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PROJECT
PW PW ELIGIBLE $ AMOUNT $ AMOUNT % COMPLETED TIME DATE
#
V
ERS CAT. $ AMOUNT SPENT RECEIVED TO DATE EXTENSION COMPLETED COMMENTS
NAME: SIGNATURE: DATE
:
QUARTERLY REPORT
APPLICANT NAME DATE REPORT DUE
DECLARATION: FEMA- ______ -DR-KY APPLICANT ID#
LARGE PROJECT THRESHOLD FOR FEMA-______-DR-KY: $64,200