Grantee Number
Grantee Name

		Number of People Directly Receiving Service
Models Used		(a) Measured	(b) Estimated	(c) Total
1	Mediation/alternative dispute resolution services not included in “case service” statistics
2	Direct Services not included in case service statistics
Total number of people directly receiving service

		Also provide a breakdown of this number, by type of matter, in “B” on next page.

Note	- if you have any other Matters that do not fit into any of the categories in Sections I-VI, please report on them in your Narrative under VI, Other, but do not attempt to report on them in these forms. If you have Matters that could be reported in more than one of these sections, please use whatever section best describes them, even if the fit is not perfect.

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