LARC_SWP-RF_Object Code Budget Modification Request Form_revised 08-06-24.xlsx

	A	B	C	D	E	F	G	H
1	LOS ANGELES REGIONAL CONSORTIUM (LARC)
2	Strong Workforce Program - Regional Funds
3	OBJECT CODE BUDGET MODIFICATION REQUEST
4	(Requests to modify the budget line items within an approved plan)
5	SWP - Regional Funds funded projects may request modifications to their approved budget by emailing this completed form to: TO: Alejandra Landa-Flores (Fiscal Contractor) alf@alejandralanda.com ; Liza Saado (LARC Accountant) esaado@pasadena.edu CC: Dr. Narineh Makijan (LARC Chair) Nmakijan@pasadena.edu Requests are reviewed to ensure allowability under the program RFA and alignment each grantees Work Plan. The decision of the LARC, along with any necessary next steps, will be communicated to the individual submitting this form and to the individual identified as the contact for project/program related matters in the related SWP Agreement.
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7		Funding Year (e.g. July 1, 2022 - June 30, 2024)		Funding Round (e.g. 7, 8,9)			Request Date
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10		PROJECT TITLE FROM NOVA APPLICATION (e.g. "LA-22 Mt.SAC: Noncredit Career Pathways")
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13		College		College District
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16		Contact Name		Email Address
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19		BUDGET MODIFICATION REQUEST
20		Part I. Budget: Enter only whole dollar amounts in the green cells
21		Expenditure Type	Current Approved Budget (must match amount in NOVA)	Amount of Total Expenditures Reported to Date in NOVA (must match amounts in NOVA)	Amount Remaining	Amount to be Added / Subtracted from Budget Category (total must equal zero)	Balance After Budget Modification (amounts less than zero are not allowed)	FINAL After Budget Modification (amounts less than zero are not allowed)
22		1000 - Instructional Salaries			0		0	0
23		2000 - Non-Instructional Salaries			0		0	0
24		3000 - Employee Benefits			0		0	0
25		4000 - Supplies and Materials			0		0	0
26		5000 - Other Operating Expenses and Services			0		0	0
27		6000 - Capital Outlay			0		0	0
28		Totals	$0	$0	$0	$0	$0	$0
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30		Part II. Narrative: Please answer the following two questions (you may use an attachment to this form if needed):
31		1. Brief explanation for the request
32		2. Direct alignment to the approved NOVA workplan and activities
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35		Approval of LARC Chair
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37		Printed Name		Signature				Date
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39		Approval of LARC Fiscal Agent
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41		Printed Name		Signature				Date
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