Missouri Foundation for Health
INTERIM REPORT
Date:
Grant Number:
Grantee Name:
Project Title:
Grant Period:
Reporting Period:
Email:
Phone:
Interim Financial Report
1. Using the MFH electronic financial spreadsheet, report expenses since the project start date
in the column titled ‘YTD Actual Expenses’ for MFH funds only.
2. Provide a brief financial variance explanation if actual expenses vary from the approved
budget. This is not approval to make budget changes. Any changes to the approved
budget in Attachment B of the Grant Award Agreement require prior written approval from
your Grants Manager and Program Officer.
Before your grant ends . . .

If necessary, a no-cost grant extension can be requested 60 days prior to the project end
date («Request_Project_End_Date»).

If all grant funds are not expected to be spent by the project end date
(«Request_Project_End_Date»), contact your Grants Manager.
Project Status Report Questions
These questions are different for each MFH funding program.
Certification: I have reviewed the above financial and program requirements. I verify that
the enclosed report materials accurately reflect the status of the aforementioned grant.
Authorized Signature:
Date:
Print Name:
Title:
Missouri Foundation for Health
FINAL REPORT
Date:
Grant Number:
Grantee Name:
Project Title:
Grant Period:
Reporting Period:
Email:
Phone:
Final Financial Report
1. Using the MFH electronic financial spreadsheet, report expenses since the project start date
in the column titled ‘YTD Actual Expenses’ for MFH funds only.
2. Provide a brief financial variance explanation if actual expenses vary from the approved
budget. This is not approval to make budget changes.
3. Unless otherwise instructed, provide supporting documentation for the entire grant period
(«Request_Project_Start_Date» - «Request_Project_End_Date») for the following line
items:
Expense Category
Salary
Conferences
Major & Minor Equipment
Printing
Travel
Other Direct
Appropriate Documentation
Payroll Register
Paid Invoice
Paid Invoice
Paid Invoice
Paid Invoice (airfare & hotel only)
Paid Invoice
Note: Grant funds not spent by the project end date («Request_Project_End_Date») will be
reimbursed to MFH and/or the final disbursement will be reduced. Please contact your
Grants Manager.
Project Status Report Questions
These questions are different for each MFH funding program.
Certification: I have reviewed the above financial and program requirements. I verify that
the enclosed report materials accurately reflect the status of the aforementioned grant.
Authorized Signature:
Date:
Print Name:
Title: