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YOUR ISD NAME$0.00
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NAME OF SCHOOL DISTRICTFLOW THROUGH TO DISTRICT ALLOWANCE
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EXPENDITURE REPORT
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HEAD START
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Revenue/Expense ItemsREIMBURSEMENT REQUESTBALANCE REMAINING
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 $ - Instructions: Enter your ISD Name in the upper left hand corner. Print your Detail GL. Enter the total Revenue Received (5xxx) on Line 7.
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5xxx Revenue Received
Enter total Payroll Costs (61xx) on Line 8.
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61xx Payroll Costs
Enter total Contracted Services (62xx) on Line 9.
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62xx Contracted Services
Enter total Supplies (63xx) on Line 10.
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63xx Supplies and Materials
Enter total Other Operating Expenses (63xx) on Line 11.
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64xx Other Operating ExpensesEnter total of Accruals/Payables (2xxx) on Line 12 as a negative number. We will only reimburse expenses paid. Exception: the last expenditure report for April 2024, we will reimburse 100% of
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2xxx Accruals
remaining expense, even if there are accruals. DO NOT ENTER ON FINAL REPORT
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NET REIMBURSEMENT DUE $ -
Enter total Cash balance (111x) on Line 14. This should be a negative number.
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CASH BALANCE PER GL
Net Reimbursement Due should match Cash balance.
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VARIANCE (should be 0) $ -
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I hereby certify that this report is true and correct and that funds have been expended according to the approved grant/contract.
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 Signature: Date:
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(prepared by)
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Email to :
bschlueter@esc14.net
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Note: Please attach your Detail General Ledger of the fund you are requesting reimbursement.
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For ESC Office Use Only: Payment Authorization:
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Date:
Account Number:
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Director Signature:
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