TM-30 Supplemental Budget Summary Form

OMB approval No. 0581-0235

Farmers Market Promotion Program (FMPP) – 2007
Supplemental Budget Summary Form
1. Project Title:

2. Project Number: (AMS Use)
3.

4. Organizational Name:

5. Primary Contact:

Mailing Address:

Mailing Address:

City:

State:

Zip Code:

City:

State:

E-mail:

E-mail:

6. DUNS Number:

Requested Funds:

7. Entity Type:
Agricultural Cooperative
Local government

Nonprofit corporation
Public benefit corporation

State

Zip Code:

Regional farmers market authority
Tribal government

Primary Activity: Briefly describe details of the “primary” activity.

Personnel: cost per hour:

$

number of hours:

Travel:

$

number of people:

cost per person:

Destination:

lodging cost:

$

$
number of trips:
number of days:

$
$

Equipment Cost: (List separately in box below.)

$

Supply Cost: (Estimate projected supplies expenditure.)

$

Contractual: Indicate if flat fee
or hourly rate
Number of hours:

$

. (Hourly rate must not exceed $55 per hour.)
hourly rate:
$

Indirect cost: (May not exceed 10 percent of the proposed budget)
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$

OMB approval No. 0581-0235
$

Other: (Please detail below travel mode and other information.)

Total Primary Activity:

$

1. First Secondary Activity: Briefly describe details of the “first secondary” activity.

Personnel: cost per hour:

$

number of hours:

Travel:

$

number of people:

cost per person:

Destination:

lodging cost:

$
number of trips:
number of days:

$

$
$

Equipment Cost: (List separately in box below.)

$

Supply Cost: (Estimate projected supplies expenditure.)

$

Contractual: Indicate if flat fee
or hourly rate
Number of hours:

$

. (Hourly rate must not exceed $55 per hour.)
hourly rate:
$

Indirect cost: (May not exceed 10 percent of the proposed budget)

$

Other: (Please detail below travel mode and other information.)

$

Total First Secondary Activity:

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$

OMB approval No. 0581-0235
2. Second Secondary Activity: Briefly describe details of the “first secondary” activity.

Personnel: cost per hour:
Travel:

cost per person:

Destination:

$

$

number of hours:
number of people:
lodging cost:

number of trips:
number of days:

$

$
$

Equipment Cost: (List separately in box below.)

$

Supply Cost: (Estimate projected supplies expenditure.)

$

Contractual: Indicate if flat fee
or hourly rate
Number of hours:

$

. (Hourly rate must not exceed $55 per hour.)
hourly rate:
$

Indirect cost: (May not exceed 10 percent of the proposed budget)

$

Other: (Please detail below travel mode and other information.)

$

Total Second Secondary Activity:

$

Grand Total Primary and Secondary Activities:

$

If you have additional “Secondary Activities”, please record them using a similar format.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to
a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information
collection is 0581-0235. The time required to complete this information collection is estimated to average 30 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. The U.S. Department of Agriculture (USDA) prohibits discrimination in all its
programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial
status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an
individual’s income is derived from any public assistance program (Not all prohibited bases apply to all programs.) Persons with
disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should
contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director,
Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 7206382 (TDD). USDA is an equal opportunity provider and employer.

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