CSR Matters 3 A

“MATTERS” SERVICE REPORT
III -- Referred, not included in “case service” statistics A
YEAR:

Grantee Number

Grantee Name

Number of People Directly Receiving Service

Models Used (a) Measured (b) Estimated (c)
Total

1 Referred to other provider of civil
Legal services to low income people
2 Referred to private bar (LRS or individual
private lawyers not affiliated with program)
3 Referred to provider of human or social
Services (non-legal)
4 Referred to other source of assistance,
None of the above--
If more than 10 percent of total, please describe in Narrative and
more detailed breakdown.
Total number of people directly receiving service

Also provide a breakdown of this number, by type of matter, in “B” on next page.
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		Number of People Directly Receiving Service
Models Used		(a) Measured	(b) Estimated	(c) Total
1	Referred to other provider of civil Legal services to low income people
2	Referred to private bar (LRS or individual private lawyers not affiliated with program)
3	Referred to provider of human or social Services (non-legal)
4	Referred to other source of assistance, None of the above-- If more than 10 percent of total, please describe in Narrative and more detailed breakdown.
Total number of people directly receiving service


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