Annual Service Plan Original ( ) Revision ( ) ORR-6 OMB Date: ___ ______ Time Period Covered by Plan From: To: __________________ ___________________________ State or County: Program Participants Description of Contracted or Contracted Amount Total Type of Agency and State-provided by Funding 0 - 12 13 - 60 Number Percent of Funds Services Source Months Months SS Employment TAP Other SS ELT TAP Other SS OJT TAP Other SS Skills Training TAP Other SS Case Management TAP Other SS Other TAP Other A. State/ County E. Adult Basic Education B. Mutual Assistance Association F. Other Non-Profit Organization Type of Agency C. Voluntary Agency G. _________________________ D. Community College Control No. 0970-0036 Expires 10/31/2018
Annual Service Plan Original ( ) Revision ( ) Date: ___ ______ Time Period Covered by Plan From: To: __________________ State or County: ___________________________ Description of Contracted or State-provided Services Contracted Amount by Funding Source Total Number Program 0 - 12 Months Participants 13 - 60 Months Type of Agency and Percent of Funds Employment SS TAP Other ELT SS TAP Other OJT SS TAP Other Skills Training SS TAP Other Case Management SS TAP Other Other SS TAP Other Type of Agency A. State/ County E. Adult Basic Education B. Mutual Assistance Association F. Other Non-Profit Organization C. Voluntary Agency G. _________________________ D. Community College ORR-6 OMB Control No. 0970-0036 Expires 10/31/2018
orr_6_annual_services_plan_1.docx