3135-0112 Project Budget Form

NEA Application Project Budget, Part 1

Read the instructions for this form before you start.

OMB No. 3135-0112 Expires 11/30/2007 W

Applicant (official IRS name):		     
INCOME
1. Amount requested from the Arts Endowment: $							     
2. Total match for this project Be as specific as possible. Asterisk (*) those funds that are committed or secured.
Cash (Refers to the cash donations, grants, and revenues that are expected or received for this project)								Amount
     								     
     								     
     								     
     								     
     								     
     								     
     								     
     								     
Total cash a. $								     
In-kind: Donated space, supplies, volunteer services (These same items also must be listed as direct costs under “Expenses” below or in Part 2 of the Project Budget form; identify sources)
     								     
     								     
     								     
     								     
Total donations b. $								     
Total match for this project (2a. cash + 2b. donations) $								     
EXPENSES 1. Direct costs: Salaries and wages
Title and/or type of personnel			Number of personnel	Annual or average salary range		% of time devoted to this project			Amount
     			     	     		     			     
     			     	     		     			     
     			     	     		     			     
     			     	     		     			     
     			     	     		     			     
     			     	     		     			     
     			     	     		     			     
     			     	     		     			     
Total salaries and wages a. $								     
Fringe benefits					Total fringe benefits b. $			     
Total salaries, wages, and fringe benefits (a. + b.) $								     

Applicant (official IRS name):			     
EXPENSES, CONTINUED
2. Direct costs: Travel (Include subsistence)
# of travelers		From					To			Amount
     		     					     			     
     		     					     			     
     		     					     			     
     		     					     			     
     		     					     			     
     		     					     			     
     		     					     			     
Total travel $										     
3. Direct costs: Other expenses (Include consultant and artist fees, contractual services, promotion, acquisition fees, rights, evaluation and assessment fees, access accommodations, telephone, photocopying, postage, supplies and materials, publication, distribution, translation, transportation of items other than personnel, rental of space or equipment, and other project-specific costs)
										Amount
     										     
     										     
     										     
     										     
     										     
     										     
     										     
     										     
     										     
     										     
     										     
     										     
     										     
     										     
     										     
     										     
     										     
     										     
Total other expenses $										     
4. Total direct costs (1. from Project Budget, Part 1 +2.+3.) $										     
5. Indirect costs (if applicable)
Federal Agency:	     			Rate (%)	  	x Base		     	= $	     
6. Total project costs (4.+5.) $