Connecticard Expenditure Report Form, To Fill Out in 2012

This is the Annual Connecticard Expenditure Report Form to be filled out before November 2012. Grant Expenditures may be used for general library purposes. No portion of the CCard payment shall revert to the general fund of the town.

Your library should have received a Connecticard payment in April of 2011 for participation in the Connecticard program from March 2010 to February 2011. Please indicate below how this money was expended.

1. Choose your library from this list (and note payment amount):

	Library
List of CT Public Libraries BY TOWN	Choose your library from this list (and note payment amount): List of CT Public Libraries BY TOWN Library

2. This form completed by:

This form completed by: Name
Title

3. Purpose (enter numbers only, no dollar signs, commas or spaces)

Purpose (enter numbers only, no dollar signs, commas or spaces) Purchase of library materials, including books, magazines, A/V, etc.
Library automation, including hardware, software, automation services lease/rental/purchase/memberships
Library furniture/equipment
Personnel/salaries
Library supplies
Building construction/remodeling
Educational and memberships
Library programs
Other (specify below)
Unexpended at time of report

PLEASE NOTE: the amounts listed above MUST total the amount of the grant award listed next to your library's name in question #1.

4. If you entered an amount in "Other" above, please specify here

If you entered an amount in "Other" above, please specify here

Please click on the "Submit figures" button below.