BLS LMI-1B Budget Information Form

BUREAU OF LABOR STATISTICS
BUDGET INFORMATION FORM
U.S. DEPARTMENT OF LABOR
See complete instructions in LMI Cooperative Agreement, Part II, Application Instructions.
We estimate that it will take an average of 1 to 6 hours to complete this form including time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the information. Your response is required to obtain or retain benefits under 29 USC 49L-1. If you have any comments on the estimates
or the form, send them to BLS, Division of Financial Planning and Management (1220-0079), 2 Massachusetts Avenue, NE, Room 4135, Washington, DC 20212-0001. You are not
required to respond to the collection of information unless it displays a currently valid OMB control number.

OMB No. 1220-0079
Approval Expires
05-31-2018

State Abbreviation:

Name of Submitting Official:

Page _______ of ________

CA No.:

Title of Submitting Official:

Phone:

Fiscal Year:
CA Duration:
Col. A
Col. B
Col. C
Line
FIRST QUARTER
Number Program and Cost Category Staff years
Dollars

Col. D
SECOND QUARTER
Staff years
Dollars

Program:
FLC:
1
Program Staff
2
AS & T Staff
3
Nonpersonal Services
4
Total Resources

Activity Title:

Program:
FLC:
5
Program Staff
6
AS & T Staff
7
Nonpersonal Services
8
Total Resources

Activity Title:

Program:
FLC:
9
Program Staff
10
AS & T Staff
11
Nonpersonal Services
12
Total Resources

Activity Title:

Program:
FLC:
13
Program Staff
14
AS & T Staff
15
Nonpersonal Services
16
Total Resources

Activity Title:

Program:
FLC:
17
Program Staff
18
AS & T Staff
19
Nonpersonal Services
20
Total Resources

Activity Title:

21

Total LMI AAMCs

BLS LMI-1B (Revised May 2015)

Date Completed:
Col. E
Col. F
Col. G
THIRD QUARTER
FOURTH QUARTER TOTAL: FY
AAMC
Staff years Dollars Staff years Dollars
Staff years
Dollars