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[]
["INSTRUCTIONS FOR COMPLETING THE NSEF FINANCIAL TOOL"]
[]
[" Allocation Budget (next Tab)"]
[]
["1. Fill in the estimated amount for each allocation.  Up to 5 allocations can be requested on each form.    "]
["2. Please briefly describe what is being funded.  If a quote is attached, allocation numbers can be assigned when the budget is approved.    "]
["3. For Towns: Once the budget entry is complete please email the budget to your regional coordinator for review."]
["4. For State Agencies: Once the budget entry is complete please email the budget to douglas.glowacki@ct.gov and cc cindy.tangney@ct.gov "]
["5. Once the budget is approved by DESPP/DEMHS  you will receive an electronic copy with the amounts locked in.  "]

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["State of Connecticut Department of Emergency Services and Public Protection"]
["NUCLEAR SAFETY EMERGENCY FUND"]
["AGENCY NAME","FY 2019"," "]
["SECTION I FUNDING",null,"SECTION II - DOCUMENTATION OF COSTS",null,null,null,null,"SECTION III - COST AND PAYMENT INFORMATION"]
["NSEF ANNUAL BUDGET",null,"For each allocation being claimed please fill in the appropriate items below.  Please use one section per allocation.  If you have more than 5 allocations please attach a second sheet.",null,null,null,null,"Proof of Payment: Please provide a copy of the check used to pay the bill or invoice and a copy of the bill or invoice.  "]
["Total Budget:",{"$f":"B8","v":0}]
["ALLOCATION TOTALS",null,null,null,null,null,null,"ALL DIRECT COSTS",null," "]
["Total of All Allocations:",{"$f":"B10+B17+B24+B31+B38","v":0},null,null,null,null,null,"PERSONNEL","ATTACH COPY OF"," "]
[null,null,"Fiscal Year 2019","From 7/1/18 to 6/30/19",null,null,null,"EQUIPMENT ETC.","QUOTE"," "]
["Allocation #1",0,"Breakdown of Allocation Costs"]
["Description of Allocation Request:",null,"Personnel Costs (Salary or Stipend)",null,null,null,null,0," "," "]
[null,null,"Fringe Benefits",null,null,"Enter Percentage Here:",0,0," "]
[null,null,"Equipment or Supplies Costs  ",null,null,null,null,0," "]
[null,null,"Maintenance Costs",null,null,null,null,0]
[null,null,"Other Costs",null,null,null,null,0," "," "]
[null,null,"Total:",null,null,null,null,{"$f":"SUM(H11:H15)","v":0},"Balance",{"$f":"B10-H16","v":0}]
["Allocation #2",0,"Breakdown of Allocation Costs"]
["Description of Allocation Request:",null,"Personnel Costs (Salary or Stipend)",null,null,null,null,0," "," "]
[null,null,"Fringe Benefits",null,null,"Enter Percentage Here:",0,0," "," "]
[null,null,"Equipment or Supplies Costs  ",null,null,null,null,0," "," "]
[null,null,"Maintenance Costs",null,null,null,null,null," "," "]
[null,null,"Other Costs",null,null,null,null,0," "," "]
[null,null,"Total:",null,null,null,null,{"$f":"SUM(H18:H22)","v":0},"Balance",{"$f":"B17-H23","v":0}]
["Allocation #3",0,"Breakdown of Allocation Costs"]
["Description of Allocation Request:",null,"Personnel Costs (Salary or Stipend)",null,null,null,null,0," "," "]
[null,null,"Fringe Benefits",null,null,"Enter Percentage Here:",0,0," "," "]
[null,null,"Equipment or Supplies Costs  ",null,null,null,null,null," "," "]
[null,null,"Maintenance Costs",null,null,null,null,null," "," "]
[null,null,"Other Costs",null,null,null,null,0," "," "]
[null,null,"Total:",null,null,null,null,{"$f":"SUM(H25:H29)","v":0},"Balance",{"$f":"B24-H30","v":0}]
["Allocation #4",0,"Breakdown of Allocation Costs"]
["Description of Allocation Request:",null,"Personnel Costs (Salary or Stipend)",null,null,null,null,0," "," "]
[null,null,"Fringe Benefits",null,null,"Enter Percentage Here:",0,0," "," "]
[null,null,"Equipment or Supplies Costs  ",null,null,null,null,null," "," "]
[null,null,"Maintenance Costs",null,null,null,null,null," "," "]
[null,null,"Other Costs",null,null,null,null,0," "," "]
[null,null,"Total:",null,null,null,null,{"$f":"SUM(H32:H36)","v":0},"Balance",{"$f":"B31-H37","v":0}]
["Allocation #5",0,"Breakdown of Allocation Costs"]
["Description of Allocation Request:",null,"Personnel Costs (Salary or Stipend)",null,null,null,null,0," "," "]
[null,null,"Fringe Benefits",null,null,"Enter Percentage Here:",0,0," "," "]
[null,null,"Equipment or Supplies Costs  ",null,null,null,null,null," "," "]
[null,null,"Maintenance Costs",null,null,null,null,null," "," "]
[null,null,"Other Costs",null,null,null,null,0," "," "]
[null,null,"Total:",null,null,null,null,{"$f":"SUM(H39:H43)","v":0},"Balance",{"$f":"B38-H44","v":0}]
["Unallocated:",0,"TOTAL AMOUNT EXPENDED:",null,null,null,null,{"$f":"H16+H23+H30+H37+H44","v":0},"Balance",{"$f":"J44+J37+J30+J23+J16","v":0}]
["CORRECTIONS:",null,null,null,null,null,"ACTION REQUIRED:"]
["1.",null,null,null,null,null,"1."]
["2.",null,null,null,null,null,"2."]
["3.",null,null,null,null,null,"3."]
["4.",null,null,null,null,null,"4."]
["5.",null,null,null,null,null,"5."]
["Certification: I hereby certify that the information contained herein is based on official accounting records, and that project outlays shown have been made in accordance with applicable grant terms and conditions, and that documentation is available to support these project outlays."]
[]
[]
["Signature:"]
[null,"Applicant"]
[]
["Title:"]