Form 3001 "Quarterly Financial Report" - Texas

What Is Form 3001?

This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2020;
  • The latest edition provided by the Texas Health and Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 3001 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.

ADVERTISEMENT
ADVERTISEMENT

Download Form 3001 "Quarterly Financial Report" - Texas

466 times
Rate (4.7 / 5) 28 votes
Form 3001
September 2020-E
Independent Living Services Program
Quarterly Financial Report
Service Provider
Contract No.
Budget Period
From:
To:
Report Period
First Quarter
Second Quarter
Third Quarter
Fourth Quarter
Budget Period Totals
ILS Funds
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Projected Approved
Salary and
{$0.00}
Wages
Fringe
{$0.00}
Benefits
Travel
{$0.00}
Equipment
{$0.00}
(Capitalized)
Supplies and
{$0.00}
Materials
Other Costs
{$0.00}
Indirect Cost
{$0.00}
Admin Total
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
Hearing Aids
{$0.00}
Home Mods
{$0.00}
Power
{$0.00}
Wheelchairs
Vehicle Mods
{$0.00}
Prosthetics
{$0.00}
Other
Purchased
{$0.00}
Services
PS Total
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
Totals
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
Total YTD
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
Text
Form 3001
September 2020-E
Independent Living Services Program
Quarterly Financial Report
Service Provider
Contract No.
Budget Period
From:
To:
Report Period
First Quarter
Second Quarter
Third Quarter
Fourth Quarter
Budget Period Totals
ILS Funds
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Projected Approved
Salary and
{$0.00}
Wages
Fringe
{$0.00}
Benefits
Travel
{$0.00}
Equipment
{$0.00}
(Capitalized)
Supplies and
{$0.00}
Materials
Other Costs
{$0.00}
Indirect Cost
{$0.00}
Admin Total
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
Hearing Aids
{$0.00}
Home Mods
{$0.00}
Power
{$0.00}
Wheelchairs
Vehicle Mods
{$0.00}
Prosthetics
{$0.00}
Other
Purchased
{$0.00}
Services
PS Total
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
Totals
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
Total YTD
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
Text
Form 3001
Page 2 / 09-2020-E
Report
First Quarter
Second Quarter
Third Quarter
Fourth Quarter
Budget Period Totals
Period
Program
Program
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Total
Income
Income
Remaining
Program
Income
Text
{$0.00}
Collected
Hearing Aid
Program
{$0.00}
Text
Income
Applied
Home Mods
Program
Text
{$0.00}
Income
Applied
Power
Wheelchair
Program
{$0.00}
Text
Income
Applied
Vehicle Mods
Program
Text
{$0.00}
Income
Applied
Prosthetics
Program
{$0.00}
Text
Income
Applied
Other PS
Program
Text
{$0.00}
Income
Applied
Total
Text
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
Applied
Total
Applied
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
{$0.00}
YTD
Signature
I certify that the information in this report, to the best of my knowledge, represents the current financial status of the contract cited above.
Financial Officer
Date
Page of 2