Phs 398 (Rev. 03/16), Detailed Budget For Initial Period
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1Program Director/Principal Investigator (Last, First, Middle):
FROM
THROUGH
DETAILED BUDGET FOR INITIAL BUDGET PERIOD
DIRECT COSTS ONLY
List PERSONNEL (Applicant organization only)
Use Cal, Acad, or Summer to Enter Months Devoted to Project
Enter Dollar Amounts Requested (omit cents) for Salary Requested and Fringe Benefits
ROLE ON
Cal.
Acad.
Summer
INST.BASE
SALARY
FRINGE
NAME
PROJECT
Mnths
Mnths
Mnths
SALARY
REQUESTED
BENEFITS
TOTAL
PD/PI
SUBTOTALS
CONSULTANT COSTS
EQUIPMENT (Itemize)
SUPPLIES (Itemize by category)
TRAVEL
INPATIENT CARE COSTS
OUTPATIENT CARE COSTS
ALTERATIONS AND RENOVATIONS (Itemize by category)
OTHER EXPENSES (Itemize by category)
CONSORTIUM/CONTRACTUAL COSTS
DIRECT COSTS
SUBTOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD
(Item 7a, Face Page)
$
FACILITIES AND ADMINISTRATIVE COSTS
CONSORTIUM/CONTRACTUAL COSTS
TOTAL DIRECT COSTS FOR INITIAL BUDGET PERIOD
$
PHS 398 (Rev. 03/16 Approved Through 10/31/2018)
OMB No. 0925-0001
Page
Form Page 4
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Parent category: Medical