"Summer Food Service Program Annual Year End Reconciliation Form" - Georgia (United States)

Summer Food Service Program Annual Year End Reconciliation Form is a legal document that was released by the Georgia Department of Early Care and Learning - a government authority operating within Georgia (United States).

Form Details:

  • The latest edition currently provided by the Georgia Department of Early Care and Learning;
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  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Georgia Department of Early Care and Learning.

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Download "Summer Food Service Program Annual Year End Reconciliation Form" - Georgia (United States)

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Summer Food Service Program Annual Year End Reconciliation Form
SPONSOR
Institution Name
Agreement Number
Federal ID (EIN)
Program Ye a r
Number of Sites
Version
Original or
Amended (Circle )
ACTUAL REVENUE
Prior Year Excess Funds
MAY Meal Reimbursement
JUNE Meal Reimbursement
JULY Meal Reimbursement
AUGUST Meal Reimbursement
OTHER PROGRAM INCOME
TOTAL PROGRAM INCOME
$0.00
ADMINISTRATIVE AND OPERATIONAL EXPENSES
Budget Amount
Actual Allowable Cost
Column A
Column B
Food costs
Non-Food Supply Costs
Facilities and Space Costs
Operating
Administrative
$0.00
$0.00
Labor Costs
Site Labor
Kitchen Labor
Administrator
Bookkeeper/Accountant
Monitors
Clerical Staff
Drivers
Total For Labor Costs
$0.00
$0.00
Contracted Labor
Operating
Administrative
Total For Contracted Costs
$0.00
$0.00
Equipment
Equipment $5000 or over (Depreciation Expense)
Operating
Administrative
Equipment Rental/Lease (Non-vehicle)
Operating
Administrative
Total for Equipment
$0.00
$0.00
Supplies
Expendable Supplies
Operating
Administrative
Durable
Operating
Administrative
Total for Supplies
$0.00
$0.00
Communication Cost
Celluar
Telephone, Internet
Postage
Total for Communication
$0.00
$0.00
Travel Costs
Mileage
Operating
Summer Food Service Program Annual Year End Reconciliation Form
SPONSOR
Institution Name
Agreement Number
Federal ID (EIN)
Program Ye a r
Number of Sites
Version
Original or
Amended (Circle )
ACTUAL REVENUE
Prior Year Excess Funds
MAY Meal Reimbursement
JUNE Meal Reimbursement
JULY Meal Reimbursement
AUGUST Meal Reimbursement
OTHER PROGRAM INCOME
TOTAL PROGRAM INCOME
$0.00
ADMINISTRATIVE AND OPERATIONAL EXPENSES
Budget Amount
Actual Allowable Cost
Column A
Column B
Food costs
Non-Food Supply Costs
Facilities and Space Costs
Operating
Administrative
$0.00
$0.00
Labor Costs
Site Labor
Kitchen Labor
Administrator
Bookkeeper/Accountant
Monitors
Clerical Staff
Drivers
Total For Labor Costs
$0.00
$0.00
Contracted Labor
Operating
Administrative
Total For Contracted Costs
$0.00
$0.00
Equipment
Equipment $5000 or over (Depreciation Expense)
Operating
Administrative
Equipment Rental/Lease (Non-vehicle)
Operating
Administrative
Total for Equipment
$0.00
$0.00
Supplies
Expendable Supplies
Operating
Administrative
Durable
Operating
Administrative
Total for Supplies
$0.00
$0.00
Communication Cost
Celluar
Telephone, Internet
Postage
Total for Communication
$0.00
$0.00
Travel Costs
Mileage
Operating
Adminstrative
Vehicle Rental
Operating
Adminstrative
Total for Travel Costs
$0.00
$0.00
Contracted Costs (nonfood)
Audit Costs
Maintenance Contracts
Total for Contracted Costs
$0.00
$0.00
Utilities, Maintenance, Janitoral
Utilities for Kitchen/Serving Area
Office Space Utilities
Maintenance
Operating
Administrative
Janitorial
Operating
Administrative
Total for Utilities/Maintenance/Janitorial
$0.00
$0.00
Other & Special Item Costs
Advertising Public Relations
Meetings & Conferences
Participant Training and Support Costs
Proposal Costs
Publication, Printing & Reproduction
Insurance Costs
Total for Other & Special Items Costs
$0.00
$0.00
Indirect Costs
Total Adminstrative and Operationsal Expenses
$0.00
$0.00
Unallowable Costs: If Column B > Column A, then subtract Column B - Column A and enter difference here. Leave blank if
Column B < Column A.
$0.00
$0.00
Total Expenses - Unallowable Costs = Total Allowable Expenses
Total Program Income-Total Allowable Expenses = EXCESS PROGRAM INCOME OVER EXPENSES
$0.00
Excess funds will be used for next year's summer food service program
Excess funds will be used for another Child Nutrition (Name Programs):
_______We will not be returning to the summer food program next year
I certify that the above is a correct accounting of disbursement of Summer Food Service Program funds.
All documentation for the above information is on file and available for review.
Signature
Date
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