Expenditures for Rural and Low-Income Schools Grant FY18 ________________________(b) Cash balance (“a” less “b”) ________________________ (Cash balance should be returned, payable to “State of Indiana.” If less than one dollar, balance may be transferred to general fund.) “By signing this report, I certify to the best of my knowledge and belief that the report is true, complete and accurate and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the federal award. I am aware that any false, fictitious, or fraudulent information or the omission of any material fact, may subject me to criminal civil or administrative penalties for fraud, false statements, false claims, or otherwise.” ______________ ____________________________ _________________________ Date Treasurer’s Signature Superintendent’s Signature Submit one copy of this report as soon as project is complete between now and December 31, 2020. All funds must be obligated or encumbered by September 30, 2020 and funds must be liquidated by December 15, 2020 or the funds must be returned to IDOE’s Finance Office. Return form to: Cole Dietrich at
Expenditures for Rural and Low-Income Schools Grant FY18 ________________________(b) Cash balance (“a” less “b”) ________________________ (Cash balance should be returned, payable to “State of Indiana.” If less than one dollar, balance may be transferred to general fund.) “By signing this report, I certify to the best of my knowledge and belief that the report is true, complete and accurate and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the federal award. I am aware that any false, fictitious, or fraudulent information or the omission of any material fact, may subject me to criminal civil or administrative penalties for fraud, false statements, false claims, or otherwise.” ______________ ____________________________ _________________________ Date Treasurer’s Signature Superintendent’s Signature Submit one copy of this report as soon as project is complete between now and December 31, 2020. All funds must be obligated or encumbered by September 30, 2020 and funds must be liquidated by December 15, 2020 or the funds must be returned to IDOE’s Finance Office. Return form to: Cole Dietrich at
fy18-rlis-financial-end-report.docx