Program Director/Principal Investigator
(Last, First, Middle): |
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BUDGET FOR ENTIRE PROPOSED PROJECT PERIOD
DIRECT COSTS ONLY |
BUDGET CATEGORY SPECIALS |
INITIAL BUDGET PERIOD
(From Form Page 4) |
ADDITIONAL YEARS OF SUPPORT REQUESTED |
2nd |
3rd |
4th |
5th |
| PERSONNEL: Salary and fringe benefits. Applicant organization only. |
911,334 |
953,834 |
953,834 |
953,834 |
953,834 |
| CONSULTANT COSTS |
8,900 |
8,900 |
8,900 |
8,900 |
8,900 |
| EQUIPMENT |
42,500 |
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|
|
|
| SUPPLIES |
186,160 |
186,160 |
186,160 |
186,160 |
186,160 |
| TRAVEL |
11,000 |
11,000 |
11,000 |
11,000 |
11,000 |
| PATIENT CARE COSTS |
INPATIENT |
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|
|
|
|
| OUTPATIENT |
15,600 |
15,600 |
15,600 |
15,600 |
15,600 |
| ALTERTIONS AND RENOVATIONS |
|
|
|
|
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| OTHER EXPENSES |
61,197 |
61,197 |
61,197 |
61,197 |
61,197 |
CONSORTIUM/
CONTRACTUAL COSTS |
DIRECT |
263,309 |
263,309 |
263,309 |
263,309 |
263,309 |
SUBTOTAL DIRECT COSTS
(Sum = Item 8a, Face Page) |
1,500,000 |
1,500,000 |
1,500,000 |
1,500,000 |
1,500,000 |
CONSORTIUM/
CONTRACTUAL COSTS |
F&A |
167,998 |
167,998 |
167,998 |
167,998 |
167,998 |
| TOTAL DIRECT COSTS |
1,667,998 |
1,667,998 |
1,667,998 |
1,667,998 |
1,667,998 |
| TOTAL DIRECT COSTS FOR ENTIRE PROPOSED PROJECT PERIOD |
$8,339 |
JUSTIFICATION. Follow the budget justification instructions exactly.
Use continuation page as needed.
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