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ILLINOIS FIRST PROGRAM <br /> QUARTERLY EXPENSE REPORT <br /> Grantee Name: Dept. of Commerce and Community Affairs ` <br /> Grantee Address: ' 620 East Adams <br /> Grant No: <br /> S rin field, IL 62701 <br /> Prepared By: Report From: To: <br /> Phone: Date: Period: <br /> 1 2 3 4 5 <br /> Budget Line Items from Approved Budget Prior Period Expenses Paid this Year-to-Date Grant Funds Received To Date <br /> Grant Agreement PART I (As in PART I of Year�to�Date Report Period Expenditures (This Grant Only) <br /> or subse�uent Grant Agreement or Expenditures (Grant Funds Only) (2+3) <br /> moditication� subsequent (Grant Funds Only) (Grant Funds Only) <br /> modif ication) <br /> TOTAL <br /> GRANTEE CERTIFICATION DCCA CERTIFICATION <br /> All expenditures from these project funds are for approved project costs onl . <br /> Y Authorized P <br /> Further, I certify that supporting documentation on actual expenditures is on a ment: $ <br /> file in our office, and that I have full signature authority to sign on behalf of Grant Period: FIF/Bond <br /> this agency. ' Project Manager: <br /> (date <br /> Manager of Grant Unit <br /> . or Bureau Coordinator: <br /> � BY' (date) <br /> � Authorized Official - Si nature and Title date Accountin : date <br /> � <br /> ; <br /> , <br /> t <br />