189x Filetype XLSX File size 0.04 MB Source: dss.mo.gov
Missouri Department of Social Services Division of Finance & Administrative Services P. O. Box 1643, Jefferson City, MO 65102-2320 W&CI.Invoices@dss.mo.gov SFY 2023 DVSS Monthly Expenditure Report Agency: Provider Month/Year: Program Period: J u ly 1, 2022 - June 30, 2023 Budget Allocations Domestic Violence Domestic Violence Emergency Shelter Sexual Violence Domestic Violence Support Survivors of COVID Testing and Federal Amount BUDGET LINE ITEMS (GR) (TANF) (TANF) (GR) (ARPA) Sexual Assault Mitigation (FVPSA) (ARPA) (ARPA) ADMINISTRATIVE COSTS Indirect Rate $ - $ - $ - $ - $ - $ - $ - $ - PROGRAM COSTS Personnel: $ - $ - $ - $ - $ - $ - $ - $ - Benefits: $ - $ - $ - $ - $ - $ - $ - $ - Training/Travel $ - $ - $ - $ - $ - $ - $ - $ - Equipment $ - $ - $ - $ - $ - $ - $ - $ - Supplies & Operations $ - $ - $ - $ - $ - $ - $ - $ - Contractual $ - $ - $ - $ - $ - $ - $ - $ - Total Budget: $ - $ - $ - $ - $ - $ - $ - $ - Current Period's Expenditures Domestic Violence Domestic Violence Emergency Shelter Sexual Violence Domestic Violence Support Survivors of COVID Testing and Federal Amount BUDGET LINE ITEMS (GR) (TANF) (TANF) (GR) (ARPA) Sexual Assault Mitigation (FVPSA) (ARPA) (ARPA) ADMINISTRATIVE COSTS Indirect Rate $ - $ - $ - $ - $ - $ - $ - $ - PROGRAM COSTS Personnel: $ - $ - $ - $ - $ - $ - $ - $ - Benefits: $ - $ - $ - $ - $ - $ - $ - $ - Training/Travel $ - $ - $ - $ - $ - $ - $ - $ - Equipment $ - $ - $ - $ - $ - $ - $ - $ - Supplies & Operations $ - $ - $ - $ - $ - $ - $ - $ - Contractual $ - $ - $ - $ - $ - $ - $ - $ - Total Program Costs: $ - $ - $ - $ - $ - $ - $ - $ - TOTALS $ - $ - $ - $ - $ - $ - $ - $ - Invoice Total: $ - This expenditure report is to be submitted with your agency's monthly billing invoice and is due by the 15th day of the month. Please note: we will no longer accept faxed copies. Mail original documents with original signatures to: Missouri Department of Social Services Division of Finance & Administrative Services P.O. Box 1643 Jefferson City, MO 65102 W&CI.Invoices@dss.mo.gov I hereby certify that this information is true and correct: Preparer's Signature Date
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