Subgrantees subgrant award report

																							Approved OMB No: 1121-0170 Expires: 02/28/2009
												U.S. Department of Justice
												Office for Victim of Crime	Office for Victims of Crime
					CRIME VICTIM COMPENSATION STATE CERTIFICATION FORM
								State of
					Reporting Period: October 1,								2005		through September 30,							2006
					NOTE: Please read the instructions on the Attached Page Before Completing this Form
	Part I: PAYMENT INFORMATION															Part II:			FUNDS AVAILABLE FOR THE STATE
																			VICTIM COMPENSATION PROGRAM
																			(During the Reporting Period)
	A:	Total Amount paid to or on behalf of crime														A:	Funds From All Sources Other Than VOCA Grant Funds
		victims from ALL FUNDING SOURCES															1.	General Funds											$	0.00
		(both State and Federal)								(+)		$	0.00				2.	Court Costs											$	0.00
																	3.	Fees											$	0.00
	B.	Amounts To Be Deducted From Total Paid															4.	Fines and Penalties											$	0.00
		to Crime Victims															5.	Private Donations											$	0.00
																	6.	Bond Forfeitures											$	0.00
		1.	Voca Grant Funds,			FY		FY				$	0.00				7.	Subrogation Recoveries											$	0.00
		2.	Subrogation Recoveries									$	0.00				8.	Restitution Recoveries											$	0.00
		3.	Restitution Recoveries									$	0.00				9.	Refunds											$	0.00
		4.	Refunds									$	0.00				10.	Reimbursements											$	0.00
		5.	Amount Awarded for Property									$	0.00				11.	Earned Interest											$	0.00
		6.	Other Reimbursements														12.	Reserves Carried Over											$	0.00
			Specify:									$	0.00				13.	Other Sources
												$	0.00						Specify:										$	0.00
																													$	0.00
	C.	Total Amount To Be Deducted
		(Sum of B1 through B6)								(-)		$	0.00			B.	Total Amount of Lines A1 through A13											(+)	$	0.00
	D.	Subtract Line C From Line A								(=)		$	0.00			C.	VOCA Grant Funds,					FY	-	FY	-			(+)	$
	E.	Recovery Costs, If Any														D.	Total Funds Received
		(Attach Documentation)								(+)		$	0.00				(Add Lines B and C)											(=)	$	0.00
	F.	Total State Payments Eligible for Matching
		VOCA Grant Award
		(Add Line D and Line E)								(=)		$	0.00
	Part III: CERTIFICATION
		I certify that the amount reported in Part I F of this form is complete and accurate.
		Type Name and Title of Duly Authorized Official
		Signature of Duly Authorized Official																								Date
	Note: This form must be signed by the authorized individual within the agency designated by the Governor to administer
			the VOCA crime victim compensation grant.
OJP Admin. Form (7390/5) (Rev. 4/99)