Revised Project Budget Template Page 4
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4Grant Number:____________
Date Submitted to OPM ______________________________
Other
Line Item
Other Total
Total Grant Project Budget
All Budget Revisions must include the signature of preparer and project Director
or Financial Officer
Prepared By ___________________________
Date:
(Name and Title)
Signature _____________________________
Authorized By__________________________
Date:
(Name and Title)
Signature______________________________
Mail this form to:
State of CT Office of Policy and Management
Adult Criminal Justice Policy and Planning
450 Capitol Avenue
Hartford, CT 06106
Email this form to: charlene.gallaway@ct.gov
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Revised 5-2009
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