Spreadsheet: 42e53d86-5179-42b5-9490-0c31faaf2cef
Sheet: Section G

 | Section G Program Participant Characteristics
 | 1. Name of Agency Reporting
Sec G 2a | 2a. Total Non CSBG Resources Reported in Section F
 |  |  |  |  |  |  |  | 3
Sec G 2a | 2b. Total amount of CSBG Funds allocated
 | Total Resourcs for FY 2012 (2a + 2b)
Sec G 3 | 3.  Total unduplicated number of persons about whom one or more characteristics were obtained: |  |  |  |  |  |  |  |  |  |  | 10
Sec G 4 | 4.  Total unduplicated number of persons about whom no characteristics were obtained:
Sec G 5 | 5.  Total unduplicated number of families about whom one or more characteristics were obtained: |  |  |  |  |  |  |  |  |  |  | 10
Sec G 6 | 6.  Total unduplicated number of families about whom no characteristics were obtained:
 | 7.   [NAME] |  |  | Number of Persons* |  |  |  |  | 13.  [NAME] |  |  | Number of Families***
Sec G 7a | a.   Male |  |  |  |  |  |  | a.  One |  |  |  |  | ççThis field has been prepopulated from cell 12d | Sec G 13a
Sec G 7b | b.   Female |  |  |  |  |  |  | [NAME] |  |  |  |  |  | Sec G 13b
Sec G 7 Total | TOTAL* |  |  |  |  |  |  | c.  Three |  |  |  |  |  | Sec G 13c
 |  |  |  |  |  |  |  | d.  Four |  |  |  |  |  | Sec G 13d
 | 8.  Age |  |  | Number of Persons* |  |  |  | e.  Five |  |  |  |  |  | Sec G 13e
Sec G 8a | a.    0 - 5 |  |  |  |  |  |  | f.   Six |  |  |  |  |  | Sec G 13f
Sec G 8b | b.    6 - 11 |  |  |  |  |  |  | g.  Seven |  |  |  |  |  | Sec G 13g
Sec G 8c | [NAME] |  |  |  |  |  |  | h.  Eight or more |  |  |  |  |  | Sec G 13h
Sec G 8d | d.  18 - 23 |  |  |  |  |  |  | TOTAL*** |  |  |  |  |  | Sec G 13 Total
Sec G 8e | e.  24 - 44
Sec G 8f | f.   45 - 54 |  |  |  |  |  |  | 14. Source of Family Income |  |  |  | Number of Families
Sec G 8g | [NAME] |  |  |  | Total: 24 Yrs + |  |  | [NAME] # Families Reporting |  |  |  |  |  | Sec G 14 a
Sec G 8h | h.  70 + |  |  |  |  |  |  | One or More Sources of Income
Sec G 8 Total | TOTAL* |  |  |  |  |  |  | [NAME] # Families Reporting |  |  |  |  |  | Sec G 14 b
 |  |  |  |  |  |  |  | Zero Income
 | 9.  Ethnicity/Race |  |  | Number of Persons* |  |  |  | TOTAL Unduplicated # Families Reporting One or More Sources of Income or Zero Income.***
 | [NAME] |  |  |  |  |  |  |  |  |  |  |  |  | Sec G 14 Total
Sec G 9.1a | [NAME], Latino or Spanish Origin
Sec G 9.1b | [NAME], or Spanish Origin
Sec G 9.1 Total | TOTAL* |  |  |  |  |  |  | Below please report the total # of families
 |  |  |  |  |  |  |  | identifying the applicable sources of income
 | II. Race |  |  |  |  |  |  | [NAME] |  |  |  |  |  | Sec G 14c
[NAME] | [NAME] |  |  |  |  |  |  | [NAME] |  |  |  |  |  | Sec G 14d
[NAME] | [NAME] or African American |  |  |  |  |  |  | e.  Social Security |  |  |  |  |  | Sec G 14e
Sec G 9.2c | [NAME] Indian and [NAME] |  |  |  |  |  |  | f.   Pension |  |  |  |  |  | Sec G 14f
Sec G 9.2d | d.  Asian |  |  |  |  |  |  | g.  General [NAME] |  |  |  |  |  | Sec G 14g
Sec G 9.2e | e.  Native Hawaiian and Other Pacific Islander |  |  |  |  |  |  | h.  Unemployment Insurance |  |  |  |  |  | Sec G 14h
Sec G 9.2f | f.  Other |  |  |  |  |  |  | i.   Employment + Other Source |  |  |  |  |  | Sec G 14i
Sec G 9.2g | [NAME] (any two or more of the above) |  |  |  |  |  |  | j.   Employment Only |  |  |  |  |  | Sec G 14j
Sec G 9.2 Total | TOTAL* |  |  |  |  |  |  | k.  Other |  |  |  |  |  | Sec G 14k
 |  |  |  |  |  |  |  | l.   Total (Items c-k) |  |  |  |  |  | Sec G 14 Total
 | 10.  Education Levels of Adults # |  |  |  |  |  |  | 15. Level of Family Income
 | (# For Adults 24 Years Or Older Only) |  |  | Number of Persons** |  |  |  | (% Of HHS Guideline) |  |  |  | Number of Families***
Sec G 10a | [NAME] |  |  |  |  |  |  | a.  Up to 50% |  |  |  |  |  | Sec G 15a
Sec G 10b | [NAME]9-12/Non-Graduate |  |  |  |  |  |  | [NAME]51% to 75% |  |  |  |  |  | Sec G 15b
Sec G 10c | [NAME] |  |  |  |  |  |  | [NAME]76% to 100% |  |  |  |  |  | Sec G 15c
Sec G 10d | d.  12+ Some Post Secondary |  |  |  |  |  |  | d.  101% to 125% |  |  |  |  |  | Sec G 15d
Sec G 10e | e.  2 or 4 years College Graduate |  |  |  |  |  |  | e.  126% to 150% |  |  |  |  |  | Sec G 15e
Sec G 10 Total | TOTAL** |  |  |  |  |  |  | f.   151% to 175% |  |  |  |  |  | Sec G 15f
 |  |  |  |  |  |  |  | [NAME]176% to 200% |  |  |  |  |  | Sec G 15g
 | 11. Other Characteristics |  |  | Number of Persons* |  |  |  | h.  201% and over |  |  |  |  |  | Sec G 15h
 |  |  | Yes | No | TOTAL* |  |  | TOTAL*** |  |  |  |  |  | Sec G 15 Total
Sec G 11a | a.  Health Insurance
Sec G 11b | [NAME] |  |  |  |  |  |  | 16. Housing |  |  |  | Number of Families***
 |  |  |  |  |  |  |  | [NAME] |  |  |  |  |  | Sec G 16a
 | 12.  Family Type |  |  | Number of Families*** |  |  |  | [NAME] |  |  |  |  |  | Sec G 16b
Sec G 12a | [NAME] Parent [NAME] |  |  |  |  |  |  | [NAME] |  |  |  |  |  | Sec G 16c
Sec G 12b | [NAME]Single Parent Male |  |  |  |  |  |  | d.  Other† |  |  |  |  |  | Sec G 16d
Sec G 12c | c.  Two Parent Household |  |  |  |  |  |  | TOTAL*** |  |  |  |  |  | Sec G 16 Total
Sec G 12d | d.  [NAME]
Sec G 12e | e.  Two Adults NO children |  |  |  |  |  |  | e. †Please describe housing situations included in 16.d. Other:
Sec G 12f | f.  Other |  |  |  |  |  |  |  |  |  |  |  |  | Sec G 16e
Sec G 12 Total | TOTAL***
 |  |  |  |  |  |  | *  The sum of this category should not exceed the value of Item 3
 |  |  |  |  |  |  | **  The sum of this category should not exceed the value of Items 8 e-h
 |  |  |  |  |  |  | ***  The sum of this category should not exceed the value of Item 5
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