| OFFICE OF REFUGEE RESETTLEMENT |
| CASH AND MEDICAL ASSISTANCE PROGRAM |
| ORR-2 QUARTERLY REPORT ON EXPENDITURES AND OBLIGATIONS |
| Cash and Medical Assistance |
Total Cumulative |
Total Cumulative |
Total Expenditures and |
Federal Funds |
Unobligated |
| Program Components |
Expenditures |
Uniquidated Obligations |
Unliquidated Obligations |
Authorized |
Balance |
| (Column A) |
(Column B) |
(Column C) |
(Column D) |
(Column E) |
(Column F) |
| 1. Refugee Cash Assistance (RCA) |
(a) RCA Recipient Costs |
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| (b) RCA Administration |
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| (c) Subtotal |
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| 2. Refugee Medical Assistance (RMA) |
(a) RMA Recipient Costs |
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| (b) RMA Administration |
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| (c) Medical Screening |
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| (d) Medical Screening Administration |
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| (e) Subtotal |
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| 3. Unaccompanied Refugee Minors (URM) |
(a) Services for URMs |
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| (b) URM Program Administration |
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| (c) Subtotal |
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| 4. Administration - Planning and Coordination |
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| 5. Total Administration |
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| 6. Total |
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| 7. Recipient Organization and Address |
8. Grant Document Number |
OMB N0. XXXX-XXXX |
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Approval Expires 2/28/XX |
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9. Grant Award Number |
10. Final Report |
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Yes [ ] |
No [ ] |
| 11. Grant Period |
From: |
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12. Report Period |
From: |
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13. Employer Identification Number |
| To: |
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To: |
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| 14. Remarks: |
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| 15. Name of Approving Official |
16. Title of Approving Official |
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| 17. Certification: I certify that, to the best of my knowledge, all expenditures and |
18. Telephone Number |
| obligations are for the purpose set forth in the award documents. |
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19. Email Address |
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| Signature of Approving Official |
20. Date Report Submitted |
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