>
<td colspan="11"><p id="omb-approval-no.-0348-0003" class="heading">OMB
APPROVAL NO. 0348-0003</p></td>
</tr>
<tr class="even">
<td><strong>1.</strong></td>
<td colspan="10"><h3
id="federal-sponsoring-agency-and-organizational-element-to-which-this-report">Federal
sponsoring agency and organizational element to which this report </h3>
<p><strong>is submitted</strong></p>
<p><strong>     </strong></p></td>
</tr>
<tr class="odd">
<td colspan="6"><strong>2. RECIPIENT ORGANIZATION</strong></td>
<td><strong>4.</strong></td>
<td colspan="5"><h3 id="federal-grant-or-other-identification">Federal
grant or other identification</h3>
<p><strong>number</strong></p></td>
<td><strong>5.</strong></td>
<td colspan="4"><strong>Recipient's account number or identifying
number</strong></td>
</tr>
<tr class="even">
<td colspan="2"><em>Name</em>:</td>
<td colspan="4"><strong>     </strong></td>
<td></td>
<td colspan="5"><strong>     </strong></td>
<td></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="2"><em>Number</em></td>
<td colspan="4"></td>
<td><strong>6.</strong></td>
<td colspan="5"><h3 id="letter-of-credit-number">Letter of credit
number</h3>
<p><strong>     </strong></p></td>
<td><strong>7.</strong></td>
<td colspan="4"><p><strong>Last payment voucher number</strong></p>
<p><strong>     </strong></p></td>
</tr>
<tr class="even">
<td colspan="2" rowspan="2"><p><em>and Street</em>:</p>
<p><em>City, State</em></p></td>
<td colspan="4" rowspan="2"><strong>     </strong></td>
<td colspan="11"><em><strong>Give total number for this
period</strong></em></td>
</tr>
<tr class="odd">
<td><strong>8.</strong></td>
<td colspan="5"><p><strong>Payment Vouchers credited to your
account</strong></p>
<p><strong>     </strong></p></td>
<td><strong>9.</strong></td>
<td colspan="4"><p><strong>Treasury checks received <em>(whether or not
deposited)</em></strong></p>
<p><strong>     </strong></p></td>
</tr>
<tr class="even">
<td colspan="2"><em>and Zip Code</em>:</td>
<td colspan="4"><strong>     </strong></td>
<td colspan="2"><strong>10.</strong></td>
<td colspan="9"><strong>PERIOD COVERED BY THIS REPORT</strong></td>
</tr>
<tr class="odd">
<td colspan="3" rowspan="2"><strong>3. FEDERAL EMPLOYER IDENTIFICATION
NUMBER</strong></td>
<td colspan="3" rowspan="2"><strong>     </strong></td>
<td colspan="6"><strong>FROM <em>(month, day, year)</em></strong></td>
<td colspan="5"><strong>TO <em>(month, day, year)</em></strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>     </strong></td>
<td><strong>     </strong></td>
<td colspan="2"><strong>     </strong></td>
<td colspan="2"><strong>     </strong></td>
<td colspan="2"><strong>     </strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td rowspan="10"><strong>11.</strong></td>
<td colspan="2" rowspan="10"><p><strong>STATUS OF</strong></p>
<p><strong>FEDERAL</strong></p>
<p><strong>CASH</strong></p>
<p><em><strong>(See specific</strong></em></p>
<p><em><strong>instructions</strong></em></p>
<p><em><strong>on the back)</strong></em></p></td>
<td colspan="9"><strong>a. Cash on hand beginning of reporting
period</strong></td>
<td><strong>$</strong></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="9"><strong>b. Letter of credit withdrawals</strong></td>
<td></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="9"><strong>c. Treasury check payments</strong></td>
<td></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="9"><strong>d. Total receipts <em>(Sum of lines b and
c)</em></strong></td>
<td></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="9"><strong>e. Total cash available <em>(Sum of lines a and
d)</em></strong></td>
<td></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="9"><strong>f. Gross disbursements</strong></td>
<td></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="9"><strong>g. Federal share of program income</strong></td>
<td></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="9"><strong>h. Net disbursements <em>(Line f minus line
g)</em></strong></td>
<td></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="9"><strong>i. Adjustments of prior periods</strong></td>
<td></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="9"><strong>j. Cash on hand end of period.</strong></td>
<td><strong>$</strong></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="odd">
<td rowspan="3"><strong>12.</strong></td>
<td colspan="2" rowspan="3"><p><strong>THE AMOUNT SHOWN ON LINE 11j,
ABOVE, REPRESENTS CASH REQUIREMENTS FOR THE ENSUING</strong></p>
<h1 id="days"><strong>Days</strong></h1></td>
<td colspan="2"><strong>13.</strong></td>
<td colspan="12"><h6 id="other-information">OTHER INFORMATION</h6></td>
</tr>
<tr class="even">
<td colspan="9"><strong>a. Interest income</strong></td>
<td><strong>$</strong></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="9"><strong>b. Advances to subgrantees or
subcontractors</strong></td>
<td><strong>$</strong></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="even">
<td><strong>14.</strong></td>
<td colspan="16"><p><strong>REMARKS <em>(Attach additional sheets of
plain paper, if more space is required)</em></strong></p>
<p><strong>     </strong></p></td>
</tr>
<tr class="odd">
<td><strong>15.</strong></td>
<td colspan="14"><h4 id="certification">CERTIFICATION</h4></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2"><strong>I certify to the best of my
knowledge and belief that this report is true in all respects and that
all disbursements have been made for the purpose and conditions of the
grant or agreement</strong></td>
<td rowspan="2"><p><strong>AUTHORIZED</strong></p>
<p><strong>CERTIFYING</strong></p>
<p><strong>OFFICIAL</strong></p></td>
<td colspan="8"><strong>SIGNATURE</strong></td>
<td colspan="5"><p><strong>DATE REPORT SUBMITTED</strong></p>
<p><strong>     </strong></p></td>
</tr>
<tr class="odd">
<td colspan="8"><p><strong>TYPED OR PRINTED NAME AND TITLE</strong></p>
<p><strong>     </strong></p></td>
<td colspan="5"><p><strong>TELEPHONE</strong> <em>(Area Code,</em></p>
<p><em>Number, Extension)</em></p>
<p><strong>     </strong></p></td>
</tr>
<tr class="even">
<td colspan="17"><h2 id="this-space-for-agency-use">THIS SPACE FOR
AGENCY USE</h2></td>
</tr>
<tr class="odd">
<td colspan="11"><p><strong>NSN-7540-01-016-5434</strong></p>
<p><strong>272-103</strong></p></td>
<td colspan="6"><h3 id="standard-form-272-9-97">STANDARD FORM 272
(9-97)</h3>
<h3 id="prescribed-omb-circulars-a-102-and-a-110">Prescribed OMB
Circulars A-102 and A-110</h3></td>
</tr>
</tbody>
</table>

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| : |                             |   |   |                              |
+---+-----------------------------+---+---+------------------------------+
| * | ######## Entry              |   | * | ***Entry***                  |
| * |                             |   | * |                              |
| * |                             |   | * |                              |
| I |                             |   | I |                              |
| t |                             |   | t |                              |
| e |                             |   | e |                              |
| m |                             |   | m |                              |
| * |                             |   | * |                              |
| * |                             |   | * |                              |
| * |                             |   | * |                              |
+---+-----------------------------+---+---+------------------------------+
| * | Enter employer              |   |   | employee's share of benefits |
| * | identification number       |   |   | if treated as a direct cost, |
| 3 | assigned by the U.S,.       |   |   | interdepartmental charges    |
| * | Internal Revenue Service or |   |   | for supplies and services,   |
| * | the FICE (institution)      |   |   | and the amount to which the  |
|   | code.                       |   |   | recipient is entitled for    |
|   |                             |   |   | indirect costs.              |
+---+-----------------------------+---+---+------------------------------+
| * | If this report covers more  |   |   |                              |
| * | than one grant or other     |   |   |                              |
| 4 | agreement, leave items 4    |   |   |                              |
| * | and 5 blank and provide the |   |   |                              |
| * | information on Standard     |   |   |                              |
|   | Form 272-A, Report of       |   |   |                              |
|   | Fed-eral Cash               |   |   |                              |
|   | Transactions---Continued;   |   |   |                              |
|   | otherwise;                  |   |   |                              |
|   |                             |   |   |                              |
|   | Enter Federal grant number, |   |   |                              |
|   | agreement number, or other  |   |   |                              |
|   | identifying numbers if      |   |   |                              |
|   | requested by sponsoring     |   |   |                              |
|   | agency.                     |   |   |                              |
+---+-----------------------------+---+---+------------------------------+
|   |                             |   | * | Enter the Federal share of   |
|   |                             |   | * | program income that was      |
|   |                             |   | 1 | required to be used on the   |
|   |                             |   | 1 | project or program by the    |
|   |                             |   | g | terms of the grant or        |
|   |                             |   | * | agreement.                   |
|   |                             |   | * |                              |
+---+-----------------------------+---+---+------------------------------+
|   |                             |   | * | Enter the amount of all      |
|   |                             |   | * | adjustments pertaining to    |
|   |                             |   | 1 | prior periods affecting the  |
|   |                             |   | 1 | ending balance that have not |
|   |                             |   | i | been included in any lines   |
|   |                             |   | * | above. Identify each grant   |
|   |                             |   | * | or agreement for which       |
|   |                             |   |   | adjustment was made, and     |
|   |                             |   |   | enter an explanation for     |
|   |                             |   |   | each adjustment under        |
|   |                             |   |   | "Remarks." Use plain sheets  |
|   |                             |   |   | of paper if additional space |
|   |                             |   |   | is required.                 |
+---+-----------------------------+---+---+------------------------------+
| * | This Space reserved for an  |   |   |                              |
| * | account number or other     |   |   |                              |
| 5 | identifying number that may |   |   |                              |
| * | be assigned by the          |   |   |                              |
| * | re-cipient.                 |   |   |                              |
+---+-----------------------------+---+---+------------------------------+
|   |                             |   | * | Enter the total amount of    |
|   |                             |   | * | Federal cash on hand at the  |
|   |                             |   | 1 | end of the reporting period. |
|   |                             |   | 1 | This amount should include   |
|   |                             |   | j | all funds on deposit,        |
|   |                             |   | * | imprest funds, and           |
|   |                             |   | * | undeposited funds (line e,   |
|   |                             |   |   | less line h, plus or minus   |
|   |                             |   |   | line I).                     |
+---+-----------------------------+---+---+------------------------------+
| * | Enter the letter of credit  |   |   |                              |
| * | number that applies to this |   |   |                              |
| 6 | report. If all advances     |   |   |                              |
| * | were made by Treasury       |   |   |                              |
| * | check, enter "NA" for not   |   |   |                              |
|   | applicable and leave items  |   |   |                              |
|   | 7 and 8 blank.              |   |   |                              |
+---+-----------------------------+---+---+------------------------------+
|   |                             |   | * | Enter the estimated number   |
|   |                             |   | * | of days until the cash on    |
|   |                             |   | 1 | hand, shown on line 11j,     |
|   |                             |   | 2 | will be expended. If more    |
|   |                             |   | * | than three days cash         |
|   |                             |   | * | requirements ore on hand,    |
|   |                             |   |   | provide an explanation under |
|   |                             |   |   | "Remarks" as to why the      |
|   |                             |   |   | drawdown was made            |
|   |                             |   |   | prematurely, or other        |
|   |                             |   |   | reasons for the excess cash. |
|   |                             |   |   | The requirement for the      |
|   |                             |   |   | explanation does not apply   |
|   |                             |   |   | to prescheduled or automatic |
|   |                             |   |   | advances.                    |
+---+-----------------------------+---+---+------------------------------+
| * | Enter the voucher number of |   |   |                              |
| * | the last letter-of-credit   |   |   |                              |
| 7 | payment voucher (Form TUS   |   |   |                              |
| * | 5401) that was credited to  |   |   |                              |
| * | your account.               |   |   |                              |
+---+-----------------------------+---+---+------------------------------+
| * | Enter the total amount of   |   |   |                              |
| * | Federal cash on hand at the |   |   |                              |
| 1 | beginning of the reporting  |   |   |                              |
| 1 | period including all of the |   |   |                              |
| a | Federal funds on deposit,   |   |   |                              |
| * | imprest funds, and          |   |   |                              |
| * | unde-posited Treasury       |   |   |                              |
|   | checks.                     |   |   |                              |
+---+-----------------------------+---+---+------------------------------+
|   |                             |   | * | Enter the amount of interest |
|   |                             |   | * | earned on advances of        |
|   |                             |   | 1 | Federal funds but not        |
|   |                             |   | 3 | remitted to the Federal      |
|   |                             |   | a | agency. If this includes any |
|   |                             |   | * | amount earned and not        |
|   |                             |   | * | remitted to the Federal      |
|   |                             |   |   | sponsoring agency for over   |
|   |                             |   |   | 60 days, explain under       |
|   |                             |   |   | "Remarks". Do not report     |
|   |                             |   |   | interest earned on advances  |
|   |                             |   |   | to States.                   |
+---+-----------------------------+---+---+------------------------------+
| * | Enter total amount of       |   |   |                              |
| * | Federal funds received      |   |   |                              |
| 1 | through payment vouchers    |   |   |                              |
| 1 | (Form TUS 5401) that were   |   |   |                              |
| b | cred-ited to your account   |   |   |                              |
| * | during the reporting        |   |   |                              |
| * | period.                     |   |   |                              |
+---+-----------------------------+---+---+------------------------------+
| * | Enter the total amount of   |   | * | Enter amount of advance to   |
| * | all Federal funds received  |   | * | secondary recipients         |
| 1 | during the reporting period |   | 1 | in-cluding in item 11h.      |
| 1 | through Treasury checks,    |   | 3 |                              |
| c | whether or not deposited.   |   | b |                              |
| * |                             |   | * |                              |
| * |                             |   | * |                              |
+---+-----------------------------+---+---+------------------------------+
|   |                             |   | * | In addition to providing     |
|   |                             |   | * | explanations as required     |
|   |                             |   | 1 | above, give additional       |
|   |                             |   | 4 | explanation deemed necessary |
|   |                             |   | * | by the recipient and for     |
|   |                             |   | * | information required by the  |
|   |                             |   |   | Federal sponsoring agency in |
|   |                             |   |   | compliance with governing    |
|   |                             |   |   | legis-lation. Use plain      |
|   |                             |   |   | sheets of paper if           |
|   |                             |   |   | additional space is          |
|   |                             |   |   | required.                    |
+---+-----------------------------+---+---+------------------------------+
| * | Enter the total Federal     |   |   |                              |
| * | cash disbursements, made    |   |   |                              |
| 1 | during the reporting        |   |   |                              |
| 1 | period, including cash      |   |   |                              |
| f | received as program income. |   |   |                              |
| * | Disbursements as used here  |   |   |                              |
| * | also include the amount of  |   |   |                              |
|   | advances and payments less  |   |   |                              |
|   | refunds to subgrantees or   |   |   |                              |
|   | contractors, the gross      |   |   |                              |
|   | amount of direct salaries   |   |   |                              |
|   | and wages, including the    |   |   |                              |
+---+-----------------------------+---+---+------------------------------+
|   |                             |   |   |                              |
+---+-----------------------------+---+---+------------------------------+
|   |                             |   |   |                              |
+---+-----------------------------+---+---+------------------------------+
|   |                             |   |   |                              |
+---+-----------------------------+---+---+------------------------------+
|   |                             |   |   | **STANDARD FORM 272 (Rev.    |
|   |                             |   |   | 7-97) BACK**                 |
+---+-----------------------------+---+---+------------------------------+

<table style="width:100%;">
<colgroup>
<col style="width: 3%" />
<col style="width: 0%" />
<col style="width: 27%" />
<col style="width: 2%" />
<col style="width: 18%" />
<col style="width: 3%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 9%" />
<col style="width: 6%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 19%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="5" rowspan="2"><h5
id="federal-cash-transactions-report">FEDERAL CASH TRANSACTIONS
REPORT</h5>
<p id="continuation" class="heading">CONTINUATION</p>
<p>(This form is completed and attached to Standard Form 272 only when
reporting more than one grant or assistance agreement.)</p></td>
<td colspan="8"><p
id="approved-by-office-of-management-and-budget-no-80-ro182"
class="heading">Approved by Office of Management and Budget, No
80-RO182</p></td>
</tr>
<tr class="even">
<td><strong>1.</strong></td>
<td colspan="7"><p>Federal sponsoring agency and organizational element
to which this report is submitted</p>
<p><strong>     </strong></p></td>
</tr>
<tr class="odd">
<td colspan="5" rowspan="3"><p><strong>2. RECIPIENT
ORGANIZATION</strong> <em>(Give name only as shown in tem 2, SF
272)</em></p>
<p><strong>     </strong></p></td>
<td><strong>3.</strong></td>
<td colspan="7"><strong>PERIOD COVERED BY THIS REPORT</strong></td>
</tr>
<tr class="even">
<td colspan="5"><strong>FROM <em>(month, day, year)</em></strong></td>
<td></td>
<td colspan="2"><strong>TO <em>(month, day, year)</em></strong></td>
</tr>
<tr class="odd">
<td colspan="5"><strong>     </strong></td>
<td><strong>-</strong></td>
<td colspan="2"><strong>     </strong></td>
</tr>
<tr class="even">
<td><strong>4.</strong></td>
<td colspan="12"><strong>List information below for each grant or other
agreement covered by this report. Use additional forms if more space is
required.</strong></td>
</tr>
<tr class="odd">
<td colspan="3" rowspan="2"><p><strong>FEDERAL GRANTOR OTHER
IDENTIFICATION NUMBER</strong></p>
<p><em>(Show a subdivision by other</em></p>
<p><em>identifying numbers if required by the</em></p>
<p><em>Federal Sponsoring Agency)</em></p>
<p><em>(a)</em></p></td>
<td colspan="4" rowspan="2"><p><strong>RECIPIENT ACCOUNT
NUMBER</strong></p>
<p><strong>OR OTHER</strong></p>
<p><strong>IDENTIFYING NUMBER</strong></p>
<p><em>(b)</em></p></td>
<td colspan="6"><h4 id="federal-share-of-net-disbursements">FEDERAL
SHARE OF NET DISBURSEMENTS</h4></td>
</tr>
<tr class="even">
<td colspan="4"><p><strong>NET DISBURSEMENTS</strong> <em>(Gross
disbursements less program income received)</em> <strong>FOR REPORTING
PERIOD</strong></p>
<p><em>(c)</em></p></td>
<td colspan="2"><h4 id="cumulative">CUMULATIVE</h4>
<h4 id="net-disbursements">NET DISBURSEMENTS</h4>
<p><em>(d)</em></p></td>
</tr>
<tr class="odd">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="2"><strong>5.</strong></td>
<td colspan="5"><strong>TOTALS</strong> <em>Should correspond with
amounts shown on SF 272 as follows: column c the same as line 11h;
column (d) the sum of lines 11h and 11I of this SF 272 and cumulative
disbursements shown on last report. Attach explanation of any
differences.)</em></td>
<td><strong>$</strong></td>
<td colspan="3"><strong>     </strong></td>
<td><strong>$</strong></td>
<td><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="4"><strong>272-101</strong></td>
<td colspan="5">G.P.O.:1981 O – 342-526 (6656)</td>
<td colspan="4"><h3 id="standard-form-272-a-9-76">STANDARD FORM 272-A
(9-76)</h3>
<h3 id="prescribed-by-office-of-management-and-budget">Prescribed by
Office of Management and Budget </h3>
<h3 id="federal-management-cir.-no.-a-110">FEDERAL MANAGEMENT CIR. NO.
A-110</h3></td>
</tr>
</tbody>
</table>