MQSA MEU Spending and Tracking Update Report Template_2023.xlsx

Standardized Reporting Forms for Federally Funded Public Health Projects and Agreements

MQSA MEU Spending and Tracking Update Report Template_2023.xlsx

OMB: 0910-0909

Document [xlsx]
Download: xlsx | pdf

Overview

Coversheet
MEU Report


Sheet 1: Coversheet









OMB Number: 0910-0909 Exp Date: XX/XX/XXXX See bottom of page for PRA statement






















Contract Number (auto-filled)
Select Agency






Agency Name (select from drop-down)
Select

State or US Territory (auto-filled)
Select Agency






Contract Type
MQSA






Date Report Completed (MM/DD/YYYY)




























Report Contact Name



Report Contact Email







































Sheet 2: MEU Report










Inspector First Name Inspector Last Name ID Conference/Course Title Start Date
(MM/DD/YYYY)
Accred. Org MEU's Earned Funds Spent
































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































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