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TOBACCO TRUST FUND COMMISSION <br />Exhibit B: Grantee Quarterly & Final Report Form <br />Quarterly Report Period: to <br />^ Quarterly Report <br />^ Flnal Report -The Final Report must ALSO include a summary of how the project <br />goals and objectives were met, resulting benefits and future status of project. <br />The Final Report will include a detailed financial statement on how the grant <br />funds were spent. <br />Date Submitted: Contact Person: <br />(To be filed no later than fifteen days after the end of the third month of the calendar quarter) <br />Project Title: <br />Grantee: <br />Address: <br />Phone: Email: <br />Start date of the project: <br />County: <br />Anticipated completion date: <br />1. PROJECT NARRATIVE: On a separate page or pages, write a summary of progress on your project for this <br />report period. Provide a minimum half page narrative summary addressing the status of each of the project <br />objectives noted in Exhibit A "Scope of Services" plus any other pertinent information. <br />In addition to the summary, your quarterly narrative report should also address any of the following issues <br />affecting your project during this last quarter: <br />a) Explain any project costs that were below or above expectations. <br />b) Explain any problems your project has encountered and steps taken to overcome them. <br />2. STATUS (check pertinent boxes): <br />Protect Status: ^ On Schedule ^ Completed ^ Delayed ^ Canceled <br />Project Cost Status: ^ Cost Unchanged ^ Cost Overrun ^ Cost Underrun <br />3. PROJECT IMPACT NARRATIVE: On a separate page or pages, write a summary of how grant-funded <br />activities are affecting specific populations of people. Who are these people and how many are being served? <br />Where do these people live? Name specific counties, towns, or neighborhoods. <br />4. PROJECT IMPACT TABLE: Complete all line items that pertain to your project and the activities funded by <br />our rant. <br />IMPACT TYPE Quarter) Im act Project to Date <br />Jobs Created <br />Workers Re-Em to ed <br />Former Quota Holders Assisted <br />Worker Skills U raded # of Workers <br />Persons Receivin Increased Educational Trainin <br />Amount of New Income for Former Tobacco Workers <br />Current or Former Tobacco Farmers Assisted <br />Acres of Farmland Protected <br />Acres of New Cro Production <br />Total Number of Peo le Served <br />Dollars Levera ed <br />State Tax Revenue Generated <br />Other Ex lain <br />Other Ex lain <br />5. EXHIBIT C: Attach your most recent Exhibit C, Financial Request Form, with the signature of the Chief <br />Financial Officer. <br />Authorized Signature: <br />Project Number: <br />Print Name: Title: <br />