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:art III - Distribution cf Estimated Revenue for Total Cost Reimbursement Method <br />Estimated Eligible and Matchable Costs <br />1. Estimated Eligible Clients <br />2. Estimated Ineligible Clients <br />3. Total Clients <br />Eligible Costs <br />(2) Less I ,) Net (a) <br />Earned Matchable estimated <br />Income I Costs of Eligibles <br />B.(1 ) Less 21 fA. 1. b <br />S <br />( 1 ; ;A3 tcna i e <br />i.osts <br />4Part I, Line M, <br />Part IV - Additional Revenue and Fees <br />Amount <br />Program Costs <br />46,197.93 <br />1. Federal /State Funos <br />S 2,514.07 <br />2. Local Matching Share —. <br />3. Other Budgeted Funds S <br />4. TOTAL REVENUE 5 4 <br />Fees (If Applicable) <br />c <br />1. Administrative Fee <br />Certification Fee S <br />3. TOT: L FEES <br />5 <br />(a) (b) <br />Numpner Ratio <br />e <br />b <br />d <br />T <br />a 4osts Eligible <br />for Financial j <br />Participation <br />g. 3 x 4 1 <br />C � <br />J _ <br />Source of Funds <br />I <br />JOBS I <br />I <br />i <br />I <br />I <br />I <br />I <br />I <br />Part V - Reimbursement Projections (For Title XX Providers Only) <br />i <br />I <br />Annual Pro�ectian <br />5 <br />July- Septemoer <br />Proiection <br />cned: <br />Provicar /;.utror, zed Urr "icial <br />�Lounty :11rectar or Designee <br />2 ) <br />C 5 <br />Date_ <br />Date. <br />October -June <br />Pro.iection <br />I{ <br />I <br />