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Lincoln-Lancaster County Health Department
Environmental Public Health

Neighborhood Association Expense Report


This form is required for Neighborhood Association Grants only. Community Improvement Grant Recipients do not need to complete an expense report. Enter expenses below and submit receipts with this form. Keep copies for your records.

Association Name: Contact Person:
Phone Number:  Email Address:
Address: City/State/Zip:
Project Date:

Expenses
Item/Service: Company Paid: Expense Amount:
Item/Service: Company Paid: Expense Amount:
Item/Service: Company Paid: Expense Amount:
Item/Service: Company Paid: Expense Amount:
Item/Service: Company Paid: Expense Amount:
Item/Service: Company Paid: Expense Amount:
Total Expenses: $

By checking this box you confirm that the expenses listed above were used exclusively for the cleanup project.

Return expense report with receipts, final report, photos and volunteer waivers.

Thank you for keeping our community clean, healthy and safe!
Funding for this program is provided by the City of Lincoln


InterLinc City of Lincoln Departments Category Location

Health Environmental Public Health Environmental Quality KLLCB